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)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 20, 2016
Footnotes
Supported by the National Institute on Disability and Rehabilitation Research (grant no. H133E100007), the National Institutes of Health (grant nos. R42HD043664 and UL1TR00150), and the National Science Foundation (grant no. IIP-0750515).
Clinical Trial Registration No.: NCT02359799.
Disclosures: L.-Q.Z. and Y.R. hold equity positions in Rehabtek LLC, which received funding from the National Institutes of Health (grant no. R42HD043664) and National Science Foundation (grant no. IIP-0750515) for developing the rehabilitation robot used in this study. The other authors have nothing to disclose.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
