Swiss Children's Rehab, Research Department, University Children's Hospital Zurich, Eleonore Foundation, Affoltern am Albis, Switzerland.
Functioning and Rehabilitation, CAPHRI, Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.
J Pediatr Rehabil Med. 2020;13(2):137-148. doi: 10.3233/PRM-190614.
To investigate the effectiveness of outpatient robot-assisted gait training (RAGT) in ambulatory children with spastic cerebral palsy.
Children were randomized to two different intervention sequences within a pragmatic crossover design. They performed five weeks of RAGT (3 sessions per week) and five weeks of usual care (UC). Dimension E of the Gross Motor Function Measure-88 (GMFM E) as the primary outcome as well as Dimension D (GMFM D), and timed walking tests were assessed before and after each treatment sequence and after a 5-week follow-up.
The trial was stopped early because of recruitment problems. We included 16 children with a mean age of 11.3 years (6.0-15.3 years). GMFM E median (IQR) change scores were -0.7 (-2.8 to 3.5) after RAGT and 0 (-2.4 to 2.4) after UC. Neither GMFM E nor any secondary outcome measure changed significantly after RAGT or UC, nor were any period, follow-up, or carry-over effects observable.
RAGT as a single intervention was not effective in improving walking abilities in the included children. It should be embedded in a holistic treatment approach, as it cannot cover all aspects relevant to gait. Furthermore, children's personalized rehabilitation goals should be carefully monitored with individualized measurement instruments.
研究门诊机器人辅助步态训练（RAGT）对痉挛性脑瘫患儿步行能力的疗效。
采用实用交叉设计，将患儿随机分为两种不同的干预序列。他们进行了五周的 RAGT（每周 3 次）和五周的常规护理（UC）。主要结局是 88 项粗大运动功能测量量表（GMFM）的 E 维度（GMFM E），以及 D 维度（GMFM D）和计时步行测试，分别在每个治疗序列前后以及 5 周随访后进行评估。
由于招募问题，试验提前停止。我们纳入了 16 名平均年龄为 11.3 岁（6.0-15.3 岁）的儿童。RAGT 后 GMFM E 中位数（IQR）变化评分为-0.7（-2.8 至 3.5），UC 后为 0（-2.4 至 2.4）。RAGT 或 UC 后 GMFM E 或任何次要结局测量均无明显变化，也无周期、随访或延续效应。
作为单一干预措施，RAGT 对纳入儿童的步行能力改善无效。它应该嵌入到整体治疗方法中，因为它不能涵盖与步态相关的所有方面。此外，应使用个体化测量工具仔细监测儿童的个性化康复目标。
