Effect of robot-assisted gait training on motor functions in adolescent and young adult patients with bilateral spastic cerebral palsy: A randomized controlled trial

Abstract

Background: Robot-assisted gait training (RAGT) allows an intensive gait training in patients with cerebral palsy (CP). There are few evidences on the effectiveness of RAGT in adults with CP.

Objective: To assess the effect of RAGT on gross motor function in adolescent and adult patients with bilateral spastic CP and to compare the effect of RAGT with conventional kinesiotherapy.

Methods: Forty-seven patients (mean age 21.2±5.33 years) with bilateral spastic CP were divided into two groups. Twenty-one patients underwent 20 therapeutic units of RAGT and 26 patients underwent 20 therapeutic units of conventional therapy/training (CON). The following parameters were evaluated before (V1) and after the therapy (V2): dimension A (lying and rolling), B (sitting), C (crawling and kneeling), D (standing), E (walking, running and jumping) of the Gross Motor Function Measure (GMFM-88). In patients in the experimental RAGT group, these parameters were also evaluated 3-4 months later (V3).

Results: Comparing the mean improvements in endpoints in both groups (RAGT vs. CON) after 20 TUs, we observed the statistically significant difference (p < 0.001) and large effect size in all GMFM dimensions and total GMFM improvement in favour of the RAGT group. In RAGT patients, the improvement persisted even 3-4 months after RAGT (p < 0.001).

Conclusion: We demonstrated that the intensive RAGT regimen is more effective than conventional therapy in terms of improvements in gross motor functions in adolescent and adult patients with bilateral spastic CP.

Keywords: Rehabilitation; cerebral palsy; gross motor function; robot-assisted gait training.