Effect of robotic-assisted gait training as adjunct to traditional therapy on motor impairments in children with cerebral palsy

Abstract

Aims. The aim of the study was to assess the effectiveness of robotic-assisted gait treadmill training (Lokomat) as an adjunct to traditional physiotherapy in improving the range of motion, muscle strength and decreasing spasticity in lower extremities in children with cerebral palsy. Materials and Methods. Twenty-six participants, with mean 7.69 ± 2.90 years, levels I-IV on Gross Motor Classification System (38.5% level I-II and 61.5% level III-IV) with a bilateral and unilateral form of cerebral palsy underwent intensive 20 Lokomat and 20 traditional physiotherapy sessions, each training session lasting 40 minutes. Preand post-testing was done using goniometer measure, manual muscle testing and modified Ashworth scale. Results. Positive effects were seen in participant who underwent a combination of Lokomat training and traditional therapy. An increase in the range of motion was minimal (2 - 4 degrees) in hip flexion, extension, and abduction. A significant improvement was achieved in ankle dorsiflexion on the right (p = 0.003) and left side (p = 0.006), while the values of knee extension for the left and right extremity were p = 0.062 left and p = 0.075, respectively. An increase in muscle strength of the lower limb was seen in 30.8% - 80% of participants. Reduction of spasticity in adductors, hamstrings and gastrocnemius were seen in 26.9% of participants. Conclusion. Lokomat training is an adjunct to conventional physiotherapy treatment. It has a negligible effect on the increase in the range of motion and muscle strength of the lower limb and reduction of spasticity in children with cerebral palsy.