Abstract
Background
Robot-enhanced therapies are increasingly being used to improve gross motor performance
in patients with cerebral palsy.
Aim
To evaluate gross motor function, activity and participation in patients with bilateral
spastic cerebral palsy (BS-CP) after Robot-enhanced repetitive treadmill therapy (ROBERT)
in a prospective, controlled cohort study.
Methods
Participants trained for 30–60 min in each of 12 sessions within a three-week-period.
Changes in Gross Motor Function Measure (GMFM 66) scores, standardized walking distance,
self-selected and maximum walking speed (ICF domain “Activity”), and Canadian Occupational
Performance Measure (COPM; “Participation”) were measured. Outcome measures were assessed
three weeks in advance (V1), the day before (V2) as well as the day after, and 8 weeks
after ROBERT (V3 + V4).
Results
18 patients with BS-CP participated; age 11.5 (mean, range: 5.0–21.8) years, body
weight 36.4 (15.0–72.0) kg. GMFCS levels I–IV were: n = 4; 5; 8; 1. There was no significant difference comparing V1 and V2. GMFM 66 (total
+2.5 points, Dimension D +3.8 and E +3.2) and COPM (Performance +2.1 points, Satisfaction
+1.8 points) showed statistically significant improvements for V3 or V4 compared to
V1 or V2 representing clinically meaningful effect sizes. Age, GMFCS level, and repeated
ROBERT blocks correlated negatively with GMFM improvement, but not with COPM improvement.
Interpretation
Following ROBERT, this prospective controlled cohort study showed significant and
clinically meaningful improvements of function in ICF domains of “activity” and “participation”
in patients with BS-CP. Further assessment in a larger cohort is necessary to allow
more specific definition of factors that influence responsiveness to ROBERT program.
Keywords
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Article info
Publication history
Published online: April 24, 2014
Accepted:
April 4,
2014
Received in revised form:
March 31,
2014
Received:
February 13,
2013
Identification
Copyright
© 2014 Published by Elsevier Inc.
