Investigating the Feasibility of Locomotor Training for Children Under 5 Years With Complex Neurodisabilties.

Abstract

Purpose Children with neurodisabilities, including cerebral palsy and rare diseases, often experience significant mobility limitations. Locomotor training, including a combination of partial body weight-supported treadmill training and overground walking in a supported stepping device, may support functional development. This study evaluated the feasibility of a 6-week locomotor training program for young children with neurodisabilities and significant motor impairments. Methods A single-group pre-post study included 71 children (mean age = 2.8 years). Feasibility was assessed using Bowen's framework across 4 domains: limited efficacy testing, practicality, acceptability, and adaptability. Outcome measures included Goal Attainment Scaling, Canadian Occupational Performance Measure, 10-m walk test, and 6-minute walk test. Results All outcome measures improved. Goal Attainment Scaling scores increased from 12.8 to 56.2, with 85% achieving goals. Canadian Occupational Performance Measure and mobility outcome measures exceeded clinically meaningful thresholds. The program was well-tolerated (mean therapy hours = 14.1), was adaptable across a heterogeneous cohort, and there were no major adverse events. Conclusions Locomotor training involving partial body weight-supported treadmill training and overground walking in supported stepping devices is feasible and beneficial for young children with neurodisabilities and significant motor impairments. Further studies are warranted to explore long-term efficacy and generalizability.