Robot-assisted gait training might be beneficial for more severely affected children with cerebral palsy

Dev Neurorehabil. 2016 Dec;19(6):410-415. doi: 10.3109/17518423.2015.1017661. Epub 2015 Apr 2.

Abstract

Purpose: Robot-assisted gait training (RAGT) can complement conventional therapies in children with cerebral palsy. We investigated changes in walking-related outcomes between children with different Gross Motor Function Classification System (GMFCS) levels and the dose-response relationship.

Methods: Data from 67 children (3.9-19.9 years) with GMFCS levels II-IV were evaluated retrospectively. Every child received RAGT with the Lokomat complementing a multidisciplinary rehabilitation program. Changes in various walking-related outcomes were assessed.

Results: Walking-related outcomes did not improve differently between GMFCS level groups. Significant within-group improvements were mainly observed in children with GMFCS level IV. A dose-response relationship was present for children with GMFCS levels III and IV.

Conclusions: Our results indicated that, although children with a GMFCS level IV walked less during an average Lokomat session, they experienced significant improvements in walking-related outcomes. Further, training dose correlated with changes in walking-related outcomes. However, between-group differences in changes in walking-related outcomes were not significant.

Keywords: Congenital brain lesion; Functional Independence Measure for Children (WeeFIM); Gross Motor Function Classification System; Gross Motor Function Measure; Lokomat; dose–response relationship; pediatric neurorehabilitation; timed walking tests; training intensity; walking ability; walking-related outcomes; youth.

MeSH terms

  • Adolescent
  • Cerebral Palsy / diagnosis
  • Cerebral Palsy / physiopathology
  • Cerebral Palsy / rehabilitation*
  • Child
  • Child, Preschool
  • Exercise Therapy / instrumentation*
  • Female
  • Gait / physiology*
  • Humans
  • Male
  • Retrospective Studies
  • Robotics*
  • Severity of Illness Index
  • Treatment Outcome
  • Walking / physiology*
  • Young Adult