title: Patient-specific determinants of responsiveness to robot-enhanced treadmill therapy in children and adolescents with cerebral palsy.
abstract: The aim of the study was to evaluate patient-specific determinants of responsiveness to robot-enhanced repetitive treadmill therapy (ROBERT) in patients with early-developed movement disorders.
  
  
  
  Patients were treated over 12 sessions during a 3-week period. Gross Motor Function Measure-66 (GMFM-66) scores 1 day before ROBERT were compared with scores recorded 1 day after ROBERT. The association of GMFM-66 baseline score, age, sex, aetiology, and add-on botulinum toxin therapy to response to treatment was assessed.
  
  
  
  Eighty-three patients aged between 4 and 18 years (48 males, 35 females; mean age 10y 8mo, SD 6y 1mo; Gross Motor Function Classification System level I [n=12], II [n=21], III [n=35], IV [n=10], and V [n=1]) were each treated for a total of 7.2 (SD 1.9) treadmill walking hours. Aetiology was bilateral spastic cerebral palsy (BS-CP; n=69), unilateral CP (n=3), ataxic CP (n=3), hereditary spastic paraparesis (n=6), and genetic syndrome including spasticity (n=2). Meaningful improvements were observed in GMFM-66 (+2.5; 95% CI 2.0-3.0), GMFM-D (+5.2; 95% CI 3.6-6.8), and GMFM-E (+4.0; 95% CI 2.8-5.3). There was a high inter-individual variability in treatment response. After multivariable adjustment, the improvements in GMFM-66 and GMFM-E scores were positively associated with the GMFM-66 baseline score. The effect on GMFM-D improvement was inversely associated with age.
  
  
  
  Gross motor abilities at baseline and age were identified as relevant determinants for the high degree of interpersonal variability in response to ROBERT.
authors.affiliation: Department of Pediatric Neurology and Developmental Medicine, Hauner Children's Hospital, University of Munich, Munich, Germany.|German Center of Vertigo and Balance Disorders, IFBLMU, University of Munich, Munich, Germany.
authors.forename: Andreas Sebastian
authors.initials: AS
authors.lastname: Schroeder
authors.affiliation: Institute of Social Pediatrics and Adolescent Medicine, University of Munich, Munich, Germany.
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Von Kries
authors.affiliation: Institute of Social Pediatrics and Adolescent Medicine, University of Munich, Munich, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Riedel
authors.affiliation: Department of Pediatric Neurology and Developmental Medicine, Hauner Children's Hospital, University of Munich, Munich, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Homburg
authors.affiliation: Department of Pediatric Neurology and Developmental Medicine, Hauner Children's Hospital, University of Munich, Munich, Germany.
authors.forename: Helene
authors.initials: H
authors.lastname: Auffermann
authors.affiliation: Department of Pediatric Neurology and Developmental Medicine, Hauner Children's Hospital, University of Munich, Munich, Germany.
authors.forename: Astrid
authors.initials: A
authors.lastname: Blaschek
authors.affiliation: German Center of Vertigo and Balance Disorders, IFBLMU, University of Munich, Munich, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Jahn
authors.affiliation: Department of Pediatric Neurology and Developmental Medicine, Hauner Children's Hospital, University of Munich, Munich, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Heinen
authors.affiliation: Department of Pediatric Neurology and Developmental Medicine, Hauner Children's Hospital, University of Munich, Munich, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Borggraefe
authors.affiliation: Department of Pediatric Neurology and Developmental Medicine, Hauner Children's Hospital, University of Munich, Munich, Germany.|Specialist Center for Pediatric Neurology, Epilepsy Center for Children and Adolescents, Vogtareuth, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Berweck
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000503:physiopathology* / Q000534:rehabilitation*; D002648:Child; D004185:Disability Evaluation; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D012044:Regression Analysis; D012371:Robotics / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome