Paediatric Neurorehabilitation Division, 'Bambino Gesù' Children's Hospital - IRCCS, Rome, Italy.
Int J Rehabil Res. 2021 Mar 1;44(1):69-76. doi: 10.1097/MRR.0000000000000451.
Although robotic-assisted locomotor treadmill therapy is utilized on children with cerebral palsy (CP), its impact on the gait pattern in childhood is not fully described. We investigated the outcome of robotized gait training focusing on the gait pattern modifications and mobility in individuals with CP. An additional intention is to compare our results with the previous literature advancing future solutions. Twenty-four children with diplegic CP (average age 6.4 years old with Gross Motor Functional Classification System range I-IV) received robotized gait training five times per week for 4 weeks. Gait analysis and Gross Motor Function Measurement (GMFM) assessments were performed before and at the end of the treatment. Gait analysis showed inconsistent modifications of the gait pattern. GMFM showed a mild improvement of the dimension D in all subjects, while dimension E changed only in the younger and more severely affected patients. In this study, a detailed investigation comprehensive of electromyography patterns, where previous literature reported only sparse data without giving information on the whole gait pattern, were conducted. We carried on the analysis considering the age of the participants and the severity of the gait function. The findings differentiate the concept of specific pattern recovery (no gait pattern changes) from the concept of physical training (mild GMFM changes).
尽管机器人辅助的跑步机疗法已应用于脑瘫(CP)儿童,但它对儿童步态模式的影响尚未完全描述。我们研究了机器人步态训练的结果,重点关注 CP 患者的步态模式改变和移动能力。另一个目的是将我们的结果与之前的文献进行比较,为未来的解决方案提供参考。24 名双瘫 CP 儿童(平均年龄 6.4 岁,粗大运动功能分级系统范围 I-IV)每周接受 5 次机器人步态训练,共 4 周。在治疗前和治疗结束时进行步态分析和粗大运动功能测量(GMFM)评估。步态分析显示步态模式的改变不一致。GMFM 显示所有受试者的维度 D 均有轻度改善,而维度 E 仅在年龄较小和病情较重的患者中发生变化。在这项研究中,我们进行了详细的调查,包括肌电图模式,而之前的文献仅报告了稀疏的数据,没有提供整个步态模式的信息。我们考虑了参与者的年龄和步态功能的严重程度进行分析。研究结果区分了特定模式恢复(无步态模式改变)的概念和物理训练(GMFM 轻度改变)的概念。