Evidence-informed clinical perspectives on selecting gait trainer features for children with cerebral palsy

Abstract

Background/Aims: Children with cerebral palsy often use gait trainers to augment their mobility. These are supportive walking devices that take the weight of the body through a solid or fabric ‘seat’, stabilise the trunk, and support the pelvis. The purpose of this analysis article is to review the evidence and clinical considerations influencing the selection of gait trainer features for children with cerebral palsy and to describe gait trainer models. Methods: A scoping methodology was used to identify any relevant research and clinical literature supporting the selection of different gait trainer features. An internet search was undertaken to identify a wide range of gait trainers currently available. Factors influencing the selection of different gait trainer features including frame and wheel style and support options are discussed, combining information from manufacturers’ websites, expert opinion and evidence from the literature review. Results: Twenty-seven articles were included in this study. These included nine intervention studies, three articles describing gait trainer development, three expert opinion articles, a survey of therapist opinion and a study comparing physical properties of three different gait trainers. In addition information on device features relevant to gait trainers was drawn from 10 intervention studies of children using hand-held walkers. Twenty-four different gait trainers were identified as being commercially available in the UK, Canada and USA at time of searching. Conclusions: Evidence supporting selection of gait trainer styles and features for children with cerebral palsy is very limited. Further research is needed in all aspects of gait trainer assessment, selection and implementation. Clinical consensus may be helpful in providing guidance in decision-making around prescription and use of gait trainers and features for children with cerebral palsy who have differing clinical profiles and needs.