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Home-Based Versus Laboratory-Based Robotic Ankle Training for Children With Cerebral Palsy: A Pilot Randomized Comparative Trial

Published:February 20, 2016DOI:https://doi.org/10.1016/j.apmr.2016.01.029

      Abstract

      Objective

      To examine the outcomes of home-based robot-guided therapy and compare it to laboratory-based robot-guided therapy for the treatment of impaired ankles in children with cerebral palsy.

      Design

      A randomized comparative trial design comparing a home-based training group and a laboratory-based training group.

      Setting

      Home versus laboratory within a research hospital.

      Participants

      Children (N=41) with cerebral palsy who were at Gross Motor Function Classification System level I, II, or III were randomly assigned to 2 groups. Children in home-based and laboratory-based groups were 8.7±2.8 (n=23) and 10.7±6.0 (n=18) years old, respectively.

      Interventions

      Six-week combined passive stretching and active movement intervention of impaired ankle in a laboratory or home environment using a portable rehabilitation robot.

      Main Outcome Measures

      Active dorsiflexion range of motion (as the primary outcome), mobility (6-minute walk test and timed Up and Go test), balance (Pediatric Balance Scale), Selective Motor Control Assessment of the Lower Extremity, Modified Ashworth Scale (MAS) for spasticity, passive range of motion (PROM), strength, and joint stiffness.

      Results

      Significant improvements were found for the home-based group in all biomechanical outcome measures except for PROM and all clinical outcome measures except the MAS. The laboratory-based group also showed significant improvements in all the biomechanical outcome measures and all clinical outcome measures except the MAS. There were no significant differences in the outcome measures between the 2 groups.

      Conclusions

      These findings suggest that the translation of repetitive, goal-directed, biofeedback training through motivating games from the laboratory to the home environment is feasible. The benefits of home-based robot-guided therapy were similar to those of laboratory-based robot-guided therapy.

      Keywords

      List of abbreviations:

      6MWT (6-minute walk test), AROM (active range of motion), CP (cerebral palsy), GMFCS (Gross Motor Function Classification System), PBS (Pediatric Balance Scale), PROM (passive range of motion), SCALE (Selective Control Assessment of the Lower Extremity), TUG (timed Up and Go)
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