Effect of low dose robotic-gait training on walking capacity in children and adolescents with cerebral palsy

Objective: Robotic gait training presents a promising training modality. Nevertheless, evidence supporting the efficacy of such therapy in children with cerebral palsy remains insufficient. This study aimed to assess the effect of robotic gait training in children/adolescents with cerebral palsy.

Methods: Twenty-four children/adolescents with bilateral cerebral palsy (12 female, 10.1 ± 3.1 years, Gross Motor Function Classification System II to IV) took part in this study. They received two 30-45 min sessions/week of Lokomat training for 12-weeks. Muscle strengths, 6-min walk exercise and gait parameters were evaluated pre- and post-training and at 6-months-follow-up. Training effect according to the level of impairment severity (moderate vs severe) was analyzed using a change from the baseline procedure.

Results: A significant increase in muscle strength was observed after training (p ≤ 0.01). Hip flexors and knee extensors strength changes were maintained or improved at follow-up (p < 0.05). Comfortable walking speed was significantly increased by +20% after training with a slight reduction at follow-up compared to post-training condition (-2.7%, p < 0.05). A significant step length increase was observed after training (14%, p ≤ 0.001). The distance covered in 6 min was higher in post-training (+24%, p ≤ 0.001) and maintained at follow-up compared to pre-training conditions. No significant changes in kinematic patterns were observed. The analysis by subgroup showed that both groups of children (with moderate and severe impairments) improved muscle strength and walking capacities after Lokomat training.

Conclusion: The suggested Lokomat training induced improvement in walking capacity of children/adolescents with cerebral palsy whatever the level of severity. Hence, Lokomat training could be viewed as a valuable training modality in this population.