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.
Borggraefe
Ingo
I
Department of Paediatric Neurology and Developmental Medicine, Dr. von Haunersches Children's Hospital, University of Munich, Germany. ingo.borggraefe@med.uni-muenchen.de
Schaefer
Jan Simon
JS
Klaiber
Mirjam
M
Dabrowski
Edward
E
Ammann-Reiffer
Corinne
C
Knecht
Beat
B
Berweck
Steffen
S
Heinen
Florian
F
Meyer-Heim
Andreas
A
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