Robotic-assisted treadmill therapy improves walking and standing performance in children and adolescents with cerebral palsy.
OBJECTIVE
Task-specific body-weight-supported treadmill therapy improves walking performance in children with central gait impairment. The aim of the study was to investigate the effect of robotic-assisted treadmill therapy on standing and walking performance in children and adolescents with cerebral palsy and to determine parameters influencing outcome.


METHODS
20 Patients (mean age 11.0 ± 5.1, 10 males and 10 females) with cerebral palsy underwent 12 sessions of robotic-assisted treadmill therapy using the driven gait orthosis Lokomat. Outcome measures were the dimensions D (standing) and E (walking) of the Gross Motor Function Measure (GMFM).


RESULTS
Significant improvements in dimension D by 5.9% (± 5.2, p=0.001) and dimension E by 5.3% (± 5.6, p<0.001) of the GMFM were achieved. Improvements in the GMFM D and E were significantly greater in the mildly affected cohort (GMFCS I and II) compared to the more severely affected cohort (GMFCS III and IV). Improvement of the dimension E but not of D correlated positively with the total distance and time walked during the trial (r(s)=0.748, p<0.001).


CONCLUSIONS
Children and adolescents with bilateral spastic cerebral palsy showed improvements in the functional tasks of standing and walking after a 3-week trial of robotic-assisted treadmill therapy. The severity of motor impairment affects the amount of the achieved improvement.
Department of Paediatric Neurology and Developmental Medicine, Dr. von Haunersches Children's Hospital, University of Munich, Germany. ingo.borggraefe@med.uni-muenchen.de
Ingo
I
Borggraefe
Jan Simon
JS
Schaefer
Mirjam
M
Klaiber
Edward
E
Dabrowski
Corinne
C
Ammann-Reiffer
Beat
B
Knecht
Steffen
S
Berweck
Florian
F
Heinen
Andreas
A
Meyer-Heim
D000293:Adolescent; D002547:Cerebral Palsy / Q000150:complications* / Q000534:rehabilitation; D002648:Child; D005080:Exercise Test / Q000379:methods*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D011187:Posture / Q000502:physiology*; D012371:Robotics / Q000379:methods*; D016138:Walking / Q000502:physiology*; D055815:Young Adult