Abstract / Summary
Introduction: Children with spastic diplegia commonly present with reduced muscle strength and limited joint mobility, particularly in the hip and ankle, which adversely impacts gait efficiency and functional mobility. Although treadmill training is widely utilised in paediatric neurorehabilitation, incorporating additional resistance through Lower Limb (LL) weights may enhance the muscular engagement. However, evidence supporting its effectiveness in improving strength and Range Of Motion (ROM) remains limited. Aim: To determine the effectiveness of LL weighted treadmill training on hip flexor and ankle dorsiflexor muscle strength and joint ROM in children with spastic diplegia. Materials and Methods: This randomised controlled trial was conducted at the outpatient Department of Paediatric Physiotherapy Unit, Justice KS Hegde Charitable Hospital and Kapikad Community Rehabilitation Centre, Mangaluru, Karnataka, India from March 2025 to March 2026. A total of 26 children with spastic diplegia were randomly allocated to an intervention group and a control group. The intervention group received treadmill training with added LL weights in addition to conventional physiotherapy, whereas the control group underwent conventional physiotherapy alongside treadmill training without additional weights. The intervention was carried out over six weeks. Outcome measures included assessment of hip flexor and ankle dorsiflexor muscle strength and joint ROM using dynamometer and goniometer respectively. A paired t-test was utilised to evaluate significant changes between pre- and post-test measurements within each group, while an unpaired t-test was used to determine significant differences between the two groups. The level of significance was set at p-value <0.05. Results: Both groups showed improvements following the intervention. However, the intervention group demonstrated greater improvement in muscle strength (p-value <0.05) and active ROM (p-value <0.05) compared to the control group. No statistically significant changes were observed in passive ROM in either group. Conclusion: The LL weighted treadmill training combined with conventional physiotherapy significantly improved muscle strength and active ROM in children with spastic diplegia. This combined approach may serve as an effective adjunct to rehabilitation strategies aimed at optimising functional abilities.