CSUS therapist aim for special needs children: Have treadmill, will walk

12/18/2013 12:00 AM

12/18/2013 11:55 AM

Michael Cimino, just 2 1/2 years old, put one step forward on a tot-sized treadmill and squealed with joy.

Cimino, who has cerebral palsy, normally finds walking a challenge. But on the treadmill, he repeatedly aimed his foot at the hand puppet his mother slid in front of him. The monkey-faced puppet darted away before his foot landed, bringing another pair of steps, another shriek of excitement, another measure of progress.

The treadmill game was part of the STEPS program launched this semester at California State University, Sacramento, where eight students working toward a doctorate in physical therapy help young children with neuro-motor impairment accelerate their mobility, balance and confidence.

The program is an outgrowth of research by Katrin Mattern-Baxter, an assistant professor at CSUS. She and two others – the vice president of pediatric services at Easter Seals and a University of the Pacific professor – examined the effects of treadmill training on motor function in young children with cerebral palsy.

Their work, published this year in the Archives of Physical Medicine and Rehabilitation, showed that children who used treadmills six days a week for up to 30 minutes developed walking skills sooner and required less support than did those in a control group after six weeks of training. A month after training ended, the disparity between the groups remained significant, Mattern-Baxter said in an interview.

The children walk at a speed of less than 1 mile an hour, which is typical for very young children in general.

“It’s the principle of neuroplasticity,” Mattern-Baxter said. “If you practice intensively and specific to the task, you will make neuroplastic changes to your brain. The analogy – if you want to get better at playing tennis, it’s a good idea to play tennis.”

That means creating new synaptic connections in the brain. A close description is brain rewiring, she said.

Mattern-Baxter and therapists from Easter Seals conceived the program, which started last spring at Easter Seals and moved this fall to the college’s Folsom Hall. The new STEPS, or Supported Treadmill Exercise Program at Sacramento State-Easter Seals, expanded beyond children that Easter Seals helps, she said.

So far, eight families with children who have neuro-motor impairments have signed up for the twice-weekly program, where the students and Mattern-Baxter donate their time.

On Monday, Pajo and Angie Bruich watched intently as their 2 1/2-year-old daughter, Portia, used a miniature treadmill. Ordinarily, children begin walking around 11 or 12 months of age.

Before starting the regimen, Portia “was very good at crawling but would not stand on her own or take steps” unassisted, said Angie Bruich.

Pajo Bruich, executive chef at Enotria, said his daughter was diagnosed with epilepsy, a condition linked to a small area of her temporal lobe that did not develop fully at birth. That affected both her motor control and speech.

“The great thing about the brain is that at her age it has a remarkable ability to rewire itself,” he said. “That’s exactly what we’re seeing happen.”

Portia, the couple’s second daughter, is starting to walk unassisted, Pajo Bruich said. And in the last six weeks, her ability to speak has improved dramatically.

“The actual progress we’ve witnessed through the program has been remarkable,” he said.

Brenda Chacon’s 4-year-old son, Cruz, was in a harness for his treadmill walk, with Mattern-Baxter serving as his safety net.

Cruz has a rare chromosomal disorder called Cri-du-chat syndrome. The diagnosis was devastating. Chacon said she was told her son, the third of three children, would never be able to go to school, walk or talk.

“Once we got over that (news) and he started having in-home therapy, he seemed to become more aware and more social. Things opened up for him,” Chacon said. He progressed enough to get into the CSUS program.

Participants can be referred by physical therapists if they are 4 years or younger, weigh less than 60 pounds, are able to sit for 30 seconds without support and can take five or more steps with limited support.

At the miniature treadmill, Cruz’s mom enticed him with an iPad.

“When he first got on the treadmill, his toes turned totally inward and he would trip over his feet,” Chacon said. With the harness, he’s walking straight.

When he pauses on the treadmill, there’s no iPad. When he wants to see the animated “Thomas & Friends,” she said, he resumes walking. And Chacon again holds up the iPad.

Michael Cimino, the child tantalized by the hand puppet, copes with spastic cerebral palsy, a form of the condition that causes his leg muscles to contract and remain tense.

Michael was born two months premature and diagnosed at 18 months, said his mother, Marleny Cimino.

“Before the treadmill therapy, I would take him for walks,” she said. “But in the walker, he tended to run and drag his feet.

“With the treadmill, you can adjust the speed, and he has learned to go slow. With all the great help he has been getting, Michael is going to be walking (independently) in no time.”

Mattern-Baxter said she’s hopeful that the CSUS program eventually can expand.

“At this point, it’s a labor of love,” she said. “But if this program grows, we will have to rely on outside funding sources and donations.”

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