Gait Changes Following Robot-assisted Gait Training in Children with Cerebral Palsy

Overview

Journal Physiol Res

Specialty Physiology

Date 2022 Jan 31

PMID 35099258

Authors

D Zarkovic

M Sorfova

J J Tufano

P Kutilek

S Viteckova

D Ravnik

K Groleger-Srsen

I Cikajlo

J Otahal

Affiliations

Soon will be listed here.

Abstract

This study investigated changes of gait pattern induced by a 4-week robot-assisted gait training (RAGT) in twelve ambulatory spastic diparesis children with cerebral palsy (CP) aged 10.4+/-3.2 years old by using computerized gait analysis (CGA). Pre-post intervention CGA data of children with CP was contrasted to the normative data of typically developing children by using cross-correlation and statistically evaluated by a Wilcoxon test. Significant pre-post intervention changes (p<0.01) include: decreased muscle activity of biceps femoris, rectus femoris, and tibialis anterior; a decrease in range of internal hip joint rotation, higher cadence, step length, and increased stride time. This study suggests that RAGT can be used in muscle reeducation and improved hip joint motion range in ambulatory children with CP.

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References

Hof A, Elzinga H, Grimmius W, Halbertsma J . Detection of non-standard EMG profiles in walking. Gait Posture. 2005; 21(2):171-7. DOI: 10.1016/j.gaitpost.2004.01.015. View

Sankar C, Mundkur N . Cerebral palsy-definition, classification, etiology and early diagnosis. Indian J Pediatr. 2005; 72(10):865-8. DOI: 10.1007/BF02731117. View

Goldberg E, Fowler E, Oppenheim W . Case reports: the influence of selective voluntary motor control on gait after hamstring lengthening surgery. Clin Orthop Relat Res. 2011; 470(5):1320-6. PMC: 3314745. DOI: 10.1007/s11999-011-2028-2. View

Fowler E, Staudt L, Greenberg M, Oppenheim W . Selective Control Assessment of the Lower Extremity (SCALE): development, validation, and interrater reliability of a clinical tool for patients with cerebral palsy. Dev Med Child Neurol. 2009; 51(8):607-14. DOI: 10.1111/j.1469-8749.2008.03186.x. View

Koopman B, van Asseldonk E, van der Kooij H . Selective control of gait subtasks in robotic gait training: foot clearance support in stroke survivors with a powered exoskeleton. J Neuroeng Rehabil. 2013; 10:3. PMC: 3585791. DOI: 10.1186/1743-0003-10-3. View

Reinkensmeyer D, Aoyagi D, Emken J, Galvez J, Ichinose W, Kerdanyan G . Tools for understanding and optimizing robotic gait training. J Rehabil Res Dev. 2006; 43(5):657-70. DOI: 10.1682/jrrd.2005.04.0073. View

Armand S, Decoulon G, Bonnefoy-Mazure A . Gait analysis in children with cerebral palsy. EFORT Open Rev. 2017; 1(12):448-460. PMC: 5489760. DOI: 10.1302/2058-5241.1.000052. View

Stewart C, Shortland A . The biomechanics of pathological gait - from muscle to movement. Acta Bioeng Biomech. 2011; 12(3):3-12. View

Foran J, Steinman S, Barash I, Chambers H, Lieber R . Structural and mechanical alterations in spastic skeletal muscle. Dev Med Child Neurol. 2005; 47(10):713-7. DOI: 10.1017/S0012162205001465. View

10.

Katz R, Rymer W . Spastic hypertonia: mechanisms and measurement. Arch Phys Med Rehabil. 1989; 70(2):144-55. View

11.

MacWilliams B, Cowley M, Nicholson D . Foot kinematics and kinetics during adolescent gait. Gait Posture. 2003; 17(3):214-24. DOI: 10.1016/s0966-6362(02)00103-0. View

12.

Brunner R, Romkes J . Abnormal EMG muscle activity during gait in patients without neurological disorders. Gait Posture. 2007; 27(3):399-407. DOI: 10.1016/j.gaitpost.2007.05.009. View

13.

Zarkovic D, Sorfova M, Tufano J, Kutilek P, Viteckova S, Groleger-Srsen K . Effect of Robot-Assisted Gait Training on Selective Voluntary Motor Control in Ambulatory Children with Cerebral Palsy. Indian Pediatr. 2020; 57(10):964-966. PMC: 7605485. View

14.

Wu M, Kim J, Gaebler-Spira D, Schmit B, Arora P . Robotic Resistance Treadmill Training Improves Locomotor Function in Children With Cerebral Palsy: A Randomized Controlled Pilot Study. Arch Phys Med Rehabil. 2017; 98(11):2126-2133. PMC: 5660940. DOI: 10.1016/j.apmr.2017.04.022. View

15.

Druzbicki M, Rusek W, Snela S, Dudek J, Szczepanik M, Zak E . Functional effects of robotic-assisted locomotor treadmill thearapy in children with cerebral palsy. J Rehabil Med. 2013; 45(4):358-63. DOI: 10.2340/16501977-1114. View

16.

Meyer-Heim A, Borggraefe I, Ammann-Reiffer C, Berweck S, Sennhauser F, Colombo G . Feasibility of robotic-assisted locomotor training in children with central gait impairment. Dev Med Child Neurol. 2007; 49(12):900-6. DOI: 10.1111/j.1469-8749.2007.00900.x. View

17.

SUTHERLAND D, Davids J . Common gait abnormalities of the knee in cerebral palsy. Clin Orthop Relat Res. 1993; (288):139-47. View

18.

Colombo G, JOERG M, Schreier R, Dietz V . Treadmill training of paraplegic patients using a robotic orthosis. J Rehabil Res Dev. 2001; 37(6):693-700. View

19.

Riener R, Lunenburger L, Jezernik S, Anderschitz M, Colombo G, Dietz V . Patient-cooperative strategies for robot-aided treadmill training: first experimental results. IEEE Trans Neural Syst Rehabil Eng. 2005; 13(3):380-94. DOI: 10.1109/TNSRE.2005.848628. View

20.

Burden A, Bartlett R . Normalisation of EMG amplitude: an evaluation and comparison of old and new methods. Med Eng Phys. 1999; 21(4):247-57. DOI: 10.1016/s1350-4533(99)00054-5. View