IS ROBOTIC-GAIT TRANING MORE EFFECTIVE THAN TRADITIONAL PHYSIOTHERAPY IN CHILDREN WITH SPASTIC CEREBRAL PALSY?

D. Djuric¹, A.M. Isleem², A.A. Alhumaidan², M.D.A. Al-Jarrah¹, A. Zeghan³

¹Fatima College of Health Sciences, Physiotherapy, Abu Dhabi, United Arab Emirates, ²Zayed Higher Organization for People of Determination, Abu Dhabi, United Arab Emirates, ³Cerebral Palsy Foundation, Amman, Jordan

Background: Robotic-assisted gait training (Lokomat) is used for treating mild, moderate, and severe spastic cerebral palsy children. It is a type of intensive training that enables physiological walking pattern enhancing motor learning and brain neuroplasticity. The focus of this study was to investigate if intensive individually tailored one month robotic-assisted gait training more effective than traditional physiotherapy.

Purpose: The aim of this study was to determine the effect of robotic-assisted gait training on gross motor functions and walking.

Methods: This study included 41 participants aged 4-14 divided into two groups: the experimental group (26) and the control group (15). The experimental group underwent 20 Lokomat sessions (40 mins per session) in addition to 20 traditional training sessions (40 mins per session), while the control group were given only 20 traditional training sessions (40 mins per session). The experimental group took place in Zayed Higher Organization for People of Determination, Abu Dhabi (UAE) and control group in Clinical Center Nis (Serbia) during the period of Covid-19 pandemic in 2020-2021.

Results: The experimental group showed a significant improvement in all examined functional tests. Positive effects in the Gross Motor Function Measure (GMFM-88) dimension D (p<0.001) in experimental and (p=0.222) in control group, GMFM dimension E (p<0.001) in experimental and (p=0.018) in control group were seen, as well in the the 6-minute walk test (p<0.001) in experimental and (p=0.154) in control group, 10-meter walk test (p<0.001) in experimental and (p=0.041) in control group. In Pediatric Balance Scale (PBS), (p<0.001) in experimental and (p=0.075) in control group.

Conclusions: Robotic-assisted treadmill training is effective for children with cerebral palsy for levels I—IV on the GMFCS on gross motor functions, balance and walking. Children had high motivation and active participation during video games, which made the robotic training more engaging.

Implications: The implementation of robotic-assisted gait training as a complementary method to the traditional training in the rehabilitation of children with cerebral palsy could be strongly considered.Improvement of postural control, increased gait speed and endurance can lead to increase activity and participation of spastic cerebral palsy children.

Funding acknowledgements: None

Keywords:
Cerebral palsy
robot-assisted gait training
gross motor functions

Topics:
Innovative technology: robotics
Paediatrics: cerebral palsy
Paediatrics

Did this work require ethics approval? Yes

Institution: Fatima College of Health Sciences

Committee: Dr. Ahmed Saifan Chair of FCHS Ethics Committee

Ethics number: INTSTF018PHY20