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Journal of NeuroEngineering and Rehabilitation

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01-12-2020 | Research

Gait improvements by assisting hip movements with the robot in children with cerebral palsy: a pilot randomized controlled trial

Authors: Shihomi Kawasaki, Koji Ohata, Takeshi Yoshida, Atsushi Yokoyama, Shigehito Yamada

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2020

Abstract

Background

Recently, rehabilitation robots are expected to improve the gait of cerebral palsy (CP) children. However, only few previous studies have reported the kinematic and kinetic changes by using wearable exoskeleton robots. The aim of this study was to investigate the change in gait parameters in CP children by training with the wearable robot-assisted gait training.

Methods

10 spastic CP children with Gross Motor Function Classification Scale levels I-III completed a sham-controlled crossover randomized trial. Robot-assisted gait training (RAGT) and non-assisted gait training (NAGT) were performed on the treadmill with the Honda Walking Assist (HWA) in two different days. To examine the carry-over effect from treadmill walking to overground walking, participants also performed 5.5 m overground-walks without the HWA before and after treadmill training (pre- and post-trial). During treadmill walking, peak of both hip and knee angles were measured. Also, we calculated the limb symmetry of hip range of motion. In addition, gait speed and ground reaction force were measured in overground trials.

Results

The maximum hip angle on the limb with fewer hip movements, which was defined as the affected limb, showed a significant interaction between ASSIST (RAGT and NAGT) and TIME (pre- and post-trial) (p < 0.05). Limb symmetry significantly improved after RAGT (p < 0.05), but not in NAGT. Furthermore, the affected limb showed a significant increase in the positive peak of the anterior-posterior ground reaction force during 70–100% of the gait cycle (p < 0.05). However, there was no change in gait speed.

Conclusion

By assisting the both hip movements with the HWA, maximum hip flexion and extension angle of the affected limb improved. Also, limb symmetry and propulsion force of the affected limb improved. Our results suggest that assisting both hip movements with the HWA might be an effective method for improving gait in CP children.

Trial registration

UMIN-CTR, UMIN000030667. Registered 3 January 2018, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000033737

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Title: Gait improvements by assisting hip movements with the robot in children with cerebral palsy: a pilot randomized controlled trial
Authors: Shihomi Kawasaki
Koji Ohata
Takeshi Yoshida
Atsushi Yokoyama
Shigehito Yamada
Publication date: 01-12-2020
Publisher: BioMed Central
Published in: Journal of NeuroEngineering and Rehabilitation / Issue 1/2020
Electronic ISSN: 1743-0003
DOI: https://doi.org/10.1186/s12984-020-00712-3

At a glance: The STEP trials

Springer Medicine

Gait improvements by assisting hip movements with the robot in children with cerebral palsy: a pilot randomized controlled trial

Abstract

Background

Methods

Results

Conclusion

Trial registration

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Trial registration

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