Cerebral palsy is the most common motor disorder in children, and it is difficult to realize the correct behavior of walking due to muscle weakness and muscle stiffness. Recently, robot assisted gait training has been applied to provide visual feedback through virtual reality programs along with repetitive training using treadmill for functional gait training. However, research on the effects of robotic gait training on children with cerebral palsy is insufficient.
Chart reviews were assessed the effectiveness of the robot assisted gait training (RAGT) by examining the medical records of children with cerebral palsy who had received child robot assisted gait training using the Lokomat(Hocoma AG, Swiss) from January 2016 to June 2019. This study investigated age, sex, type of cerebral palsy, the presence of combined therapy (botulinum toxin injection of lower extremity within 6 month, orthopedic surgery or selective dorsal rhizotomy with 12 month), GMFM-66, TCMS, PBS, 6MWT, TUG and 10MWT of children with cerebral palsy treated during the period. The Wilcoxon signed rank test had use to compare the pre-and post-training evaluations of children.
A total of 28 children with cerebral palsy received robot-assisted gait training. Among them, 4 children with dyskinetic types) and 6 with combined therapy(3 botulinum toxin, 2 orthopedic surgery, 1 selective dorsal thizotomy) were excluded(Figure 1). Result of the 18 children, functional level was the highest number of GMFCS Ⅲ and an average age of 8.5 years(Table 1).
After the 20 session of RAGT, the GMFM total score and D dimension values were improved by 1.1 points and 4 points(p<0.05). The TCMS, which shows the function of trunk control, showed significant improvement in comparison with the before RAGT in 10, 20, 40, and 60 sessions(p<0.05). After 10 sessions, 6MWT and PBS, which represent walking speed and balance, improved 13.5m and 2.9points(p<0.05)(Figure 2).
RAGT showed the improvement of the gross motor function, trunk control ability, balance and the walking speed of children with cerebral palsy. In particular, the trunk control function improved with the increase in the number of robot treatments increased. Accordingly, different treatment methods may be set according to the treatment direction and goal of RAGT in children with cerebral palsy.
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