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Improvement of walking abilities after robotic-assisted locomotion training in children with cerebral palsy
  1. A Meyer-Heim1,
  2. C Ammann-Reiffer1,
  3. A Schmartz1,
  4. J Schäfer2,
  5. F H Sennhauser1,
  6. F Heinen2,
  7. B Knecht1,
  8. E Dabrowski3,
  9. I Borggraefe2
  1. 1
    Rehabilitation Centre, Affoltern am Albis, University Children’s Hospital Zurich, Switzerland
  2. 2
    Department of Child Neurology and Developmental Medicine, Dr von Haunersches Children’s Hospital, University of Munich, Germany
  3. 3
    Department of Pediatrics, Division of Physical Medicine and Rehabilitation, Children’s Hospital of Michigan, Wayne State University, Detroit, Michigan, USA
  1. Andreas Meyer-Heim, Mühlebergstr. 104, University Children’s Hospital Zurich, 8910 Affoltern am Albis – Switzerland; Andreas.Meyer-Heim{at}kispi.uzh.ch

Abstract

Objective: To measure functional gait improvements of robotic-assisted locomotion training in children with cerebral palsy (CP).

Design: Single-case experimental A-B design.

Settings: Rehabilitation Centre Affoltern am Albis, Children’s University Hospital Zurich, Switzerland (inpatient group) and Neurology Department of the Dr von Haunersches Children’s Hospital Munich, Germany (outpatient group).

Participants: 22 children (mean age 8.6 years, range 4.6–11.7) with CP and a Gross Motor Function Classification System level II to IV.

Interventions: 3 to 5 sessions of 45–60 minutes/week during a 3–5-week period of driven gait orthosis training.

Main outcome measures: 10-metre walk test (10MWT), 6-minute walk test (6MinWT), Gross Motor Function Measure (GMFM-66) dimension D (standing) and dimension E (walking), and Functional Ambulation Categories (FAC).

Results: The mean (SD) maximum gait speed (0.78 (0.57) to 0.91 (0.61) m/s; p<0.01) as well as the mean (SD) dimension D of the GMFM-66 (40.3% (31.3%) to 46.6% (28.7%); p<0.05) improved significantly after the intervention period. The mean (SD) 6MinWT (176.3 (141.8) to 199.5 (157.7) m), the mean FAC (2.6 (1.7) to 3.0 (1.6)) and the mean (SD) dimension E of the GMFM-66 (29.5% (30.3%) to 31.6% (29.2%)) also showed an increase, but did not reach a statistically significant level.

Conclusion: These results suggest that children with CP benefit from robotic-assisted gait training in improving functional gait parameters.

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Footnotes

  • Competing interests: AMH and IB have been reimbursed by Hocoma AG, the manufacturer of Pediatric Lokomat for attending two conferences as invited speakers and received a fee for speaking at one conference. Hocoma AG financed equipment for development and research of an augmented feedback system of the Pediatric Lokomat. AS has been employed by Hocoma AG during the submission of the paper to ADC.

  • Ethics approval: Approval for the study was obtained from the local ethics committees.

  • Patient consent: Parental consent obtained.

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