Locomotor training through a novel robotic platform for gait rehabilitation in pediatric population: short report.
C Bayón, S Lerma, O Ramírez and 6 others
PMID 27842562WHAT IT FOUND
Three children with spastic diplegia walked faster, took more steps per minute and had longer steps after 10 sessions on a robotic gait trainer.
Because each child had different goals and no control group, this does not prove the robot caused the gains.
Key findings
01After 5 weeks and 10 sessions with CPWalker, the three children improved walking speed, steps per minute and step length.
02Post-therapy 3D gait studies showed trajectories for both legs closer to normal values than before therapy.
03Because the therapy was individually tailored, the paper presents the results as separate case studies rather than a common treatment effect.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only three children were studied, so this is a small pilot and cannot show how most children with cerebral palsy would respond. The paper does not describe randomisation, blinding or a control group, so the improvements cannot be compared with usual therapy or natural change. Each child received a different tailored therapy, and the robot provided several components at once, including body-weight support, exoskeleton guidance, posture biofeedback and progressive speed or range-of-motion targets. The follow-up was only after 5 weeks and 10 sessions, so long-term gains were not measured. The children were selected to use the exoskeleton: aged 11 to 18 years, up to 75 kg, GMFCS I to III, no deformations preventing use, and able to signal pain. One child had hereditary spastic paraparesis rather than cerebral palsy, so the group was not uniform.
Declared interests
The paper reports funding from Secretaría de Estado de Investigación, Desarrollo e Innovación. No other conflict-of-interest declaration is provided.
The easy way to misread this
Do not conclude that CPWalker alone improves gait in children with cerebral palsy. Three children received robot-assisted over-ground walking with partial body-weight support, exoskeleton guidance, posture biofeedback and gradually increased speed and range-of-motion targets, and there was no control group.