The impact of AlterG training on balance and structure of vestibulospinal tract in cerebral palsy children

We aimed to investigate the effects of an antigravity treadmill (AlterG) on the balance and structure of the vestibulospinal tract. The AlterG can reduce the weightbearing of patients and hence can facilitate their locomotion. Three children with cerebral palsy (CP) received AlterG training three days per week for eight weeks with each session lasting 45 minutes. The balance of children was evaluated using the Berg balance test and the Timed Up and Go (TUG) test. The diffusion tensor imaging (DTI) method was employed to quantify changes of the structure of the vestibulospinal tract. Evaluations were performed before and after the 8-week training. DTI metrics including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD) were measured to evaluate the vestibulospinal tract structure. The results showed that the mean FA of the vestibulospinal tract increased and other metrics decreased for all subjects. Our findings indicated that the balance and structure of the vestibulospinal tract were improved up to 30% for all children following the 8-week AlterG training. This indicates that the balance improvement of the CP children following the AlterG training was accompanied with persistent neuroplasticity in their brain. The clinical implication is that the AlterG training has a potential to be used as an effective therapeutic tool for the treatment of balance impairment in CP children.