title: Robotic-assisted gait training improves walking abilities in diplegic children with cerebral palsy.
abstract: The robotic-assisted gait training therapy (RAGT), based on intensity and repetition of movement, presents beneficial effects on recovery and improvement of postural and locomotor functions of the patient. This study sought to highlight the effect of this RAGT on the dynamic equilibrium control during walking in children with Cerebral Palsy (CP) by analyzing the different postural strategies of the fullbody (upper/lower body) before and after this RAGT in order to generate forward motion while maintaining balance. Data were collected by a motion analysis system (Vicon®- Oxford Metrics). Thirty children with bilateral spastic CP were evaluated using a full-body marker set which allows assessing both the lower and upper limb kinematics. The children were divided into two groups in such a way as to obtain a randomized controlled population: i) a group of fourteen children (Treated Group) underwent 20 sessions of RAGT using the driven gait orthosis Lokomat®Pediatric (Hocoma) compared to ii) a group of sixteen children without sessions of Lokomat®Pediatric (Control Group) receiving only daily physiotherapy. Significant improvements are observed between the TG pre- and post-test values of i) the kinematic data of the full-body in the sagittal and frontal planes and ii) the Gross Motor Function Measure test (D and E). This study shows the usefulness of this RAGT mainly in the balance control in gait. Indeed, the Treated Group use new dynamic strategies of gait that are especially characterized by a more appropriate control of the upper body associated with an improvement of the lower limbs kinematics.
authors.affiliation: Université catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal Lab (NMSK), Avenue Mounier 53, B-1200 Brussels, Belgium. Electronic address: wallard_laura@hotmail.fr.
authors.forename: L
authors.initials: L
authors.lastname: Wallard
authors.affiliation: Laboratoire Education Discours Apprentissages EA4071, Centre Universitaire des Saints-Pères, 45 rue des Saints-Pères, 75270 Paris Cedex 06, France.
authors.forename: G
authors.initials: G
authors.lastname: Dietrich
authors.affiliation: Laboratoire Education Discours Apprentissages EA4071, Centre Universitaire des Saints-Pères, 45 rue des Saints-Pères, 75270 Paris Cedex 06, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Kerlirzin
authors.affiliation: Centre de Santé - Institut Rossetti-PEP06, Unité Clinique d'Analyse du Mouvement, 400, Boulevard de la Madeleine, 06000 Nice, France; Université Côte d'Azur, LAMHESS, France.
authors.forename: J
authors.initials: J
authors.lastname: Bredin
mesh_terms: D001696:Biomechanical Phenomena; D002547:Cerebral Palsy / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D005081:Exercise Therapy; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D008297:Male; D004856:Postural Balance / Q000502:physiology; D012371:Robotics; D016138:Walking / Q000502:physiology*
keywords: Cerebral palsy; Clinical gait analysis; Driven gait orthosis; Dynamic equilibrium control; Kinematics