Type of Article:  Original Research

Volume 5; Issue 6 (December 2017)

Page No.: 2560-2565

DOI: https://dx.doi.org/10.16965/ijpr.2017.249


Nahla M. Ibrahim, Mai E. Abbass *.

Faculty of physical therapy, Cairo University, Giza, Egypt.

Address for Correspondence: Dr. Mai Elsayed Abbass, Faculty of physical therapy, Cairo University, Giza, Egypt. E-Mail: mai.tamer.elmasry@gmail.com


Background: Cerebral palsy is associated with impairment in functional performance, balance and gait

Objective: Slow walking speed represents the major functional problems in children with cerebral palsy; our aim was to improve the average speed of gait by increasing the number of repetitive cycles by pedaling.

Design: Biodex gait trainer was used to assess average walking speed and step length in twenty hemiparetic cerebral palsy children, who were divided into study and control groups. Both groups had received the prescribed rehabilitation program. Study group had received 20-min pedal exercise in addition to the exercise program.

Results: In post treatment results, there was significant improvement in speed for both groups in favor to study group and a significant improvement in step length in the study group, with non-significant improvement in step length in the control group.

Conclusion: Adding pedal exercise to the rehabilitation program for children with hemiparetic cerebral palsy causes improvement in walking average speed.

Key words: Pedaling, Gait, Speed, Hemiparesis, Cerebral palsy.


  1. Mancini MC, Fiúza PM, Rebelo JM, Magalhães LC, Coelho ZAC, Paixão ML, et al. Comparison of functional activity performance in normally developing children and children with cerebral palsy. Arq Neuropsiquiatr. 2002;60(2):446–52.
  2. Gage JR. Gait analysis in cerebral palsy. In: Clinics in developmental medicine. Mac Keith Press; 1991.
  3. Seifart A, Unger M, Burger M. The effect of lower limb functional electrical stimulation on gait of children with cerebral palsy. Pediatr Phys Ther [Internet]. 2009;21(1):23–30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19214073
  4. Brown DA, Kautz SA. Pedaling Exercise in Persons With Poststroke Hemiplegia. Stroke. 1998;29(153):598–607.
  5. Hutton JL. Effect of severity of disability on survival in north east England cerebral palsy cohort. Arch Dis Child [Internet]. 2000;83(6):468–74. Available from: http://adc.bmj.com/content/83/6/468.abstract
  6. Rowe PJ, Durward B, Baer G. Functional human movement: measurement and analysis. Butterworth-Heinemann; 1999.
  7. BenAbdelkader C, Cutler R, Davis L. Stride and cadence as a biometric in automatic person identification and verification. Proc – 5th IEEE Int Conf Autom Face Gesture Recognition, FGR 2002. 2002;372–7.
  8. Gage JR, Deluca PA, Renshaw TS. Gait Analysis: Principles and Applications. Am Acad Orthop Surg. 1995;77(10):1607–23.
  9. Gharib NM, El-Maksoud GM a., Rezk-Allah SS. Efficacy of gait trainer as an adjunct to traditional physical therapy on walking performance in hemiparetic cerebral palsied children: a randomized controlled trial. Clin Rehabil. 2011;25(10):924–34.
  10. Burnfield JM, Shu Y, Buster T, Taylor A. Perry Issue : Training and Walking : Implications for Practice. 2010;90(2):289–305.
  11. Rimmer JH. Physical fitness levels of persons with cerebral palsy. Dev Med Child Neurol. 2001;43(3):208–12.
  12. Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol. 1997;39(2):214–23.
  13. Pirpiris M, Wilkinson A, Rodda J, Nguyen T, Baker R, Nattrass G, et al. Walking speed in children and young adults with neuromuscular disease: comparison between two assessment methods. J Pediatr Orthop [Internet]. 2003;23(3):302–7. Available from: http://journals.lww.com/pedorthopaedics/Abstract/2003/05000/Walking_Speed_in_Children_and_Young_Adults_With.6.aspx
  14. Blundell SW, Shepherd RB, Dean CM, Adams RD, Cahill BM. Functional strength training in cerebral palsy: a pilot study of a group circuit training class for children aged 4-8 years. Clin Rehabil. 2003;17(1):48–57.
  15. Shinohara T, Suzuki N, Oba M, Kawasumi M, Kimizuka M, Mita K. Effect of exercise at the AT point for children with cerebral palsy. Bull Hosp Jt Dis [Internet]. 2003;61(1–2):63–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12828382
  16. Bryanton C, Bossé J, Brien M, McLean J, McCormick a, Sveistrup H. Feasibility, motivation, and selective motor control: virtual reality compared to conventional home exercise in children with cerebral palsy. Cyberpsychol Behav. 2006;9(2):123–8.
  17. Fowler EG, Knutson LM, Demuth SK, Siebert KL, Simms VD, Sugi MH, et al. Strengthening ( PEDALS ) for Children Stationary Cycling : A Randomized. Phys Ther. 2010;90(3).
  18. Sharma S. Methodology for Study of the Effect of Cyclic Ergo Meter Exercise on Improving Gait Parameters in Ambulatory Spina Bifida Children. Int J Educ Plan Adm. 2011;1(2):109–17.
  19. Williams H, Pountney T. Effects of a static bicycling programme on the functional ability of young people with cerebral palsy who are non-ambulant. Dev Med Child Neurol. 2007;49(7):522–7.
  20. Kaplan SL. Cycling patterns in children with and without cerebral palsy. Dev Med Child Neurol. 1995;37(7):620–30.
  21. Lin SI, Lo CC, Lin PY, Chen JJJ. Biomechanical assessments of the effect of visual feedback on cycling for patients with stroke. J Electromyogr Kinesiol [Internet]. 2012;22(4):582–8. Available from: http://dx.doi.org/10.1016/j.jelekin.2012.03.009

Cite this article: Nahla M. Ibrahim, Mai E. Abbass. EFFECT OF PEDAL TRAINING ON GAIT SPEED IN CHILDREN WITH HEMIPARETIC CEREBRAL PALSY. Int J Physiother Res 2017;5(6):2560-2565. DOI: 10.16965/ijpr.2017.249
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