Robotic lower extremity exoskeleton use in a non-ambulatory child with cerebral palsy: a case study

Abstract

Purpose

With few treatment options available for non-ambulatory children with cerebral palsy (CP), a robotic lower extremity gait trainer may provide a non-invasive addition to conventional treatment options. This case study investigates the usage and impact of robotic lower extremity gait trainer use in a participant with CP over the initial 3 months of use.

Materials and methods

This prospective case study involves a 7-year old female (GMFCS V) with CP (registered clinical trial: NCT04251390). The participant used a Trexo Home robotic gait trainer (Trexo) in the community with assessments occurring in the home and school. Trexo usage and bowel movements (BMs) were tracked daily. Postural control and lower extremity range of motion (ROM) and spasticity were evaluated prior to Trexo use and weekly to biweekly thereafter.

Results

The participant used the device an average of 46 min/week, over 3.3 d/week. BM frequency increased from 0.4/d at baseline, to 1.2 (±0.5)/d during Trexo use. There were no diffuse systematic changes in postural stability, ROM or muscle spasticity, but specifically head control and spasticity in the knee flexors had improvements.

Conclusions

Data and anecdotal reports suggest that regular use of the Trexo Home robotic gait trainer has positive outcomes on frequency and quality of BMs, and may improve head control, and knee flexor spasticity. Larger controlled studies are needed to evaluate the impacts of Trexo use in children with CP.

Implications for Rehabilitation

• Non-ambulatory children with CP can use and may experience benefits from using a robot-assisted gait trainer (RAGT).

• Constipation, aspects of balance and focal spasticity may improve.

Keywords:

• Robotics
• cerebral palsy
• neurological rehabilitation
• locomotion
• constipation
• postural balance
• muscle spasticity

Acknowledgements

The authors wish to extend our gratitude to the participant, family and caregivers involved in this study.

Disclosure statement

The authors have no conflicts of interest to disclose.

Additional information

Funding

Child Health Research Development Fund supported by the Alberta Children's Hospital Foundation.