Robotic Walkers for Children and Youth with Cerebral Palsy: A Review of Past Successes and Ongoing Advancement

Abstract

Each child with a disability deserves the support required to achieve their maximum physical potential, optimal participation and an active lifestyle throughout their lifespan. In this paper, we aim to highlight past successes, present work and share a vision for future advancements in robotic gait technologies that enable walking in children and youth with severe physical disabilities. We will summarize work which demonstrates how a robotic walker with a lift and body weight support system has shown great promise in mobilization, exercise and participation in youth and young adults with Cerebral Palsy (CP). This study was conducted in 3 phases; 1) a case study, 2) a pilot study evaluating mobility in a clinical setting, and 3) a study focusing on training and participation in a community setting. Secondly, we will describe the planned assessment of the Trexo Plus, a walker and wearable lower extremity robotic device combination, in younger children with significant physical involvement secondary to CP. This device allows precise repetition of normal gait patterns while controlling range of motion at the hip, knee and ankle. Lastly, we will highlight international innovative robotic work which has produced a novel robotic platform with a partial body weight support system (PBWS), active system for adapting hip height and an exoskeleton with joint motion control. A multimodal human-robot interface (MHRI) accompanies the unique walker system which assesses intent to move, posture and balance and gait patterns. This system has the potential to allow therapists to construct and precisely evaluate unique robot facilitated programming. There is a new generation of robotic devices providing the means for individuals with CP to walk independently. With a look to the future, we endeavour to evaluate and facilitate the development of this robotic technology as it is integrated into clinical care, activity enhancement and community participation.

Wearable Lower-Limb Exoskeleton for Children With Cerebral Palsy: A Systematic Review of Mechanical Design, Actuation Type, Control Strategy, and Clinical Evaluation

“…Using a tablet for remote control, an operator can manage speed, gait angles, and the amount of torque assistance of the exoskeleton. This device can be modified in height and width to suit a broad spectrum of ages from two years upwards [165,166]. Unfortunately, more information about the mechanical design, actuator type, and control algorithm is not available to the best of the authors' knowledge.…”

“…In a clinical study, children aged from three to six were recruited to ascertain the advantages and disadvantages of training with Trexo Plus in comparison with routine clinical care, particularly for children with CP [166]. This device has been designed for CP children with moderate and severe mobility disorder (GMFCS III-V) [167].…”