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

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
• dose–response relationship
• Functional Independence Measure for Children (WeeFIM)
• Gross Motor Function Classification System
• Gross Motor Function Measure
• Lokomat
• pediatric neurorehabilitation
• timed walking tests
• training intensity
• walking-related outcomes
• walking ability
• youth

Acknowledgments

We would like to thank the children who were trained during these years and whose data we could use for the present study. We are grateful to all physical therapists and movement scientists, especially Mrs Tabea Aurich-Schuler and Mrs Judith Graser, who continuously contributed to keeping our database up to date. We appreciate the help of Mrs Von Spreckelsen and Mrs Seiler for their help in obtaining the data of the conventional therapies. This work was sponsored by the Mäxi-Foundation, the Fondation Gaydoul and the Clinical Research Priority Program (CRPP) Neurorehabilitation of the Medical Faculty of the University of Zurich.

Declaration of interest

The authors report no conflict of interest. The authors alone are responsible for the content of this article.