Improvement of walking abilities after robotic-assisted locomotion training in children with cerebral palsy

Meyer-Heim, Andreas; Ammann-Reiffer, Corinne; Schmartz, A.; Schäfer, J.; Sennhauser, Felix H.; Heinen, Florian; Knecht, Beat; Dabrowski, Edward; Borggraefe, Ingo

doi:10.1136/adc.2008.145458

Cited by 125 publications

(87 citation statements)

References 31 publications

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“…However, this measure has not been used in gait trainer research and use with only a few children at GMFCS level IV has been demonstrated in studies investigating body-weight support treadmill training [77] and robotic step training [80]. One study [43] states that the 6-min walk test [41] is not valid for young children who walk with walking aids following pilot testing with children at GMFCS III.…”

Section: Discussionmentioning

confidence: 99%

Measuring Outcomes for Children with Cerebral Palsy Who Use Gait Trainers

Livingstone

Paleg

2016

Technologies

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Gait trainers are walking devices that provide additional trunk and pelvic support. The primary population of children using gait trainers includes children with cerebral palsy (CP) functioning at Gross Motor Function Classification System (GMFCS) levels IV and V. A recent systematic review found that evidence supporting the effectiveness of gait trainer interventions for children was primarily descriptive and insufficient to draw firm conclusions. A major limitation identified was the lack of valid, sensitive and reliable tools for measuring change in body structure and function, activity and participation outcomes. Twelve different clinical tools were identified in the systematic review and in this paper we review and discuss the evidence supporting their reliability, validity and clinical utility for use with children using gait trainers. We also describe seven additional clinical measurement tools that may be useful with this intervention and population. The Pediatric Evaluation of Disability Inventory (PEDI) rated highest across all areas at this time. Individualized outcome measures, such as the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling and measuring user satisfaction with tools, such as the Quebec User Evaluation of Satisfaction with assistive Technology, show potential for gait trainer outcomes research. Spatiotemporal measures appear to be less useful than functional measures with this intervention and population. All tools would benefit from further development for use with children with CP functioning at GMFCS levels IV and V.

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Section: Discussionmentioning

confidence: 99%

Measuring Outcomes for Children with Cerebral Palsy Who Use Gait Trainers

Livingstone

Paleg

2016

Technologies

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“…For example, as partial bodyweight support during gait training is shown to allow the child to practice walking at a faster pace, 20 apparently, many clinical researchers consider an improvement in speed as the main therapeutic goal of RATT. [21][22][23][24] However, training protocols and device applications are variable and in general it remains unclear how a patient's walking ability within such devices becomes affected when specific, modifiable parameters such as walking speed, bodyweight support, and assistive force of the device are varied. Recently published recommendations 25 provide no complete answers as how to adjust training settings within a single and over multiple training sessions.…”

Section: Introduction: a Summary Of Pertinent Researchmentioning

confidence: 99%

Practical Recommendations for Robot-Assisted Treadmill Therapy (Lokomat) in Children with Cerebral Palsy: Indications, Goal Setting, and Clinical Implementation within the WHO-ICF Framework

Warken

Graser

Ulrich³

et al. 2015

Neuropediatrics

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Active participation and the highest level of independence during daily living are primary goals in neurorehabilitation. Therefore, standing and walking are key factors in many rehabilitation programs. Despite inconclusive evidence considering the best application and efficacy of robotic tools in the field of pediatric neurorehabilitation, robotic technologies have been implemented to complement conventional therapies in recent years. A group of experienced therapists and physicians joined in an "expert panel." They compared their clinical application protocols, discussed recurring open questions, and developed experience-based recommendations for robot-assisted treadmill therapy (exemplified by the Lokomat, Hocoma, Volketswil, Switzerland) with a focus on children with cerebral palsy. Specific indications and therapeutic goals were defined considering the severity of motor impairments and the International Classification of Functioning, Disability and Health framework (ICF). After five meetings, consensus was found and recommendations for the implementation of robot-assisted treadmill therapy including postsurgery rehabilitation were proposed. This article aims to provide a comprehensive overview on therapeutical applications in a fast developing field of medicine, where scientific evidence is still scarce. These recommendations can help physicians and therapists to plan the child's individual therapy protocol of robot-assisted treadmill therapy.

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“…Der Einsatz neuer Therapieformen [z. B. Laufbandtherapie, "robotic medicine" und "constraint indu ced movement therapie" (CIMT)] stellt hier eine geeignete Möglichkeit zum ge zielten Kraft und Ausdaueraufbau dar und ermöglicht es, den Therapieeffekt zu objektivieren [6,21,26,27,31].…”

Section: Update 2009unclassified

Botulinum toxin as part of an integrative therapeutic approach

Schröder

Huß

Berweck

et al. 2009

Monatsschr Kinderheilkd

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LeitthemaSeit den 1990er Jahren hat Botulinum toxin (BoNT) als therapeutisches Prin zip immer neue Indikationsfelder er schlossen und nimmt in der Erwach senenmedizin, aber auch in der Pädia trie sowie der kosmetischen Indus trie mittlerweile einen großen Stel lenwert ein. Neben reißerischen und nicht fundierten Schlagzeilen im Zu sammenhang mit kosmetischen In dikationen besteht weiterhin Bedarf an einer seriösen Auseinanderset zung mit Aspekten der Anwendung und der Sicherheit bei der Behand lung mit BoNT. Der Effekt von Botu linumtoxin im Verlauf der Therapie ist klinisch zwar erforscht, das Ver ständnis bezüglich der strukturellen Effekte ist jedoch unvollständig. Die se Lücken im Verständnis des Wirk effektes gilt es zu schließen.

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Improvement of walking abilities after robotic-assisted locomotion training in children with cerebral palsy

Cited by 125 publications

References 31 publications

Measuring Outcomes for Children with Cerebral Palsy Who Use Gait Trainers

Measuring Outcomes for Children with Cerebral Palsy Who Use Gait Trainers

Practical Recommendations for Robot-Assisted Treadmill Therapy (Lokomat) in Children with Cerebral Palsy: Indications, Goal Setting, and Clinical Implementation within the WHO-ICF Framework

Botulinum toxin as part of an integrative therapeutic approach

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