PEDALS (Pediatric Endurance Development and Limb Strengthening).

Sixty-four children between 7 and 18 years of age with spastic diplegic cerebral palsy (CP) who could walk independently with or without assistive devices (GMFCS levels I-III) were enrolled in this study. These inclusion criteria representa broad age range and functional walking ability of children with spastic diplegic CP. As with STEPS, exclusion criteria were limited to factors that would affect safety during training (ie, serious medical conditions such as cardiac disease, diabetes, asthma, of uncontrolled seizures), responsiveness to therapy (ie, recent musculoskeletal or neurosurgical surgery, baclofen pump implantation, botulinum toxin injections, serial casting, new orthoses, significant lower-extremity contractures, start of physical therapy, current participation in a fitness program), or ability to fully participate (ie, inability or unwillingness to maintain age-appropriate behavior).