Effect of Robot-Assisted Gait Training in a Large Population of Children With Motor Impairment Due to Cerebral Palsy or Acquired Brain Injury

Elena Beretta, Fabio Alexander Storm, Sandra Strazzer, Flaminia Frascarelli, Maurizio Petrarca, Alessandra Colazza, Giampietro Cordone, Emilia Biffi, Roberta Morganti, Cristina Maghini, Luigi Piccinini, Gianluigi Reni, Enrico Castelli

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate retrospectively the effect of robotic rehabilitation in a large group of children with motor impairment; an additional goal was to identify the effects in children with cerebral palsy (CP) and acquired brain injury (ABI) and with different levels of motor impairment according to the Gross Motor Function Classification System. Finally, we examined the effect of time elapsed from injury on children's functions. Design: A cohort, pretest-posttest retrospective study was conducted. Setting: Hospitalized care. Participants: A total of 182 children, 110 with ABI and 72 with CP and with Gross Motor Function Classification System (GMFCS) levels I-IV, were evaluated retrospectively. Interventions: Patients underwent a combined treatment of robot-assisted gait training and physical therapy. Main Outcome Measures: All the patients were evaluated before and after the training using the 6-minute walk test and the Gross Motor Function Measure. A linear mixed model with 3 fixed factors and 1 random factor was used to evaluate improvements. Results: The 6-minute walk test showed improvement in the whole group and in both ABI and CP. The Gross Motor Function Measure showed improvement in the whole group and in the patients with ABI but not in children with CP. The GMFCS analysis showed that all outcomes improved significantly in all classes within the ABI subgroup, whereas improvements were significant only for GMFCS III in children with CP. Conclusions: Children with motor impairment can benefit from a combination of robotic rehabilitation and physical therapy. Our data suggest positive results for the whole group and substantial differences between ABI and CP subgroups, with better results for children with ABI, that seem to be consistently related to time elapsed from injury.

Original languageEnglish
Pages (from-to)106-112
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Volume101
Issue number1
DOIs
Publication statusPublished - 2020

Fingerprint

Cerebral Palsy
Gait
Brain Injuries
Population
Robotics
Rehabilitation
Wounds and Injuries
Systems Analysis
Linear Models
Therapeutics
Retrospective Studies
Outcome Assessment (Health Care)

Keywords

  • Brain injuries
  • Cerebral palsy
  • Neurological rehabilitation
  • Rehabilitation

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

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title = "Effect of Robot-Assisted Gait Training in a Large Population of Children With Motor Impairment Due to Cerebral Palsy or Acquired Brain Injury",
abstract = "Objective: To evaluate retrospectively the effect of robotic rehabilitation in a large group of children with motor impairment; an additional goal was to identify the effects in children with cerebral palsy (CP) and acquired brain injury (ABI) and with different levels of motor impairment according to the Gross Motor Function Classification System. Finally, we examined the effect of time elapsed from injury on children's functions. Design: A cohort, pretest-posttest retrospective study was conducted. Setting: Hospitalized care. Participants: A total of 182 children, 110 with ABI and 72 with CP and with Gross Motor Function Classification System (GMFCS) levels I-IV, were evaluated retrospectively. Interventions: Patients underwent a combined treatment of robot-assisted gait training and physical therapy. Main Outcome Measures: All the patients were evaluated before and after the training using the 6-minute walk test and the Gross Motor Function Measure. A linear mixed model with 3 fixed factors and 1 random factor was used to evaluate improvements. Results: The 6-minute walk test showed improvement in the whole group and in both ABI and CP. The Gross Motor Function Measure showed improvement in the whole group and in the patients with ABI but not in children with CP. The GMFCS analysis showed that all outcomes improved significantly in all classes within the ABI subgroup, whereas improvements were significant only for GMFCS III in children with CP. Conclusions: Children with motor impairment can benefit from a combination of robotic rehabilitation and physical therapy. Our data suggest positive results for the whole group and substantial differences between ABI and CP subgroups, with better results for children with ABI, that seem to be consistently related to time elapsed from injury.",
keywords = "Brain injuries, Cerebral palsy, Neurological rehabilitation, Rehabilitation",
author = "Elena Beretta and Storm, {Fabio Alexander} and Sandra Strazzer and Flaminia Frascarelli and Maurizio Petrarca and Alessandra Colazza and Giampietro Cordone and Emilia Biffi and Roberta Morganti and Cristina Maghini and Luigi Piccinini and Gianluigi Reni and Enrico Castelli",
year = "2020",
doi = "10.1016/j.apmr.2019.08.479",
language = "English",
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pages = "106--112",
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T1 - Effect of Robot-Assisted Gait Training in a Large Population of Children With Motor Impairment Due to Cerebral Palsy or Acquired Brain Injury

AU - Beretta, Elena

AU - Storm, Fabio Alexander

AU - Strazzer, Sandra

AU - Frascarelli, Flaminia

AU - Petrarca, Maurizio

AU - Colazza, Alessandra

AU - Cordone, Giampietro

AU - Biffi, Emilia

AU - Morganti, Roberta

AU - Maghini, Cristina

AU - Piccinini, Luigi

AU - Reni, Gianluigi

AU - Castelli, Enrico

PY - 2020

Y1 - 2020

N2 - Objective: To evaluate retrospectively the effect of robotic rehabilitation in a large group of children with motor impairment; an additional goal was to identify the effects in children with cerebral palsy (CP) and acquired brain injury (ABI) and with different levels of motor impairment according to the Gross Motor Function Classification System. Finally, we examined the effect of time elapsed from injury on children's functions. Design: A cohort, pretest-posttest retrospective study was conducted. Setting: Hospitalized care. Participants: A total of 182 children, 110 with ABI and 72 with CP and with Gross Motor Function Classification System (GMFCS) levels I-IV, were evaluated retrospectively. Interventions: Patients underwent a combined treatment of robot-assisted gait training and physical therapy. Main Outcome Measures: All the patients were evaluated before and after the training using the 6-minute walk test and the Gross Motor Function Measure. A linear mixed model with 3 fixed factors and 1 random factor was used to evaluate improvements. Results: The 6-minute walk test showed improvement in the whole group and in both ABI and CP. The Gross Motor Function Measure showed improvement in the whole group and in the patients with ABI but not in children with CP. The GMFCS analysis showed that all outcomes improved significantly in all classes within the ABI subgroup, whereas improvements were significant only for GMFCS III in children with CP. Conclusions: Children with motor impairment can benefit from a combination of robotic rehabilitation and physical therapy. Our data suggest positive results for the whole group and substantial differences between ABI and CP subgroups, with better results for children with ABI, that seem to be consistently related to time elapsed from injury.

AB - Objective: To evaluate retrospectively the effect of robotic rehabilitation in a large group of children with motor impairment; an additional goal was to identify the effects in children with cerebral palsy (CP) and acquired brain injury (ABI) and with different levels of motor impairment according to the Gross Motor Function Classification System. Finally, we examined the effect of time elapsed from injury on children's functions. Design: A cohort, pretest-posttest retrospective study was conducted. Setting: Hospitalized care. Participants: A total of 182 children, 110 with ABI and 72 with CP and with Gross Motor Function Classification System (GMFCS) levels I-IV, were evaluated retrospectively. Interventions: Patients underwent a combined treatment of robot-assisted gait training and physical therapy. Main Outcome Measures: All the patients were evaluated before and after the training using the 6-minute walk test and the Gross Motor Function Measure. A linear mixed model with 3 fixed factors and 1 random factor was used to evaluate improvements. Results: The 6-minute walk test showed improvement in the whole group and in both ABI and CP. The Gross Motor Function Measure showed improvement in the whole group and in the patients with ABI but not in children with CP. The GMFCS analysis showed that all outcomes improved significantly in all classes within the ABI subgroup, whereas improvements were significant only for GMFCS III in children with CP. Conclusions: Children with motor impairment can benefit from a combination of robotic rehabilitation and physical therapy. Our data suggest positive results for the whole group and substantial differences between ABI and CP subgroups, with better results for children with ABI, that seem to be consistently related to time elapsed from injury.

KW - Brain injuries

KW - Cerebral palsy

KW - Neurological rehabilitation

KW - Rehabilitation

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