Abstract
Robot assisted gait training (RAGT) and virtual reality plus treadmill training (VRTT) are two technologies that can support locomotion rehabilitation in children and adolescents affected by acquired brain injury (ABI). The literature provides evidence of their effectiveness in this population. However, a comparison between these methods is not available. This study aims at comparing the effectiveness of RAGT and VRTT for the gait rehabilitation of children and adolescents suffering from ABI. This is a prospective cohort study with propensity score matching. Between October 2016 and September 2018, all patients undergoing an intensive gait rehabilitation treatment based on RAGT or VRTT were prospectively observed. To minimize selection bias associated with the study design, patients who underwent RAGT or VRTT were retrospectively matched for age, gender, time elapsed from injury, level of impairment, and motor impairment using propensity score in a matching ratio of 1:1. Outcome measures were Gross Motor Function Mesure-88 (GMFM-88), six-min walking test (6MWT), Gillette Functional Assessment Questionnaire (FAQ), and three-dimensional gait analysis (GA). The FAQ and the GMFM-88 had a statistically significant increase in both groups while the 6MWT improved in the RAGT group only. GA highlighted changes at the proximal level in the RAGT group, and at the distal district in the VRTT group. Although preliminary, this work suggests that RAGT and VRTT protocols foster different motor improvements, thus recommending to couple the two therapies in the paediatric population with ABI.
Highlights
Acquired brain injury (ABI), occurred after a period of normal development, is one of the main causes of death and neurologic disability in children after infancy [1]
The inability of patients to perform test, 6 min walking test distance (6MWT) was performed in 32 patients in the robot-assisted gait training (RAGT) group and 28 patients in the virtual reality plus treadmill training (VRTT)
A test, 6MWT was performed in 32 patients in the RAGT group and 28 patients in the group, Functional Assessment Questionnaire (FAQ) was present for 38 patients in the RAGT group and 15 patients in the VRTT
Summary
Acquired brain injury (ABI), occurred after a period of normal development, is one of the main causes of death and neurologic disability in children after infancy [1]. One of the primary rehabilitation goals for children and adolescents suffering from ABI is the improvement of walking ability, in terms of pattern, quality, and independence. Robot-assisted gait training (RAGT) is widely used in the gait rehabilitation of adults with different diseases such as stroke, spinal cord injury, and multiple sclerosis [3,4,5,6], as well as of children and adolescents with neuro-motor impairment [7]. The most common gait rehabilitation robots available for the developmental age are exoskeletons. These devices operate mechanically on the human body by means of cuffs connected to the patient’s lower limbs. The impact of RAGT on the gait pattern of children with
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