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Robotic Resistance Treadmill Training Improves Locomotor Function in Children With Cerebral Palsy: A Randomized Controlled Pilot Study

      Highlights

      • Children with cerebral palsy underwent 6 weeks (3 times a week) of robotic treadmill training.
      • An assistance/resistance load was applied to both legs to help/hinder the swing phase.
      • Resistance training is more effective than assistance training in improving walking function.

      Abstract

      Objective

      To determine whether applying controlled resistance forces to the legs during the swing phase of gait may improve the efficacy of treadmill training as compared with applying controlled assistance forces in children with cerebral palsy (CP).

      Design

      Randomized controlled study.

      Setting

      Research unit of a rehabilitation hospital.

      Participants

      Children with spastic CP (N=23; mean age, 10.6y; range, 6–14y; Gross Motor Function Classification System levels, I–IV).

      Interventions

      Participants were randomly assigned to receive controlled assistance (n=11) or resistance (n=12) loads applied to the legs at the ankle. Participants underwent robotic treadmill training 3 times a week for 6 weeks (18 sessions). A controlled swing assistance/resistance load was applied to both legs starting from the toe-off to mid-swing phase of gait during training.

      Main Outcome Measures

      Outcome measures consisted of overground walking speed, 6-minute walk distance, and Gross Motor Function Measure scores and were assessed pre and post 6 weeks of training and 8 weeks after the end of training.

      Results

      After 6 weeks of treadmill training in participants from the resistance training group, fast walking speed and 6-minute walk distance significantly improved (18% and 30% increases, respectively), and 6-minute walk distance was still significantly greater than that at baseline (35% increase) 8 weeks after the end of training. In contrast, overground gait speed and 6-minute walk distance had no significant changes after robotic assistance training.

      Conclusions

      The results of the present study indicated that robotic resistance treadmill training is more effective than assistance training in improving locomotor function in children with CP.

      Keywords

      List of abbreviations:

      ANOVA (analysis of variance), CP (cerebral palsy), GMFCS (Gross Motor Function Classification System), GMFM (Gross Motor Function Measure), IQR (interquartile range), RPE (rating of perceived exertion)
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