Hubertus J A van Hedel1,2,3, Andreas Meyer-Heim1,2,3, Christina Rüsch-Bohtz1,2. 1. a Rehabilitation Center Affoltern am Albis, University Children's Hospital Zurich , Affoltern am Albis , Zurich , Switzerland. 2. b Children's Research Center, University Children's Hospital Zurich , Affoltern am Albis , Zurich , Switzerland , and. 3. c Neuroscience Center Zurich (ZNZ) , Zurich , Switzerland.
Abstract
PURPOSE: Robot-assisted gait training (RAGT) can complement conventional therapies in children with cerebral palsy. We investigated changes in walking-related outcomes between children with different Gross Motor Function Classification System (GMFCS) levels and the dose-response relationship. METHODS: Data from 67 children (3.9-19.9 years) with GMFCS levels II-IV were evaluated retrospectively. Every child received RAGT with the Lokomat complementing a multidisciplinary rehabilitation program. Changes in various walking-related outcomes were assessed. RESULTS: Walking-related outcomes did not improve differently between GMFCS level groups. Significant within-group improvements were mainly observed in children with GMFCS level IV. A dose-response relationship was present for children with GMFCS levels III and IV. CONCLUSIONS: Our results indicated that, although children with a GMFCS level IV walked less during an average Lokomat session, they experienced significant improvements in walking-related outcomes. Further, training dose correlated with changes in walking-related outcomes. However, between-group differences in changes in walking-related outcomes were not significant.
PURPOSE: Robot-assisted gait training (RAGT) can complement conventional therapies in children with cerebral palsy. We investigated changes in walking-related outcomes between children with different Gross Motor Function Classification System (GMFCS) levels and the dose-response relationship. METHODS: Data from 67 children (3.9-19.9 years) with GMFCS levels II-IV were evaluated retrospectively. Every child received RAGT with the Lokomat complementing a multidisciplinary rehabilitation program. Changes in various walking-related outcomes were assessed. RESULTS: Walking-related outcomes did not improve differently between GMFCS level groups. Significant within-group improvements were mainly observed in children with GMFCS level IV. A dose-response relationship was present for children with GMFCS levels III and IV. CONCLUSIONS: Our results indicated that, although children with a GMFCS level IV walked less during an average Lokomat session, they experienced significant improvements in walking-related outcomes. Further, training dose correlated with changes in walking-related outcomes. However, between-group differences in changes in walking-related outcomes were not significant.
Entities:
Keywords:
Congenital brain lesion; Functional Independence Measure for Children (WeeFIM); Gross Motor Function Classification System; Gross Motor Function Measure; Lokomat; dose–response relationship; pediatric neurorehabilitation; timed walking tests; training intensity; walking ability; walking-related outcomes; youth
Authors: Helen Hartley; Elizabeth Cassidy; Lisa Bunn; Ram Kumar; Barry Pizer; Steven Lane; Bernie Carter Journal: Cerebellum Date: 2019-10 Impact factor: 3.847