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This study compared the efficacy of Adeli suit treatment (AST) with neurodevelopmental treatment (NDT) in children with cerebral palsy (CP). Twenty-four children with CP, Levels II to IV according to the Gross Motor Function Classification System (GMFCS), were matched by age and functional status and randomly assigned to the AST or NDT treatment groups. In the AST group (n=12; eight males, four females; mean age 8.3y [SD 2.0]), six children had spastic/ataxic diplegia, one triplegia and five spastic/mixed quadriplegia. In the NDT group (n=12; nine males, three females; mean age 8.1y [SD 2.2]), five children had spastic diplegia and seven had spastic/mixed quadriplegia. Both groups were treated for 4 weeks (2 hours daily, 5 days per week, 20 sessions). To compare treatments, the Gross Motor Function Measure (GMFM-66) and the mechanical efficiency index (EI HB ) during stair-climbing were measured at baseline, immediately after 1 month of treatment, and 10 months after baseline. The small but significant time effects for GMFM-66 and EI HB that were noted after 1 month of both intensive physiotherapy courses were greater than expected from natural maturation of children with CP at this age. Improvements in motor skills and their retention 9 months after treatment were not significantly different between the two treatment modes. Post hoc analysis indicated a greater increase in EI HB after 1 month (p=0.16) and 10 months (p=0.004) in AST than that in NDT, predominantly in the children with higher motor function (GMFCS Levels II and III). The results suggest that AST might improve mechanical efficiency without a corresponding gain in gross motor skills, especially in children with higher levels of motor function.

In higher functioning children with cerebral palsy, the motor learning coaching treatment resulted in significantly greater retention of gross motor function and transfer of mobility performance to unstructured environments than neurodevelopmental treatment.

SUMMARYRobotics Agent Coacher for Cerebral Palsy motor Function (RAC CP Fun) is an attempt to implement socially assistive robotics, and a motor learning approach in rehabilitating movement disorders with a central origin. The concept and architecture of RAC CP Fun implements the motor learning theory and behavioral approach, i.e. principles of repetition, stages of learning, appropriate feedback, random practice, and enriched environments. Eleven children with cerebral palsy (CP) and fourteen typically developed (TD) children participated in two procedures while interacting with a robot and performing motor exercises. The interaction level and motor performance of children were measured and compared. Children with CP exhibited a higher interaction level; however, their motor performance was lower than that of TD children. RAC CP Fun was found to be feasible to interact with children of pre-school age, to augment the motivation of the children with CP, and to involve the children in motor exercises.

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