Randomized Controlled Trial
Robotic-assisted gait training improves walking abilities in diplegic children with cerebral palsy
Wallard l, Dietrich G, Kerlirzin Y & Bredin J
European Journal of Paediatric Neurology 2017, http://dx.doi.org/10.1016/j.ejpn.2017.01.012
Objective: For children with diplegic cerebral palsy, robotic-assisted gait training (RAGT) can result in improved gait and posture compared to children who receive only traditional physical therapy. Of particular interest here is dynamic equilibrium control: upper body strategies such as shoulder elevation and elbow flexion used to maintain balance while propelling forward.
The authors propose: "RAGT presents beneficial effects on improvement of postural and locomotor functions of the patient resulting in a reorganization of gait pattern and full-body kinematic illustrating the dynamic equilibrium control in gait. This would translate in a better stabilization of the head, a better control of the displacement of the arms associated with an improvement in the kinematics of the lower limb."
Process: Thirty children with diplegic cerebral palsy from 8 to 18 years of age were randomly assigned to either a treatment group or a control group. The treatment group received 40-minute sessions of Lokomat Pediatric robot-assisted walking therapy, 5 days a week for 4 weeks. Body-weight support and walking speed were altered through the sessions to match the child’s functional capacity. The control group received daily 40-minute sessions of traditional therapy.
Findings: Gross Motor Function Classification System dimensions GMFM- D (standing) and GMFM-E (walking/running/climbing) were measured and showed improvement within the treatment group, and between treatment and control groups.
Children in the treatment group demonstrated new strategies for gait with significantly reduced shoulder elevation and elbow flexion, "more appropriate control of the upper body... associated with an improvement of the lower limbs kinematics which is similar to the values observed in typically developing children."
There was no follow-up to indicate whether the effects are preserved over the long term.