Factors influencing neuromuscular responses to gait training with a robotic ankle exoskeleton in cerebral palsy.
Benjamin C Conner, Alyssa M Spomer, Katherine M Steele and 1 others
PMID 36194197WHAT IT FOUND
In eight children with cerebral palsy, walking kinematics influenced soleus muscle response to a robotic ankle exoskeleton more than device resistance or practice.
A more extended leg posture during stance increased muscle activation. This pilot suggests monitoring for compensatory crouch gait is critical.
Key findings
01Kinematic parameters had the largest net effect on soleus modulation, with peak stance phase hip flexion and ankle dorsiflexion showing the strongest influence.
02Increased soleus activation was associated with greater spasticity, higher functional level, and a decrease in motor control complexity.
03Gait training practice increased soleus activation, but some adaptation was retained two weeks after the final training visit.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Very small sample size (n=8) limits generalizability. One participant was removed from the analysis due to outlier status. Findings cannot be applied to all individuals with cerebral palsy due to population heterogeneity. Verbal coaching was not provided, which may have allowed compensatory strategies to go uncorrected.
Declared interests
One author is a co-founder with shareholder interest in a university start-up seeking to commercialize the device used in the study and holds intellectual property inventorship rights.
The easy way to misread this
Do not interpret the strong kinematic influence as evidence that resistance levels are ineffective. The small sample and lack of verbal coaching mean participants may have adopted compensatory strategies that altered the expected relationship between resistance and muscle activation.