title: Robot-assisted gait training might be beneficial for more severely affected children with cerebral palsy.
abstract: OBJECTIVE
  Robot-assisted gait training (RAGT) can complement conventional therapies in children with cerebral palsy. We investigated changes in walking-related outcomes between children with different Gross Motor Function Classification System (GMFCS) levels and the dose-response relationship.
  
  
  METHODS
  Data from 67 children (3.9-19.9 years) with GMFCS levels II-IV were evaluated retrospectively. Every child received RAGT with the Lokomat complementing a multidisciplinary rehabilitation program. Changes in various walking-related outcomes were assessed.
  
  
  RESULTS
  Walking-related outcomes did not improve differently between GMFCS level groups. Significant within-group improvements were mainly observed in children with GMFCS level IV. A dose-response relationship was present for children with GMFCS levels III and IV.
  
  
  CONCLUSIONS
  Our results indicated that, although children with a GMFCS level IV walked less during an average Lokomat session, they experienced significant improvements in walking-related outcomes. Further, training dose correlated with changes in walking-related outcomes. However, between-group differences in changes in walking-related outcomes were not significant.
authors.affiliation: a Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich , Affoltern am Albis , Zurich , Switzerland.|b Children's Research Center, University Children's Hospital Zurich , Affoltern am Albis , Zurich , Switzerland , and.|c Neuroscience Center Zurich (ZNZ) , Zurich , Switzerland.
authors.forename: Hubertus J A
authors.initials: HJ
authors.lastname: van Hedel
authors.affiliation: a Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich , Affoltern am Albis , Zurich , Switzerland.|b Children's Research Center, University Children's Hospital Zurich , Affoltern am Albis , Zurich , Switzerland , and.|c Neuroscience Center Zurich (ZNZ) , Zurich , Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Meyer-Heim
authors.affiliation: a Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich , Affoltern am Albis , Zurich , Switzerland.|b Children's Research Center, University Children's Hospital Zurich , Affoltern am Albis , Zurich , Switzerland , and.
authors.forename: Christina
authors.initials: C
authors.lastname: Rüsch-Bohtz
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D005081:Exercise Therapy / Q000295:instrumentation*; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012371:Robotics; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*; D055815:Young Adult
keywords: Congenital brain lesion; Functional Independence Measure for Children (WeeFIM); Gross Motor Function Classification System; Gross Motor Function Measure; Lokomat; dose–response relationship; pediatric neurorehabilitation; timed walking tests; training intensity; walking ability; walking-related outcomes; youth