Within- and between-therapist agreement on personalized parameters for robot-assisted gait therapy: the challenge of adjusting robotic assistance.

Only 14 children were included, and analyses used 13 within-therapist comparisons and 12 between-therapist comparisons, so small numbers make the agreement estimates unstable. All therapists came from a single centre and shared the same Lokomat training philosophy, so results may not apply to other services. The task was standardised and therapists were blinded to earlier settings, which may not match real therapy where patient condition, motivation, and therapist-patient relationship vary. Robotic assistance was reported as one combined value from Guidance Force and Path Control, so the contribution of each control mode cannot be separated. The study outcome was agreement in parameter settings, not a patient walking outcome. Within-therapist agreement was measured on different days, so differences could reflect the child's day-to-day state as well as therapist choice.

Funding came from the ACCENTUS Foundation, Schweizerische Stiftung für das Cerebral Gelähmte Kind, J&K Wonderland Foundation, and Olga Mayenfisch Stiftung. The supplied text gives no additional author conflict declaration.

Do not treat the robotic assistance number as a fixed dose that can be copied between therapists. The study found wide differences in robotic assistance settings, and a lower setting may not mean less help because it can allow more movement before a safety stop.