Improvement of motor performance in children with cerebral palsy treated with exoskeleton robotic training: A retrospective explorative analysis¹

Article type: Research Article

Authors: Digiacomo, Fabio^a | Tamburin, Stefano^{b; *} | Tebaldi, Stefano^a | Pezzani, Marco^a | Tagliafierro, Mario^a | Casale, Roberto^c | Bartolo, Michelangelo^{a; *}

Affiliations: [a] Department of Rehabilitation, Pediatric Neurorehabilitation Unit, Habilita, Zingonia (Bergamo), Italy | [b] Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy | [c] Scientific Direction, Habilita, Zingonia (Bergamo), Italy

Correspondence: [*] Corresponding authors. Michelangelo Bartolo, MD, PhD, Department of Rehabilitation, Neurorehabilitation Unit, HABILITA, via Bologna, 1, 24040 Zingonia/Ciserano, Bergamo, Italy. Tel.: +39 035 4815511; Fax: +39 035 882402; E-mail: [email protected], and Stefano Tamburin, MD, PhD, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, GB Rossi Hospital, Piazzale Scuro 10, 37134 Verona, Italy. Tel.: +39 347 5235580; Fax: +39 045 8027276; E-mail: [email protected].

Note: [1] This article received a correction notice (Erratum) with the reference: 10.3233/RNN-200001, available at https://content.iospress.com/articles/restorative-neurology-and-neuroscience/rnn200001.

Abstract: Background:Robot-assisted gait training (RAGT) is widely used in children with cerebral palsy (CP), but information about optimal intervention frequency and duration is still lacking and the current evidence about effect of RAGT on motor endurance and fitness is very preliminary. Objective:To investigate the effect of RAGT on motor performance and endurance in children affected by CP. Methods:Data from 14 consecutive children (6 females, age range: 4.6–15.8 years) affected by CP, who underwent a multidisciplinary rehabilitation program during a 18–24 month period, were retrospectively collected. Rehabilitation program included conventional physical therapy and RAGT (60/60 minutes, 20 daily sessions, 5 days/week). CP severity was stratified according to the Gross Motor Function Classification System. Clinical evaluation was performed by means of the six-minute walking test, the modified Ashworth scale, and RAGT measures (total distance, mean distance for session and speed). Results:Clinical outcomes and speed did not improve after treatment, while total distance (p = 0.006) and mean distance for session (p = 0.007) significantly improved. Conclusions:Our preliminary study suggests that RAGT combined with conventional treatment may improve motor performance and endurance in children with CP. Future randomized controlled trials comparing RAGT to conventional treatment are needed.

Keywords: Robotic gait training, cerebral palsy, endurance, neurorehabilitation, outcome

DOI: 10.3233/RNN-180897

Journal: Restorative Neurology and Neuroscience, vol. 37, no. 3, pp. 239-244, 2019