CEREBRO EN LLAMAS PLUS

The period, follow-up, and carry-over effects were not statistically significant. Significant treatment effects were observed in dimensions D and E of the GMFM (D: p = 0.018 E: p = 0.021) scores, WeeFIM mobility subtotal (p = 0.007), and COPM performance (p < 0.001) and satisfaction (p = 0.001) measure scores. Energy expenditure and body composition were measured pre- and post-RAGT. The Gross Motor Function Measure-88 (GMFM-88), the pediatric functional independence measure (WeeFIM), and the Canadian occupational performance measure (COPM) scores were assessed pre- and post-RAGT or SC periods and treatment, period, follow-up, and carry-over effects were analyzed. The SC program comprised 2-4 conventional physiotherapy sessions/week for 6 weeks. Using a Walkbot-K system, the RAGT program comprised 3 × 30-min sessions/week for 6 weeks with a continued SC program. The participants were randomized into the RAGT/standard care (SC) (n = 10) and SC/RAGT/SC sequence groups (n = 10). In this single-center, single-blinded, randomized cross-over trial, we enrolled 20 children with CP with Gross Motor Function Classification System (GMFCS) levels II-IV (13 males age range, 6.75 ± 2.15 years). Therefore, we aimed to investigate the effectiveness of RAGT in children with CP. The effectiveness of robot-assisted gait training (RAGT) in children with cerebral palsy (CP), especially in terms of improving the performance of daily activities, remains unclear. Our findings suggest that providing real-time biofeedback and using step length as the target can be effective for increasing the rate at which individuals with CP improve their gait mechanics when walking with wearable ankle assistance. Additionally, we observed near immediate improvements in lower-extremity posture, moments, and positive power relative to baseline for biofeedback-plus-assistance (p < 0.05), with none, or more-limited improvements observed for assistance alone. We achieved our clinical feasibility goal by demonstrating that biofeedback-plus-assistance resulted in a 14% increase in step length relative to baseline (p ≤ 0.05), while no difference in step length was observed for assistance alone. We achieved our technical validation goal by demonstrating a strong correlation between estimated step length and real step length (r = 0.77, p < 0.001).

CEREBRO EN LLAMAS PLUS

We assessed lower-extremity gait mechanics and muscle activity in seven ambulatory individuals with CP as they walked with adaptive ankle assistance alone and with ankle assistance plus step-length biofeedback. An adaptive ankle exoskeleton control algorithm provided assistance proportional to the real-time ankle moment. We selected step length as a clinically-relevant gait performance target and utilized a visual interface with live performance scores. Seeking to improve the effectiveness of gait training in this patient population, this study developed and assessed the feasibility of a real-time biofeedback mechanism to augment untethered ankle exoskeleton-assisted walking performance in individuals with CP. Most people with cerebral palsy (CP) suffer from impaired walking ability and pathological gait patterns. More studies are needed to prove and test the extent to which these devices aid in the treatment of children with cerebral palsy. Unfortunately, the low quality of some of the randomized clinical trials that were reviewed made it difficult to establish conclusive results. However, it seems clear that they have presented a good complement to conventional physical therapies, although not a therapy as themselves. There is no consensus about the effectiveness of these devices. Motor dysfunctions in the lower limbs and those that are specifically related to gait are the main parameters that are affected by cerebral palsy and the robotic systems Lokomat, Innowalk, Robogait and Waltbox-K are the most commonly used. In total, 653 potential manuscripts were selected but only 7 of them met the inclusion criteria. Randomized clinical trials in Spanish and English were included. A systematic review of the Pubmed, Web of Science, MEDLINE, Cochrane, Dialnet, CINAHL, Scopus, Lilacs and PEDro databases from November 2021 to February 2022 was conducted to prove the effectiveness of these devices for the treatment of motor dysfunctions in children who were diagnosed with cerebral palsy. Robotic systems are new devices that are becoming increasingly popular as a part of the treatment for cerebral palsy. Cerebral palsy is a neurological condition that is associated with multiple motor alterations and dysfunctions in children.

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