Rehabilitation and Therapy Commons^™

Spatial Characteristics Of Reactive Stepping Among People Living With Chronic Incomplete Spinal Cord Injury, Matthew G Heffernan, Jae Woung Lee, Katherine Chan, Janelle Unger, Susan Marzolini, Timothy N Welsh, Kei Masani, Kristin E Musselman

Physical Therapy Publications

Objective: Compare the spatial characteristics of reactive stepping between individuals with chronic motor incomplete spinal cord injuries (iSCI) and able-bodied (AB) individuals.

Design: Cross sectional.

Setting: Lyndhurst Centre.

Participants: Twelve individuals with iSCI (3 males, 53.6 ± 15.2 years old) and 11 age- and sex-matched AB individuals (3 males, 54.8 ± 14.0 years old).

Interventions: The Lean-and-Release test was used to elicit reactive stepping. A horizontal cable, attached at waist height, was released when 8-12% body weight was supported in a forward lean position. Participants underwent up to 10 Lean-and-Release trials in a session. Kinematic and …

Association Between Measures Of Cognitive Function On Physical Function In Novice Users Of A Lower Limb Prosthesis, Humberto Omana, Courtney Frengopoulos, Manuel Montero-Odasso, Michael W. Payne, Ricardo Viana, Susan W. Hunter

Physical Therapy Publications

BACKGROUND: Cognitive impairment is prevalent in people with lower limb amputations (PLLA) and is associated with adverse outcomes, such as falls and worse rehabilitation outcomes. Physical function tests are essential to examine abilities; however, no research in PLLA has clarified the magnitude of cognitive demands amongst available tests in users novice at walking with a prosthesis.

METHODS: People from inpatient prosthetic rehabilitation were recruited. Inclusion criteria were: age ≥ 50 years, unilateral transtibial amputation and able to walk independently. Gait velocity and the L Test under single-task (usual) and dual-task (walking while counting backwards) conditions assessed functional mobility. The Four …

Association Between Balance Confidence And Basic Walking Abilities In People With Unilateral Transtibial Lower-Limb Amputations: A Cross-Sectional Study, Humberto Omaña, Courtney Frengopoulos, Manuel Montero-Odasso, Michael W. Payne, Ricardo Viana, Susan W. Hunter

Physical Therapy Publications

INTRODUCTION: Falls are common for people with lower-limb amputations (PLLA). Low balance confidence is also prevalent, is worse in PLLA not reporting walking automaticity, and is known to negatively affect prosthesis use, social engagement, and quality of life. Moreover, walking with a prosthesis requires continuous attention. Low balance confidence may act as a distractor imposing an additional cognitive load on the already cognitively demanding task of walking with a prosthesis.

METHODS: Adults with unilateral, transtibial amputations were recruited. The Activities-specific Balance Confidence (ABC) scale quantified balance confidence. The L Test assessed basic walking abilities under single-task (ST) (usual) and dual-task …

Premotor And Posterior Parietal Cortex Activity Is Increased For Slow, As Well As Fast Walking Poststroke: An Fnirs Study, Shannon B Lim, Sue Peters, Chieh-Ling Yang, Lara A Boyd, Teresa Liu-Ambrose, Janice J Eng

Physical Therapy Publications

Background and Purpose. The ability to change gait speeds is important for interacting with the surrounding environment. Gait speed modulation poststroke is often impaired and is related to decreased walking independence after stroke. Assessment of brain activation during walking at different speeds can provide insight into important regions for facilitating gait recovery. The purpose is to determine: (1) the symmetry of brain activation as individuals increase or decrease their gait speed, (2) the activation levels in frontal to parietal brain regions during walking at different speeds, and (3) the relationship between an individual’s stroke impairment or their ability to modulate …

Implementation Of Increased Physical Therapy Intensity For Improving Walking After Stroke: Walk 'N Watch Protocol For A Multisite Stepped-Wedge Cluster-Randomized Controlled Trial, Sue Peters, Shannon B Lim, Mark T Bayley, Krista Best, Louise A Connell, Hélène Corriveau, Sarah J Donkers, Sean P Dukelow, Tara D Klassen, Marie-Hélène Milot, Brodie M Sakakibara, Lisa Sheehy, Hubert Wong, Jennifer Yao, Janice J Eng

Physical Therapy Publications

RATIONALE: Clinical practice guidelines support structured, progressive protocols for improving walking after stroke. Yet, practice is slow to change, evidenced by the little amount of walking activity in stroke rehabilitation units. Our recent study (n = 75) found that a structured, progressive protocol integrated with typical daily physical therapy improved walking and quality-of-life measures over usual care. Research therapists progressed the intensity of exercise by using heart rate and step counters worn by the participants with stroke during therapy. To have the greatest impact, our next step is to undertake an implementation trial to change practice across stroke units where …

Effects Of Treadmill Interventions On Infants With Developmental Delays Presenting With Mild And Severe Impairments: A Case Series, Eric Nguyen Spt, Nicolle Gerchak Spt

Physical Therapy Research Symposium

Background: Physical development delays can severely limit a child’s ability to explore and learn about their environment. Evidence supports that this exploration promotes a child’s development in cognition, language acquisition, social skills, and further physical skills. Thus, interventions that target and improve early mobility can be highly valuable to a child’s life. Treadmill training in infants with developmental delays has shown to be an effective intervention in moving infants toward earlier independent walking and improved gross motor function.

Purpose: This study aims to explore the potential benefits of an established treadmill training program in infants with varying degrees of motor …

Implementing A Structured Walking Program For Prek Through 8th Grade Teachers, Caitlin M. Kile, Robin Harris, Robin Bowden

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Physical inactivity has become a significant health concern not only in the United States but worldwide. Adults are becoming sedentary due to sitting at work and school, computer use, and motorized transportation. During the COVID-19 pandemic, teachers experienced increased workloads, increased sedentary work time for virtual classes, and longer work hours. A PreK-8^th grade school system in the southeastern United States had health promotion and prevention programs for students but no health and wellness programs for teachers. Wellness programs can promote physical health and less worker absenteeism. At the completion of a 12-week walking program, the teacher's weekly time …

Quantifying Physical Resilience In Ageing Using Measurement Instruments: A Scoping Review, Sue Peters, Theodore D Cosco, Dawn C Mackey, Gurkaran S Sarohia, Jeffrey Leong, Andrew Wister

Physical Therapy Publications

Purpose: The capacity to recover motor function with pathology or age-related decline is termed physical resilience. It is unknown what outcome domains are captured with existing measurement instruments. Thus, this scoping review aimed to identify measurement instruments for physical resilience, identify research gaps, and make recommendations for future research. Methods: Articles were included from the search when their subject matter included the term resilience in relation to the physical health of older adults. Data on physical resilience measurement instruments were extracted using the outcome domains: body function or structure, activity and participation, and societal impact. Results: The majority of the …

The Effects On Gait Of 4-Wheeled Walker Use In People With Alzheimer's Disease Dementia And Gait Impairment: A Pilot Study, Humberto Omaña, Edward Madou, Susan W. Hunter

Physical Therapy Publications

In people with dementia, provision of mobility aids is standard treatment for those with impaired gait. However, mobility aid use is independently associated with increased falls risk. In this short communication, gait velocity and stride time variability were recorded in eleven adults with Alzheimer's disease dementia. Three conditions were tested: single-task (no aid), walking with a walker, and dual-task (walker use and counting backwards) under both a straight path and Figure-of-8 walking configuration. Gait velocity increased when using a walker compared to no aid in the Figure-of-8 walking configuration. Walker use improved gait in simple walking, but benefits diminished upon …

Association Of Disease Outcomes With Physical Activity In Multiple Sclerosis: A Cross-Sectional Study, Trinh L T Huynh, Stephanie L Silveira, Brenda Jeng, Robert W Motl

Journal Articles

UNLABELLED: Purpose/Objective Research: This study examined combinations of disease outcomes (i.e., walking, cognition, and symptoms) as correlates of physical activity subgroups (insufficiently active vs. sufficiently active) in persons with multiple sclerosis (MS).

RESEARCH METHOD/DESIGN: This study included 213 participants who completed walking and cognitive function tests and self-report measures of symptoms and physical activity. Multivariate analysis of variance and discriminant function analysis identified combinations of MS outcomes associated with physical activity.

RESULTS: The sample had a mean age of 49.6 years (

CONCLUSION/IMPLICATIONS: The findings identified walking endurance and limitations, processing speed, depression, and fatigue as primary correlates of physical …

Walking With Poles Improves Step Length Of Simulated Prosthetic Gait, Marissa Elquist, Daniel Perez, Jonathan Garcia, Brady Owens

UNLV Theses, Dissertations, Professional Papers, and Capstones

Individuals with lower limb loss often demonstrate gait deviations which cause instability and asymmetry. Walking with poles has been shown to improve stride length and stability in older adult and other patient populations. The enhanced arm involvement in bipedal walking with poles has the potential to facilitate interlimb coordination among arms and legs, and therefore is likely to improve prosthetic gait. The purpose of this study was to examine the effect of walking poles on temporal gait parameters and the center of mass (COM) displacement during prosthetic and simulated prosthetic gait. It was hypothesized that walking with poles would improve …

Do People With Low Back Pain Walk Differently? A Systematic Review And Meta-Analysis, Jo Armour Smith, Heidi Stabbert, Jennifer J. Bagwell, Hsiang-Ling Teng, Vernie Wade, Szu-Ping Lee

Physical Therapy Faculty Articles and Research

Background

The biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial research, it is still unclear whether consistent and generalizable changes in walking or running gait occur in association with LBP. The purpose of this systematic review was to identify whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls.

Methods

A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Studies were included …

Use Of Real-Time Cadence To Prescribe Aerobic Physical Activity Intensity And Its Comparison With Existing Methods, Heontae Kim, Wei Sun, Mary Malaska, Bridget Miller, Ho Han

Faculty and Student Publications

The purpose of this study was to determine the effectiveness of physical activity intensity prescription using real-time cadence on achieving the required intensities for health benefits. Forty adults (18–65 years) participated in the study. The intensity prescriptions included Rating of Perceived Exertion, Talk Test, Heart Rate, and Real-Time Cadence. The participants performed a2-min trial for both moderate- and vigorous-intensity according to each prescription. Atri-axial accelerometer was used as acriterion measure. After completion of the trials, participant’s preference for the prescriptions was assessed by three domains (e.g., understanding, performing, maintaining). The compliance and achievement rates of RC were calculated and compared …

The Effect Of First-Time 4-Wheeled Walker Use On The Gait Of Younger And Older Adults, Humberto A. Omana, Edward Madou, Alison Divine, Walter Wittich, Keith D. Hill, Andrew M. Johnson, Jeffrey D. Holmes, Susan W. Hunter

Physical Therapy Publications

INTRODUCTION: The 4-wheeled walker is intended to enhance balance and gait for older adults. Yet, some research suggests that walking aids increase falls risk. An understanding of the influence of age with walker use on gait performance is required.

OBJECTIVE: To examine the effect of initial 4-wheeled walker use on spatiotemporal gait parameters between younger and older adults.

DESIGN: Cross-sectional, repeated-measures.

SETTING: Community-dwelling.

PARTICIPANTS: Twenty-five younger (age: 26.5 ± 4.1 years) and 24 older (age: 68.5 ± 10.5 years) adults participated. Younger adults were aged 18 to 35 years, whereas older adults were 50 years or older. Included were people …

Effects Of Bimodal Transcranial Direct Current Stimulation On Modulation Of Spinal Circuitry In People With Chronic Post-Stroke Hemiparesis, John Patrick Gan, Rafael Cabrera, Lana Laudermilch, Benjamin Wolkenhauer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Stroke can lead to gait abnormalities such as foot drop. Foot drop can result from decreased corticospinal tract input to the ankle dorsiflexors and/or from exaggerated stretch reflexes on the soleus due to reduced reciprocal inhibition from spinal reflex pathways. Transcranial direct current stimulation (tDCS) attempts to modulate corticospinal tract input and spinal reflex pathways by delivering electrical signals to parts of the brain. The degree of neuromodulation from tDCS can be measured through the Hoffman Reflex (H-reflex)—a tool used to estimate alpha motor neuron excitability which is increased in individuals post-stroke. Purpose: The primary purpose of this study …

Effects Of Altered Somatosensory Input On Lower Limb Mechanics Via Different Shoes And Barefoot Walking In Individuals With Chronic Post-Stroke Hemiparesis, Aaron Abraham Simon, Jynelle Marie Guerrero Arches, Megan Leigh Keohane, Wee Jin Jed Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

[Purpose/Hypothesis] Stroke is a leading cause of disability that results in various neurological deficits. Stroke can cause impaired somatosensory input, which results in decreased balance and gait speed, ultimately increasing fall risks. Therapies to increase somatosensory input have shown promise for people with stroke as well as other neurological populations. However, few studies have systematically investigated varying somatosensory input via different footwear to improve walking in people post-stroke. The purpose of this study was to investigate the effects of altering somatosensory input via different types of footwear (i.e., barefoot, self-selected shoes, and memory foam shoes) on gait kinetics and ankle …

Neurophysiological Assessments Of Brain And Spinal Cord Associated With Lower Limb Functions In Children With Cerebral Palsy: A Protocol For Systematic Review And Meta-Analysis, Leonard Ubalde, Jing Nong Liang

Physical Therapy Faculty Publications

Background: Task-dependent neurophysiological adaptations in people with cerebral palsy have been examined using various techniques such as functional magnetic resonance imaging, peripheral nerve stimulation in order to assess H-reflexes, and transcranial magnetic stimulation. This activity-dependent plasticity is hypothesized to improve specific gross motor function in individuals with cerebral palsy. Although these adaptations have been examined extensively, most studies examined tasks utilizing the upper limbs. The aim of this review is to assess the neurophysiological adaptations of the central nervous system in individuals with cerebral palsy during lower limb functional tasks. Methods: A systematic review and meta-analysis will be conducted to …

Perspectives Of Individuals With Chronic Spinal Cord Injury Following Novel Balance Training Involving Functional Electrical Stimulation With Visual Feedback: A Qualitative Exploratory Study, David J Houston, Janelle Unger, Jae W Lee, Kei Masani, Kristin E Musselman

Physical Therapy Publications

BACKGROUND: Individuals with an incomplete spinal cord injury (iSCI) are highly susceptible to falls during periods of walking or standing. We recently reported the findings of a novel intervention combining functional electrical stimulation with visual feedback balance training (FES + VFBT) on standing balance abilities among five individuals with motor iSCI. However, the previous publication did not report the perceived impact of the intervention on the participants' lives. In this report, the experiences of these five individuals with incomplete spinal cord injury (iSCI) who had recently completed the four-week balance training program are described.

METHODS: Five individuals with a motor …

Evaluating Intrinsic Fall Risk Factors After Incomplete Spinal Cord Injury: Distinguishing Fallers From Nonfallers., Kristin E Musselman, Tarun Arora, Katherine Chan, Mohammad Alavinia, Mackenzie Bone, Janelle Unger, Joel Lanovaz, Alison Oates

Physical Therapy Publications

OBJECTIVE: To determine whether performance on measures of lower extremity muscle strength, sensory function, postural control, gait speed, and balance self-efficacy could distinguish fallers from nonfallers among ambulatory individuals with spinal cord injury or disease (SCI/D).

DESIGN: Prospective cohort study.

SETTING: Community.

PARTICIPANTS: Individuals (N=26; 6 female, aged 58.9±18.2y) with motor incomplete SCI/D (American Spinal Injury Association Impairment Scale rating C [n=5] or D [n=21]) participated. Participants were 7.5±9.1 years post injury. Seventeen participants experienced traumatic causes of spinal cord injury.

MAIN OUTCOME MEASURES: Participants completed laboratory-based and clinical measures of postural control, gait speed, balance self-efficacy, and lower extremity …

Effects Of Goal Type And Reinforcement Type On Self-Reported Domain-Specific Walking Among Inactive Adults: 2×2 Factorial Randomized Controlled Trial, Mindy L. Mcentee, Alison Cantley, Emily Foreman, Vincent Berardi, Christine B. Phillips, Jane C. Hurley, Melbourne F. Hovell, Steven Hooker, Marc A. Adams

Psychology Faculty Articles and Research

Background: WalkIT Arizona was a 2×2 factorial trial examining the effects of goal type (adaptive versus static) and reinforcement type (immediate versus delayed) to increase moderate to vigorous physical activity (MVPA) among insufficiently active adults. The 12-month intervention combined mobile health (mHealth) technology with behavioral strategies to test scalable population-health approaches to increasing MVPA. Self-reported physical activity provided domain-specific information to help contextualize the intervention effects.

Objective: The aim of this study was to report on the secondary outcomes of self-reported walking for transportation and leisure over the course of the 12-month WalkIT intervention.

Methods: A total of …

Feasibility Of Twice A Week In-Clinic Treadmill Intervention In Infants With Down Syndrome, Taylor Clark Spt, Nicole Craig Spt, Katie Westin Spt, Laura Zuniga-Morales Spt, Julia Looper Pt, Phd

Physical Therapy Research Symposium

Background: Children with Down syndrome (DS) on average take independent steps at 24-26 months compared to 12 months for typically developing children. In-home treadmill training has been shown to be an effective intervention to reduce delayed walking onset for infants with DS.

Purpose: To see if 20 minutes of in clinic treadmill training twice a week for infants with DS is a feasible intervention.

Methods: Participants must pull to stand independently but not yet walk. Pre-intervention testing included 5 minutes of treadmill walking and scores for sections D and E of Gross Motor Function Measure (GMFM). 20 minute treadmill sessions …

Supplementary Material To The Manuscript Titled: Mobile Phone Sensors Can Discern Medication-Related Gait Quality Changes In Parkinson's Patients In A Real-World Setting, Niklas König Ignasiak, Albert Pierce, Vincent Berardi, Wilford K. Eiteman-Pang, Cyril Rakovski

Physical Therapy Faculty Data Sets

This file contains the data that was used to classify high and low quality gait patterns in patients with Parkinson's disease. Acceleration and gyroscope data was recorded with a conventional smartphone in a real-world environment. High (i.e. ON medication) and low (i.e. OFF medication) quality labels were given by a human observer according to medication intake times.

The Effects Of Somatosensory Input On Gait In Individuals Post-Stroke, Victor Hung, Amanda Reilly, Rachel Wood, Nikita Yuskov

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background and Purpose: Stroke is a leading cause of disability that results in various neurological deficits, one of which is hemiplegia. This deficit alters the gait cycle, resulting in decreased propulsion force by plantar flexor muscles, decreased activation of dorsiflexor (DF) muscles, and increased coactivation of antagonistic ankle muscles. Stroke also leads to altered somatosensory input which results in decreased balance and gait speed, ultimately increasing fall risk. Therapies targeting increased somatosensory input have been shown to be beneficial in stroke as well as other neurological populations. However, no known studies have investigated the acute effects of local vibration to …

Walking Kinematics In Young Children With Limb Loss Using Early Versus Traditional Prosthetic Knee Prescription Protocols, Mark Daniel Geil, Zahra Safaeepour, Brian Giavedoni, Colleen Coulter

Faculty and Research Publications

The traditional treatment protocol for young children with congenital or acquired amputations at or proximal to the knee prescribes a prosthesis without a working knee joint, based in part on the assumption that a child learning to walk cannot properly utilize a passively flexing prosthetic knee component. An alternative to this Traditional Knee (TK) protocol is an “Early Knee” (EK) protocol, which prescribes an articulating prosthetic knee in the child’s first prosthesis, during development of crawling and transitioning into and out of upright positions. To date, no study has compared samples of children with limb loss at or proximal to …

Effect Of Dual-Tasking On Walking And Cognitive Demands In Adults With Alzheimer's Dementia Experienced In Using A 4-Wheeled Walker, Susan W. Hunter, Humberto Omana, Edward Madou, Walter Wittich, Keith D Hill, Andrew M Johnson, Alison Divine, Jeffrey D Holmes

Physical Therapy Publications

BACKGROUND: Learning to walk with a 4-wheeled walker increases cognitive demands in people with Alzheimer's dementia (AD). However, it is expected that experience will offset the increased cognitive demand. Current research has not yet evaluated gait in people with AD experienced in using a 4-wheeled walker under complex gait situations.

RESEARCH QUESTION: What is the effect of dual-task testing on the spatial-temporal gait parameters and cognitive performance of people with AD experienced with a 4-wheeled walker?

METHODS: Twenty-three adults with mild to moderate AD (87.4 ± 6.2 years, 48 % female) and at least 6 months of walker use experience …

Can A Prescribed Walking Program With Or Without Monitoring Impact Dizziness In The Older Adults? A Pilot Study, Amie Marie Jasper

Department of Physical Therapy Student Theses, Dissertations and Capstones

Background. Dizziness, a common complaint among older adults, is associated with multiple falls, loss of function and independence, and reduced balance confidence. The Clinical Practice Guideline for Peripheral Vestibular Hypofunction recommends walking for endurance as a component of vestibular rehabilitation (VR). However, studies on VR in the olderadults do not include walking in the intervention.

Research Design: 1) A pragmatic, randomized, experimental design to evaluate the impact of walking on vestibular outcomes, length of stay, and number of visits, and to examine whether pedometers increase the adherence of older adults with vestibular issues to a walking program; 2) a descriptive …

Case Study: Efficacy Of Physical Therapy On A Patient With Cva In Normalizing Gait And Shoulder Mechanics, Jane Mongkolvipakul, Amanda Orr, Queenie Lim, Rajbir Basati, Faris Alshammari

San Marcos, Fall 2019

Background & Purpose: Cerebrovascular Accident (CVA) is known as Stroke. It is a damage to the brain due to an interruption of blood supply. Two main types of stroke are ischemic stroke and hemorrhagic stroke. Ischemic stroke, the most common type of stroke, is due to a blocked artery and a hemorrhagic stroke is due to a leak or burst of a blood vessel. Signs and symptoms of stroke are presented contralaterally. The purpose of this case report is to demonstrate the use of PT interventions to improve shoulder function and gait mechanics in a post CVA patient.

Case …

Brain Activity Associated With Dual-Task Performance Of Ankle Motor Control During Cognitive Challenge., Sue Peters, Janice J Eng, Teresa Liu-Ambrose, Michael R Borich, Elizabeth Dao, Ameen Amanian, Lara A Boyd

Physical Therapy Publications

INTRODUCTION: Skilled Ankle motor control is frequently required while performing secondary cognitively demanding tasks such as socializing and avoiding obstacles while walking, termed "Dual tasking." It is likely that Dual-task performance increases demand on the brain, as both motor and cognitive systems require neural resources. The purpose of this study was to use functional MRI to understand which brain regions are involved in resolving Dual-task interference created by requiring high levels of Ankle motor control during a cognitive task.

METHODS: Using functional MRI, brain activity was measured in sixteen young adults during performance of visually cued Ankle plantar flexion to …

Validity Of The Early Activity Scale For Endurance And The 6-Minute Walk Test For Children With Cerebral Palsy., Alyssa Laforme Fiss, Lynn Jeffries, Allison Yocum, Sarah Westcott Mccoy, On Track Study Team

Physical Therapy Publications

PURPOSE: This study aimed to describe Early Activity Scale for Endurance (EASE) scores and 6-minute walk test (6MWT) distances of children with cerebral palsy (CP) by functional ability level, sex, and age and to examine the convergent validity of the 2 tests.

METHODS: A total of 708 participants with CP, Gross Motor Function Classification System (GMFCS) levels I to V, completed the EASE, and 376 of the study participants (3-12years), GMFCS levels I to III, completed the 6MWT.

RESULTS: Children with CP vary in EASE scores and 6MWT distances based on GMFCS level and, to a lesser extent, age. The …

Developmental Trajectories And Reference Percentiles For The 6-Minute Walk Test For Children With Cerebral Palsy., Alyssa Laforme Fiss, Lynn Jeffries, Kristie Bjornson, Lisa Avery, Steven Hanna, Sarah Westcott Mccoy

Physical Therapy Publications

PURPOSE: The purposes of this study were to document longitudinal developmental trajectories in 6-minute walk test (6MWT) distances and to develop age-specific reference percentiles for children across different Gross Motor Function Classification System (GMFCS) levels.

METHODS: A TOTAL OF: 456 children with cerebral palsy ages 3 to 12 years of, GMFCS levels I to III participated. Children's motor function was classified on the GMFCS, and children completed the 6MWT 2 to 5 times in 2 years.

RESULTS: Longitudinal developmental trajectories support that 6MWT distances increase with age followed by a tapering, as children approach their functional limit relative to their …