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http://dx.doi.org/10.13066/kspm.2021.16.3.123

Effect of an End-effector Type of Robotic Gait Training on Stand Capability, Locomotor Function, and Gait Speed in Individuals with Spastic Cerebral Palsy  

Hwang, Jongseok (Botrium Rehabilitation Center)
Publication Information
Journal of the Korean Society of Physical Medicine / v.16, no.3, 2021 , pp. 123-130 More about this Journal
Abstract
PURPOSE: Robotic gait training is being used increasingly to improve the gross motor performance and gait speed. The present study examined the effectiveness of a novel end-effector type of robotic gait training (RGT) system on standing, walking, running, and jumping functions, as well as the gait speed in children with spastic cerebral palsy. METHODS: Eleven children with spastic cerebral palsy Gross Motor Function Classification System (GMFCS) levels I-III (6 males; age range, 15.09 ± 1.44 years) were examined. They underwent 24 sessions (30 minutes/sessions, one time/day, three days/week for eight consecutive weeks) of RGT. The Gross Motor Function Measure-88 D domain (GMFM D), and GMFM E were assessed with a pretest and posttest of RGT. The setting was a one-group pretest-posttest design. RESULTS: A comparison of the pre-test and post-test show that the outcomes in post-test of GMFM D (p < .01), GMFM E (p < .05), and 10MWT were improved significantly after RGT intervention. CONCLUSION: The present study provided the first evidence on the effects of an eight-weeks RGT intervention in participants with spastic CP. The outcomes of this clinical study showed that standing performance, locomotion function, and gait speed increased in after 24 sessions of the end-effector RGT system in children with spastic cerebral palsy.
Keywords
10-meter walking test; End-effector; GMFM; Robotic gait training; Spastic cerebral palsy;
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  • Reference
1 Ko J, Kim M. Reliability and Responsiveness of the Gross Motor Function Measure-88 in Children With Cerebral Palsy. Physical therapy. 93-9.
2 Kenyon LK. Gross Motor Function Measure (GMFM-66 and GMFM-88) Users' Manual. Physical & Occupational Therapy In Pediatrics. 2014;34(3):341-2.   DOI
3 Steffen TM, Hacker TA, Mollinger L. Age-and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther. 2002;82(2):128-37.   DOI
4 Schroeder A, Homburg M, Warken B, et al. Prospective controlled cohort study to evaluate changes of function, activity and participation in patients with bilateral spastic cerebral palsy after Robot-enhanced repetitive treadmill therapy. Eur J Paediatr Neurol. 2014;18(4):502-10.   DOI
5 Wallard L, Dietrich G, Kerlirzin Y, et al. Robotic-assisted gait training improves walking abilities in diplegic children with cerebral palsy. Eur J Paediatr Neurol. 2017;21(3):557-64.   DOI
6 Meyer-Heim A, Borggraefe I, Ammann-Reiffer C, et al. Feasibility of robotic-assisted locomotor training in children with central gait impairment. Dev Med Child Neurol. 2007;49(12):900-6.   DOI
7 Opheim A, Jahnsen R, Olsson E, et al. Walking function, pain, and fatigue in adults with cerebral palsy: a 7-year follow-up study. Dev Med Child Neurol. 2009;51(5):381-8.   DOI
8 Allum JH, Carpenter MG. A speedy solution for balance and gait analysis: angular velocity measured at the centre of body mass. Curr Opin Neurol. 2005;18(1):15-21.   DOI
9 Scrivener K, Sherrington C, Schurr K. Exercise dose and mobility outcome in a comprehensive stroke unit: description and prediction from a prospective cohort study. J Rehabil Med. 2012;44(10):824-9.   DOI
10 Berger A, Horst F, Muller S, et al. Current state and future prospects of EEG and fNIRS in robot-assisted gait rehabilitation: A brief review. Front Hum Neurosci. 2019;13:172.   DOI
11 Garvey MA, Giannetti ML, Alter KE, et al. Cerebral palsy: new approaches to therapy. Curr Neurol Neurosci Rep. 2007;7(2):147-55.   DOI
12 Smania N, Bonetti P, Gandolfi M, et al. Improved gait after repetitive locomotor training in children with cerebral palsy. Am J Phys Med Rehabil. 2011;90(2):137-49.   DOI
13 Fine MS, Thoroughman KA. Motor adaptation to single force pulses: sensitive to direction but insensitive to within-movement pulse placement and magnitude. J Neurophysiol. 2006;96(2):710-20.   DOI
14 Tsorlakis N, Evaggelinou C, Grouios G, et al. Effect of intensive neurodevelopmental treatment in gross motor function of children with cerebral palsy. Dev Med Child Neurol. 2004;46(11):740-5.   DOI
15 Schwartz I, Sajin A, Fisher I, et al. The effectiveness of locomotor therapy using robotic-assisted gait training in subacute stroke patients: a randomized controlled trial. Pm r. 2009;1(6):516-23.   DOI
16 De Santis D, Zenzeri J, Casadio M, et al. Robot-assisted training of the kinesthetic sense: enhancing proprioception after stroke. Front Hum Neurosci. 2014;8:1037.   DOI
17 Morone G, Paolucci S, Cherubini A, et al. Robot-assisted gait training for stroke patients: current state of the art and perspectives of robotics. Neuropsychiatr Dis Treat. 2017;13:1303.   DOI
18 Lang CE, MacDonald JR, Gnip C. Counting repetitions: an observational study of outpatient therapy for people with hemiparesis post-stroke. J Neurol Phys Ther. 2007;31(1):3-10.   DOI
19 Boyd LA, Winstein CJ. Explicit information interferes with implicit motor learning of both continuous and discrete movement tasks after stroke. J Neurol Phys Ther. 2006;30(2):46-57.   DOI
20 Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007;109(suppl 109):8-14.
21 Sanger TD, Chen D, Delgado MR, et al. Definition and classification of negative motor signs in childhood. Pediatrics. 2006;118(5):2159-67.   DOI
22 Pakula AT, Braun KVN, Yeargin-Allsopp M. Cerebral palsy: classification and epidemiology. Physical Medicine and Rehabilitation Clinics. 2009;20(3):425-52.
23 Blondis T. Developmental motor disorders: A neuropsychological perspective. 2004.
24 Gage JR. Gait analysis. An essential tool in the treatment of cerebral palsy. Clinical orthopaedics and related research. 1993(288):126-34.
25 Houlihan CM. Walking function, pain, and fatigue in adults with cerebral palsy. Dev Med Child Neurol. 2009;51(5):338.   DOI
26 Bohm H, Hosl M, Schwameder H, et al. Stiff-knee gait in cerebral palsy: how do patients adapt to uneven ground? Gait Posture. 2014;39(4):1028-33.   DOI
27 Dodd KJ, Taylor NF, Graham HK. A randomized clinical trial of strength training in young people with cerebral palsy. Dev Med Child Neurol. 2003;45(10):652-7.   DOI
28 Bidabe D, Barnes S, Whinnery K. MOVE: Raising expectations for individuals with severe disabilities. Physical Disabilities: Education and Related Services. 2001;19(2):31-48.
29 Dias D, Lains J, Pereira A, et al. Can we improve gait skills in chronic hemiplegics? A randomised control trial with gait trainer. Eura Medicophys. 2007;43(4):499.
30 Hesse S, Uhlenbrock D. A mechanized gait trainer for restoration of gait. Journal of rehabilitation research and development. 2000;37(6):701-8.
31 Novacheck TF, Gage JR. Orthopedic management of spasticity in cerebral palsy. Childs Nerv Syst. 2007;23(9):1015-31.   DOI
32 Goldstein M, Harper DC. Management of cerebral palsy: equinus gait. Dev Med Child Neurol. 2001;43(8):563-9.   DOI
33 Cahill-Rowley K, Rose J. Etiology of impaired selective motor control: emerging evidence and its implications for research and treatment in cerebral palsy. Dev Med Child Neurol. 2014;56(6):522-8.   DOI
34 Sutherland DH, Davids JR. Common gait abnormalities of the knee in cerebral palsy. Clinical orthopaedics and related research. 1993(288):139-47.
35 Damiano DL. Activity, activity, activity: rethinking our physical therapy approach to cerebral palsy. Phys Ther. 2006;86(11):1534-40.   DOI
36 Eagleton M, Iams A, McDowell J, et al. The effects of strength training on gait in adolescents with cerebral palsy. Pediatr Phys Ther. 2004;16(1):22-30.   DOI
37 Pirpiris M, Wilkinson AJ, Rodda J, et al. Walking speed in children and young adults with neuromuscular disease: comparison between two assessment methods. Journal of Pediatric Orthopaedics. 2003;23(3):302-7.   DOI