The children in this sample who improved the least,with
no positive MDC changesin any measure, included a teenage
girl with right hemiplegia, and the youngest boy, age six years,
also with right hemiplegia. The teenager was at an age during
which she appeared to be very conscious of her appearance,
and clinical observations were that she paid particular attention
to her gait pattern during the training. During the posttesting,
her increased attention to foot placement of her involved
extremity during the endurance and functional gait
measures slowed her pace, because she appeared to be using
cognitive motor planning to improve her heelstrike with each
step. Her intention and demonstration of improved gait quality
superseded any other goals of increased speed or endurance.
Although her pattern of increased awareness decreased
her speed on the walking velocity and also decreased her
endurance on the six-minute walk, this result could be
considered a positive outcome for this individual because
her awareness of her gait was heightened with the BWSTT
intervention.