The Effectiveness of Robotic Gait Training in Children With Neurological Impairment

IRCCS Eugenio Medea200 enrolled

Overview

The recovery of walking ability is one of the primary rehabilitation goals for children with neurological impairment. The aim of the study is to investigate the clinical effectiveness of rehabilitation treatments based of Robotic-Assisted Gait Training (RAGT). Additional goals of the research are to identify the specific effects of RAGT in children with different etiologies (acquired brain injury and cerebral palsy) and with different levels of function (according to the Gross Motor Function Classification System).

Study Type

OBSERVATIONAL

Enrollment

200

Conditions

Acquired Brain Injury Cerebral Palsy

Interventions

Robotic Assisted Gait Training (Lokomat)DEVICE

The RAGT treatment consisted of sessions lasting 45 minutes each performed with the commercially available Lokomat device. The same exercises were offered to the children with preset duration, speed, and difficulty. For all patients, the initial body-weight support was set at 50%, and was then gradually decreased according to the individual functional capacity. The guidance force was initially set to 100% for all children, and then gradually reduced.

PhysiotherapyPROCEDURE

The physiotherapic sessions aimed at strengthening the gluteus and quadriceps muscles, stretching the hip flexor and hamstrings muscles, increasing static balance, increasing dynamic balance, increasing functional abilities, improving ground gait and climbing stairs.

Eligibility

Sex: ALLMin age: 4 YearsMax age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Diagnosis of acquired brain injury in pediatric age and adolescence (4 to 18 years) or cerebral palsy; * Femur length of at least 23 cm; * Patients able to signal pain, fear or discomfort reliably and to follow simple instructions. Exclusion Criteria: * injection of botulinum toxin during the 6 months prior to the enrollment; * oral medications reducing muscle tone; * previous orthopedic surgery; * severe lower-extremity contractures; * fractures or osseous instabilities; * osteoporosis; * contraindication of full body load due to previous surgeries; * severe retarded bone growth; * unhealed skin lesions in the lower-extremities; * thromboembolic diseases * cardiovascular instability * acute or progressive neurological disorders * aggressive or self-harming behavior.

Locations (1)

Scientific Institute IRCCS E. Medea

Bosisio Parini, Lecco, Italy

Outcomes

Primary Outcomes

Change in 6minWT distance walked

The 6-minute walk test (6minWT) was used to assess endurance during self-paced, submaximal walk by measuring the distance walked within 6 minutes along a standardized route through the hospital corridors.