ATLAS2030 Pediatric Gait Exoskeleton: Changes on Range of Motion, Strength and Spasticity in Children With Cerebral Palsy. A Case Series Study

Abstract

Background: Cerebral Palsy (CP), the most common motor disability in childhood, affects individual's motor skills, movement and posture. This results in limited activity and a low social participation. The ATLAS2030 exoskeleton is a pediatric device that enables gait rehabilitation for children with neurological or neuromuscular pathologies with gait pathology.Purpose: To study changes in relation to range of motion (ROM), strength and spasticity in children with CP after using the ATLAS2030 gait exoskeleton.Methods and Participants: Three children (mean age 8.0 ± 2.0), two girls and one boy, two of them with GMFCS IV and one with GMFCS III, received robot-assisted gait training (RAGT) with ATLAS2030 for one month.Results: The average time of exoskeleton use was 54.7 ± 10.4 min in all sessions, and all participants were able to perform all exercises. The strength of all muscle groups was increased after the 10 sessions for the participants assessed and the limited ROM in the sagittal plane (hip and knee extension and ankle dorsiflexion) decreased after the use of the exoskeleton compared to the initial state. Spasticity was reduced at the end of the sessions after the use of the exoskeleton compared to their initial state.Conclusion: The ROM, spasticity and strength were improved after RAGT with ATLAS2030 exoskeleton in these children with CP. However, further studies with larger samples should be carried out to confirm our findings.

Effects of ATLAS 2030 gait exoskeleton on strength and range of motion in children with spinal muscular atrophy II: a case series

“…Other studies have evaluated changes in maximal isometric strength exerted in children diagnosed with cerebral palsy. Bayón et al [26] with CPWalker (CSIC, Spain) and Delgado et al [17] with ATLAS2030 (Marsi Bionics, Spain) found improvements in strength after 8 weeks and 4 weeks of training with a walking exoskeleton, mainly showed important peaks of improvement for hip and knee flexion-extension, in line with our study. However, Kuroda et al [27] with HAL ® (Cyberdine, Japan) reported a decrease in knee extensors strength during 4-week training.…”

“…The main differences between the ATLAS 2030 and its research prototype are in software upgrades, exoskeleton torso structure, battery and orthotics. In addition, ATLAS 2030 has been tested in children with cerebral palsy obtaining good results in ROM, strength and spasticity after the use of the exoskeleton [ 17 ].…”

Design and Control of a Size-Adjustable Pediatric Lower-Limb Exoskeleton Based on Weight Shift

“…Bayon et al [30] designed an exoskeleton for CP children with 6 active DOFs at the hip, knee, and ankle, although requiring a smart walker to ensure balance. Similar designs with extra walker are also proposed for CP or SMA 2 children [31], [32]. However, the walker limited the mobility and the patient only follows a fixed gait pattern where the capability of maintaining balance is not trained.…”

Mechanical Design of an Exoskeleton with Joint-Aligning Mechanism for Children with Cerebral Palsy

“…Bayon et al [30] designed an exoskeleton for CP children with 6 active DOFs at the hip, knee, and ankle, although requiring a smart walker to ensure balance. Similar designs with extra walker are also proposed for CP or SMA 2 children [31], [32]. However, the walker limited the mobility and the patient only follows a fixed gait pattern where the capability of maintaining balance is not trained.…”