Abstract
BackgroundThe use of robotic trainers has increased with the aim of improving gait function in patients with limitations. Nevertheless, there is an absence of studies that deeply describe detailed guidelines of how to correctly implement robot-based treatments for gait rehabilitation. This contribution proposes an accurate robot-based training program for gait rehabilitation of pediatric population with Cerebral Palsy (CP).MethodsThe program is focused on the achievement of some specifications defined by the International Classification of Functioning, Disability and Health framework, Children and Youth version (ICF-CY). It is framed on 16 non-consecutive sessions where motor control, strength and power exercises of lower limbs are performed in parallel with a postural control strategy. A clinical evaluation with four pediatric patients with CP using the CPWalker robotic platform is presented.ResultsThe preliminary evaluation with patients with CP shows improvements in several aspects as strength (74.03 ± 40.20%), mean velocity (21.46 ± 33.79%), step length (17.95 ± 20.45%) or gait performance (e.g. 66 ± 63.54% in Gross Motor Function Measure-88 items, E and D dimensions).ConclusionsThe improvements achieved in the short term show the importance of working strength and power functions meanwhile over-ground training with postural control. This research could serve as preliminary support for future clinical implementations in any robotic device.Trial registrationThe study was carried out with the number R-0032/12 from Local Ethical Committee of the Hospital Infantil Niño Jesús. Public trial registered on March 23, 2017: ISRCTN18254257.
Highlights
The use of robotic trainers has increased with the aim of improving gait function in patients with limitations
Rehabilitation device The CPWalker rehabilitation platform [7] is a robotic device composed by an exoskeleton linked to a walker that provides support and balance to the child during over-ground training (Fig. 1)
Endurance and global responses All patients improved the outcomes in D and E dimensions of the Gross motor function measure (GMFM)-88 scale [26] (Fig. 6a)
Summary
The use of robotic trainers has increased with the aim of improving gait function in patients with limitations. There is an absence of studies that deeply describe detailed guidelines of how to correctly implement robot-based treatments for gait rehabilitation. A new generation of robotic devices [6,7,8] provides means for encouraging the patients to an active participation in exercises, which are more task specific. Both the implemented novel control strategies and. New approaches are needed in order to improve the rehabilitation, making the robotic therapy a key feature of the change
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