Evaluation of the effects of gait training on the device Lokomat in children with Cerebral Palsy. Preliminary Report
DOI:
https://doi.org/10.15584/medrev.2015.4.3Keywords:
Cerebral palsy, gait, balance, Locomat, równowagaAbstract
The aim of the research. The aim of research was to esteem the results of re-education of the gait in children with Cerebral Palsy in conditions of dynamic load on the Locomat.
Materials and method. 11 patients with spastic cerebral palsy, participating in the gait training, were examined. 6 children were diagnosed to have four-limb paralysis, 5 children were diagnosed to have bilateral spastic paresis. The average age of the examined children was 9 years. Every patient was examined after 10 therapy sessions. The level of child’s motor disability was estimated according to Kudrjavcev scale and GMFCS scale, the balance was estimated according to Berg Scale, the gait according to Wisconsin Gait Scale.
Results. The improvement could be observed for all the children who had been checked, the range of improvement was diverse. The gait improvement was better for children with bilateral spastic paresis. The essential statistical difference in the balance effects esteem between two groups of examined children was not stated. The gait improvement for all children.The best improvement was in the hip movement during transfer of appropriate, the knee joint bending and the fear of reflection diminished. The balance improved for all children, the best change was in the range of standing without support, reaching forward and the ability of body changing. More therapy sessions helped obtain better therapy results. Children of ,,bigger risk” present weaker abilities to compensate for.
Conclusions. The gait of children improves in the individual way, it can be proved by the fact that children with Cerebral Palsy present diverse abilities to compensate for. The gait training contributes to the life independence increase, the therapy result depends on the clinic state of cerebral palsy and the initial functioning state of the child at the beginning of the therapy.
Downloads
References
Lam T., Wirz M., Lunenburger L., Dietz. V. Swing phase resistance enhances flexor muscle activity during treadmill locomotion in incomplete spinal cord injury. Neurorehab. Neural Repair 2008; 22 (5): 438-446.
Perry J., Burnfield J.M. Gait Analysis: Normal and Pathological Function. Nowy York: Publisher Slack 2010; 23-30.
Żak E., Durmała J., Snela S., i wsp. Wpływ rehabilitacji z wykorzystaniem dwóch zautomatyzowanych ortoz na przywracanie funkcji chodu. Act. Bio –Opt. Inform. Med. 2010; 4 (16): 329- 332.
Dimitrijevic M.R. Plastyczność układu nerwowego w procesie przywracania funkcji ruchowych przez ludzi. Neurol. Neuroch. Pol. 1996; 30 (1): 9-16.
Gajewska E. Nowe definicje i skale funkcjonalne stosowane w mózgowym porażeniu dziecięcym. Neurologia Dziecięca 2009; 18 (35): 67-72.
Chochowska M., Zgorzalewicz- Stachowiak M., Sereda-Wiszowaty E. Wpływ wybranych czynników na skuteczność metody NDT-Bobath w usprawnianiu dzieci z MPD. Fizjoterapia 2008; 16 (3): 8-24.
Drużbicki M., Przysada G., Kołodziej K. i wsp. Ocena chodu chorych z niedowładem połowiczym po udarze mózgu z wykorzystanie Wisconsin Gait Scale - doniesienia wstępne. Prz Med Uniw Rzesz Inst Leków 2010; 2: 152-159.
Opara J. Skale generyczne oceny funkcjonalnej. W: Opara J. (red.). Klinimetria w neurorehabilitacji. Ocena wyników rehabilitacji neurologicznej. Wydawnictwo Lekarskie PZWL, Wydanie 1, Warszawa 2012; 7-22.
Patritti B.L., Romaguera F., Deming L.C., et al. Enhancement and retention of loco-motor function in children with cerebral palsy after robotic gait training. Annual Meeting of the European Society of Movement Analysis for Adults and Children ( ESMAC); 14- 19 September 2009, London UK.
Maghini C., Romei M., Morganti R., et al. Robotic gait training in children affected with Cerebral Palsy. Effects on motor function, gait, pattern and posture. Gait Post. 2014; 40: 8-9.
Schroeder A.S., Homburg M., Warken B., et al. Prospective controlled cohort study to evaluate changes of function, activity and participation in patients with bilateral spastic Cerebral Palsy after Robot-enhanced repetitive treadmill therapy. Europ. J. Paed. Neurol. 2014; 18: 502-510.
Sicari M., Patritti B.L., Deming L.C., et al. Robotic gait training in children with celebral palsy. A case series. Gait Post. 2009; 30: 2.
Wirz M., Zemon D. H., Rupp R., et al. Effectiveness of automated locomotor training in patients with chronic incomplete spinal cord injury: a multicenter trial. Arch. of Phys. Med. Rehab. 2005; 86: 672-680.
Romei M., Montinaro A., Piccinini L., et al. Robotic assisted gait training and gait pattern in children affected with celebral palsy. Gait Post. 2013; 38, 1: 37.
Colombo G, Wirz M, Dietz V. Driven gait orthosis for improvement of locomator training in paraplegic patients. Spin. Cord 2001; 39 (5): 252-255.
Dietz V., Muller R., Colombo G. Locomator activity in spinal man: significance of afferent input from joint and load receptors. Brain 2002; 125: 2626-2634.
Nash M. S., Jacobs P.L., Johnson B.M., Field- Fote E. Metabolic and cardiac responses to robotic-assisted locomotion in motor-incomplete tetraplegia: a case report. J. Spinal Cord. Med. 2004; 27 (1): 78-82.
Meyer-Heim A., Amman-Reiffer C., Schmartz A., et al. Improvement of walking abilities after robotic assisted locomotion training in children with celebral palsy. Arch. Dis. Child 2009; 94: 615-620.
Kułak W., Sendrowski K., Sienkiewicz D. i wsp. Czynniki prognostyczne samodzielnego chodzenia dzieci z mózgowym porażeniem dziecięcym. Neurol. Dziec. 2011; 20 (41): 29-35.
Wright V., Lee G., Luff E. Individualized Goal Attainment Associated with Robotic Gait Training Intervention for Children with Cerebral Palsy. Poster 335 2014; 95 (10): 104.
Stoller O., Waser M., Stammler L., Schuster C. Evaluation of robot assisted gait training using integrated biofeedback in neurologic disorders. Gait Post. 2012; 35 (4): 595-600.
Krewer C, Muller F, Husemann B, et al.: The influence of different Lokomat walking conditions on the energy expenditure of hemiparetic patients and healthy subjects, Gait Post. 2007, 26, 372-377.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2015 Medical Review
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our open access policy is in accordance with the Budapest Open Access Initiative (BOAI) definition: this means that articles have free availability on the public Internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from having access to the Internet itself.
All articles are published with free open access under the CC-BY Creative Commons attribution license (the current version is CC-BY, version 4.0). If you submit your paper for publication by the Eur J Clin Exp Med, you agree to have the CC-BY license applied to your work. Under this Open Access license, you, as the author, agree that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. This facilitates freedom in re-use and also ensures that Eur J Clin Exp Med content can be mined without barriers for the research needs.
