Safety of robotic-assisted treadmill therapy in children and adolescents with gait impairment: A bi-centre survey

Objective: The aim of the present study was to report on adverse events encountered with robotic-assisted treadmill therapy in children and adolescents with gait disorders. Methods: Eighty-nine patients who underwent a trial of robotic assisted treadmill therapy in the two participating centres were analysed. Demographic data and safety data of the patients were analysed using descriptive statistics. Results: In 38 (42.7%) out of 89 patients, adverse events were documented. Most commonly, mild skin erythema at the sites of the cuffs of the device and muscle pain were encountered. In five patients (5.6%), open skin lesions (n = 2), joint pain (n = 2) or tendinopathy (n = 1) limited the continuation of the therapy with the Lokomat. No severe side-effects emerged. Conclusions: Robotic assisted treadmill therapy is a safe method to enable longer periods of gait therapy in children and adolescents with gait disorders.

[1]  A. Meyer-Heim,et al.  Improved gait parameters after robotic‐assisted locomotor treadmill therapy in a 6‐year‐old child with cerebral palsy , 2008, Movement disorders : official journal of the Movement Disorder Society.

[2]  B. Dobkin.  Clinical practice. Rehabilitation after stroke. , 2005, The New England journal of medicine.

[3]  A. Mayr,et al.  Prospective, Blinded, Randomized Crossover Study of Gait Rehabilitation in Stroke Patients Using the Lokomat Gait Orthosis , 2007, Neurorehabilitation and neural repair.

[4]  K. Krosschell,et al.  Treadmill training with partial body‐weight support in children with cerebral palsy: a systematic review , 2009, Developmental medicine and child neurology.

[5]  Ross Querry,et al.  Robotic orthoses for body weight-supported treadmill training. , 2006, Physical medicine and rehabilitation clinics of North America.

[6]  Abstract 6: Treadmill training with partial body weight support in children with cerebral palsy1 , 2003 .

[7]  J. Nielsen,et al.  Cortical and Spinal Excitability Changes After Robotic Gait Training in Healthy Participants , 2009, Neurorehabilitation and neural repair.

[8]  B. Dobkin.  Rehabilitation after Stroke , 2005 .

[9]  G. Colombo,et al.  Feasibility of robotic‐assisted locomotor training in children with central gait impairment , 2007, Developmental medicine and child neurology.

[10]  Vincent S. Huang,et al.  Robotic neurorehabilitation: a computational motor learning perspective , 2009, Journal of NeuroEngineering and Rehabilitation.

[11]  Sarah Foley,et al.  Partial body‐weight‐supported treadmill training can improve walking in children with cerebral palsy: a clinical controlled trial , 2007, Developmental medicine and child neurology.

[12]  Kelly P Westlake,et al.  Pilot study of Lokomat versus manual-assisted treadmill training for locomotor recovery post-stroke , 2009, Journal of NeuroEngineering and Rehabilitation.

[13]  A. Meyer-Heim,et al.  Improvement of walking abilities after robotic-assisted locomotion training in children with cerebral palsy , 2009, Archives of Disease in Childhood.

[14]  V. Dietz,et al.  Treadmill training of paraplegic patients using a robotic orthosis. , 2000, Journal of rehabilitation research and development.

[15]  V. Dietz,et al.  Effectiveness of automated locomotor training in patients with chronic incomplete spinal cord injury: a multicenter trial. , 2005, Archives of physical medicine and rehabilitation.

[16]  D. Jones,et al.  Muscle pain after exercise is linked with an inorganic phosphate increase as shown by31P NMR , 1986, Bioscience reports.

[17]  S. Hesse,et al.  Upper and lower extremity robotic devices for rehabilitation and for studying motor control , 2003, Current opinion in neurology.

[18]  H Kern,et al.  Treadmill training with partial body weight support in nonambulatory patients with cerebral palsy. , 2000, Archives of physical medicine and rehabilitation.

[19]  H. Barbeau.  Locomotor Training in Neurorehabilitation: Emerging Rehabilitation Concepts , 2003, Neurorehabilitation and neural repair.

[20]  S Hesse,et al.  Locomotor therapy in neurorehabilitation. , 2001, NeuroRehabilitation.

[21]  F. Müller,et al.  Effects of Locomotion Training With Assistance of a Robot-Driven Gait Orthosis in Hemiparetic Patients After Stroke: A Randomized Controlled Pilot Study , 2007, Stroke.