Functional effects of robotic-assisted locomotor treadmill thearapy in children with cerebral palsy

Abstract

There are several limitations to this study, therefore these results should be regarded as preliminary. Further research consistent with the above indications is needed to investigate the impact of this new treatment option in patients with cerebral palsy.

Practical Recommendations for Robot-Assisted Treadmill Therapy (Lokomat) in Children with Cerebral Palsy: Indications, Goal Setting, and Clinical Implementation within the WHO-ICF Framework

“…The one using the Gait Trainer GT 1 (Reha Stim, Berlin, Germany) showed better improvements in the robot-assisted group compared with the control group treated with conventional physiotherapy only 18 while the other study using the Lokomat (Hocoma, Volketswil, Switzerland) found no differences between the groups. 19 However, both and especially the latter study comprised some deciding limitations.…”

Effectiveness of Rehabilitation Interventions to Improve Gait Speed in Children With Cerebral Palsy: Systematic Review and Meta-analysis

“…It would appear that based on review of between group differences, effect size, PEDRO score and MCID, gait training without body weight support (pedometer based over-ground training, treadmill training without body weight support, and an instrumented feedback treadmill training) 19,20,32 was more effective than gait training with body weight support. 18,21,30,31,33 Gait training with body weight support effect sizes (-0.17 to .82) were lower than gait training without body weight support (1.32 to 3.20). However, 2 of the 3 studies that trained without body weight support enrolled only children with hemiplegia.…”

“…[18][19][20][21][30][31][32][33] Scores on the PEDro for the articles in this category ranged from 4 to 8, with an overall average rating of 6.5 and median of 7. Of the 8 studies included in this category, 5 (62%) rated good 18-20, 30, 32 and 3 (38%) rated fair.…”

“…The included studies investigated the effectiveness of gait training with 18,21,30,31,33 and without body weight support, 19,20,32 including robotic-assisted treadmill training, 30 over-ground "talking" pedometer based gait training 20 and treadmill training without body weight support with auditory/visual feedback 32 (Table 2, Gait training). Dosing of training was variable across all studies, ranging from a frequency of 2 to 5 sessions per week over a duration range of 2 to12 weeks.…”

“…20,32 In contrast, the studies that used body weight support enrolled children with spastic diplegia or quadriplegia who either ambulated independently or used assistive devices, such as crutches, walkers and gait trainers, and reported lower frequency and duration of intervention overall. 18,21,30,31,33 Therefore, the effect of gait training relative to body weight support across functional walking levels (GMFCS levels, hemiplegia/diplegia) remains unclear.…”