Evaluation of the effectiveness of robotic gait training and gait-focused physical therapy programs for children with cerebral palsy: A mixed methods RCT
The Lokomat is a new robotic treadmill that helps people who have neurologic conditions walk better. Early research with children with cerebral palsy (CP) shows that it may improve walking skills and that motor learning plays an important part in changes that occur.
Some experts have suggested that combining a program of Lokomat training with motor-learning based physiotherapy that works on functional gross motor activities and balance will better improve walking abilities and associated functional skills.
To determine whether the Lokomat can be used on its own or if a mixed approach of physiotherapy and the Lokomat is better able to improve the walking of children with cerebral palsy.
Children and youth with CP, between the ages of 5-18 years old will be randomly assigned to one of four groups: 1. Lokomat training, 2. A regular physiotherapy program, 3. A combined program of Lokomat training and regular physiotherapy, or 4. A control group that does not receive treatment. Participants who are assigned to the active intervention groups will receive Lokomat training and/or physiotherapy twice a week for about 50 minutes each session over an 8-10 week period.
A comprehensive assessment of functional mobility, achievement of personalized walking-based goals, participation and quality of life will be completed by a study physiotherapist assessor at three different time points: 1. Before randomization to their study group, 2. After 8-10 weeks of receiving (or not receiving) study intervention(s), and 3. Three months after the second assessment.
Participants and/or their parents will also be invited to meet with a study interviewer to talk about their experiences with the Lokomat and/or physiotherapy training they received in the study, as well as their therapy goals.
The study will help physiotherapists learn whether the Lokomat should be used on its own or combined with motor-learning based physiotherapy for children with CP who have walking-related functional goals.
The second part of the study will help physiotherapists understand how families experience therapy and how their life experiences and values affect these experiences. Additionally, discussions related to their goals of therapy will help therapists understand why children may or may not feel engaged in Lokomat therapy and experience positive outcomes.
This study is funded by the Canadian Institutes of Health Research (CIHR)
Deborah Gaebler-Spira, Shirley Ryan Ability Lab, Co-Investigator
Gloria Lee, Research Manager
Lesley Wiart, University of Alberta, Co-Principal Investigator
Virginia Wright, Bloorview Research Institute, Co-Principal Investigator