Robot-enhanced therapies are increasingly being used to improve gross motor performance in patients with cerebral palsy.
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.
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).
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.
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.
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- The updated European Consensus 2009 on the use of botulinum toxin for children with cerebral palsy.Eur J Paediatr Neurol. 2010; 14: 45-66
- International classification of functioning, disability and health, children & youth version (WHO).2005
- Bilateral spastic cerebral palsy – prevalence through four decades, motor function and growth.Eur J Paediatr Neurol. 2007; 11: 215-222
- Cerebral palsy in Norway: prevalence, subtypes and severity.Eur J Paediatr Neurol. 2008; 12: 4-13
- Treadmill training with partial body weight support in nonambulatory patients with cerebral palsy.Arch Phys Med Rehabil. 2000; 81: 301-306
- Body weight supported treadmill training improves the regularity of the stepping kinematics in children with cerebral palsy.Dev Neurorehabil. 2011; 14: 87-93
- The effect of treadmill training on gross motor function and walking speed in ambulatory adolescents with cerebral palsy: a randomized controlled trial.Am J Phys Med Rehabil. 2012; 91: 747-760
- Randomized controlled trial assessing participation and quality of life in a supported speed treadmill training exercise program vs. a strengthening program for children with cerebral palsy.J Pediatr Rehabil Med. 2012; 5: 75-88
- Treadmill interventions with partial body weight support in children under six years of age at risk of neuromotor delay.Cochrane Database Syst Rev. 2012; : CD009242
- Feasibility of robotic-assisted locomotor training in children with central gait impairment.Dev Med Child Neurol. 2007; 49: 900-906
- Improved gait parameters after robotic-assisted locomotor treadmill therapy in a 6-year-old child with cerebral palsy.Mov Disord. 2008; 23: 280-283
- Safety of robotic-assisted treadmill therapy in children and adolescents with gait impairment: a bi-centre survey.Dev Neurorehabil. 2010; 13: 114-119
- Sustainability of motor performance after robotic-assisted treadmill therapy in children: an open, non-randomized baseline-treatment study.Eur J Phys Rehabil Med. 2010; 46: 125-131
- Robotic-assisted treadmill therapy improves walking and standing performance in children and adolescents with cerebral palsy.Eur J Paediatr Neurol. 2010; 14: 496-502
- Improvement of walking abilities after robotic-assisted locomotion training in children with cerebral palsy.Arch Dis Child. 2009; 94: 615-620
- Improved gait after repetitive locomotor training in children with cerebral palsy.Am J Phys Med Rehabil – Assoc Acad Physiatr. 2011; 90: 137-149
- Should body weight-supported treadmill training and robotic-assistive steppers for locomotor training trot back to the starting gate?.Neurorehabil Neural Repair. 2012; 26: 308-317
- Effectiveness of treadmill training in children with motor impairments: an overview of systematic reviews.Pediatr Phys Ther. 2010; 22: 361-377
- Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Surveillance of Cerebral Palsy in Europe (SCPE).Dev Med Child Neurol. 2000; 42: 816-824
- Outcome tools used for ambulatory children with cerebral palsy: responsiveness and minimum clinically important differences.Dev Med Child Neurol. 2008; 50: 918-925
- Effects of a supported speed treadmill training exercise program on impairment and function for children with cerebral palsy.Dev Med Child Neurol. 2011; 53: 742-750
- Efficacy of partial body weight-supported treadmill training compared with overground walking practice for children with cerebral palsy: a randomized controlled trial.Arch Phys Med Rehabil. 2010; 91: 333-339
- Stability and decline in gross motor function among children and youth with cerebral palsy aged 2 to 21 years.Dev Med Child Neurol. 2009; 51: 295-302
- The Canadian Occupational Performance Measure: a research and clinical literature review.Can J Occup Ther. 2004; 71: 210-222
- A comparison of goal attainment scaling and the Canadian Occupational Performance Measure for paediatric rehabilitation research.Pediatr Rehabil. 2006; 9: 149-157
Published online: April 24, 2014
Accepted: April 4, 2014
Received in revised form: March 31, 2014
Received: February 13, 2013
© 2014 Published by Elsevier Inc.