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Improvement of walking abilities after robotic-assisted locomotion training in children with cerebral palsy

2009; BMJ; Volume: 94; Issue: 8 Linguagem: Inglês

10.1136/adc.2008.145458

1468-2044

Andreas Meyer‐Heim, Corinne Ammann‐Reiffer, Annick C. Schmartz, John Schafer, Felix H. Sennhauser, Florian Heinen, Beat Knecht, Edward Dabrowski, Ingo Borggraefe,

Spinal Cord Injury Research

Objective: To measure functional gait improvements of robotic-assisted locomotion training in children with cerebral palsy (CP). Design: Single-case experimental A-B design. Settings: Rehabilitation Centre Affoltern am Albis, Children's University Hospital Zurich, Switzerland (inpatient group) and Neurology Department of the Dr von Haunersches Children's Hospital Munich, Germany (outpatient group). Participants: 22 children (mean age 8.6 years, range 4.6–11.7) with CP and a Gross Motor Function Classification System level II to IV. Interventions: 3 to 5 sessions of 45–60 minutes/week during a 3–5-week period of driven gait orthosis training. Main outcome measures: 10-metre walk test (10MWT), 6-minute walk test (6MinWT), Gross Motor Function Measure (GMFM-66) dimension D (standing) and dimension E (walking), and Functional Ambulation Categories (FAC). Results: The mean (SD) maximum gait speed (0.78 (0.57) to 0.91 (0.61) m/s; p<0.01) as well as the mean (SD) dimension D of the GMFM-66 (40.3% (31.3%) to 46.6% (28.7%); p<0.05) improved significantly after the intervention period. The mean (SD) 6MinWT (176.3 (141.8) to 199.5 (157.7) m), the mean FAC (2.6 (1.7) to 3.0 (1.6)) and the mean (SD) dimension E of the GMFM-66 (29.5% (30.3%) to 31.6% (29.2%)) also showed an increase, but did not reach a statistically significant level. Conclusion: These results suggest that children with CP benefit from robotic-assisted gait training in improving functional gait parameters.