title: Locomotor training through a novel robotic platform for gait rehabilitation in pediatric population: short report.
abstract: BACKGROUND
  Cerebral Palsy (CP) is a disorder of posture and movement due to a defect in the immature brain. The use of robotic devices as alternative treatment to improve the gait function in patients with CP has increased. Nevertheless, current gait trainers are focused on controlling complete joint trajectories, avoiding postural control and the adaptation of the therapy to a specific patient. This paper presents the applicability of a new robotic platform called CPWalker in children with spastic diplegia.
  
  
  RESULTS
  CPWalker consists of a smart walker with body weight and autonomous locomotion support and an exoskeleton for joint motion support. Likewise, CPWalker enables strategies to improve postural control during walking. The integrated robotic platform provides means for testing novel gait rehabilitation therapies in subjects with CP and similar motor disorders. Patient-tailored therapies were programmed in the device for its evaluation in three children with spastic diplegia for 5 weeks. After ten sessions of personalized training with CPWalker, the children improved the mean velocity (51.94 ± 41.97 %), cadence (29.19 ± 33.36 %) and step length (26.49 ± 19.58 %) in each leg. Post-3D gait assessments provided kinematic outcomes closer to normal values than Pre-3D assessments.
  
  
  CONCLUSIONS
  The results show the potential of the novel robotic platform to serve as a rehabilitation tool. The autonomous locomotion and impedance control enhanced the children's participation during therapies. Moreover, participants' postural control was substantially improved, which indicates the usefulness of the approach based on promoting the patient's trunk control while the locomotion therapy is executed. Although results are promising, further studies with bigger sample size are required.
authors.affiliation: Neural and Cognitive Engineering group, Centro de Automática y Robótica, Consejo Superior de Investigaciones Científicas, Ctra Campo Real km 0.2, Arganda del Rey, Madrid, 28500, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Bayón
authors.affiliation: Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Lerma
authors.affiliation: Neural and Cognitive Engineering group, Centro de Automática y Robótica, Consejo Superior de Investigaciones Científicas, Ctra Campo Real km 0.2, Arganda del Rey, Madrid, 28500, Spain.
authors.forename: O
authors.initials: O
authors.lastname: Ramírez
authors.affiliation: Neural and Cognitive Engineering group, Centro de Automática y Robótica, Consejo Superior de Investigaciones Científicas, Ctra Campo Real km 0.2, Arganda del Rey, Madrid, 28500, Spain.
authors.forename: J I
authors.initials: JI
authors.lastname: Serrano
authors.affiliation: Neural and Cognitive Engineering group, Centro de Automática y Robótica, Consejo Superior de Investigaciones Científicas, Ctra Campo Real km 0.2, Arganda del Rey, Madrid, 28500, Spain.
authors.forename: M D
authors.initials: MD
authors.lastname: Del Castillo
authors.affiliation: Neural and Cognitive Engineering group, Centro de Automática y Robótica, Consejo Superior de Investigaciones Científicas, Ctra Campo Real km 0.2, Arganda del Rey, Madrid, 28500, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Raya
authors.affiliation: Instituto de Biomecánica de Valencia, Valencia, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Belda-Lois
authors.affiliation: Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Martínez
authors.affiliation: Neural and Cognitive Engineering group, Centro de Automática y Robótica, Consejo Superior de Investigaciones Científicas, Ctra Campo Real km 0.2, Arganda del Rey, Madrid, 28500, Spain. e.rocon@csic.es.|Postgraduate Program, Universidade Federal do Espírito Santo, Vitória, Brazil. e.rocon@csic.es.
authors.forename: E
authors.initials: E
authors.lastname: Rocon
mesh_terms: D001696:Biomechanical Phenomena; D002547:Cerebral Palsy / Q000150:complications / Q000534:rehabilitation*; D002648:Child; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities / Q000295:instrumentation*; D012371:Robotics / Q000295:instrumentation*; D014853:Walkers; D016138:Walking
keywords: Case report; Cerebral palsy; Exoskeleton device; Gait; Posture; Rehabilitation robotic; Spastic diplegia