Impact of robotic gait orthosis training on kinematic parameters in hemiplegic children
DOI:
https://doi.org/10.47197/retos.v77.118543Keywords:
cerebral palsy, kinematic gait analysis, robotic gait orthosisAbstract
Background: gait disturbance is one of the most common consequences of hemiplegic cerebral palsy characterized by asymmetrical step length and reduced walking speed, robotic gait orthosis therapy is the most effective in gait training and enhance kinematic gait parameters.
Purpose: to evaluate the effect of robotic gait orthosis on kinematic gait parameters in hemiplegic children.
Patient and methods: 40 Cerebral palsy children with spastic hemiplegia ranged from 7 to 12 years old. They were selected from the outpatient clinic of Haven physical therapy center on 6th October city. They were allocated randomly in two groups (20 children each). Group I (control group): received a selected physical therapy program for 3 times weekly for 8 successive weeks. Group II (Study group): received the selected physical therapy program as the control group for 30 minutes in addition to Lokomat gait training for 30 minutes. This program was performed 3 times weekly for 8 successive weeks. Both 3-D kinematic gait analysis and robotic gait orthosis were carried out before and after intervention.
Results: we found statistically significant increase in hip flexor (p=0.05) &hip extensor (p=0.018) & significant decreased in ankle at initial contact (p=0.001) &increase in single limb support (p=0.001) &decreased in cadence (p=0.020) and decreased in speed (p=0.020) at post treatment in study group compared to control group.
Conclusion: Robotic gait orthosis is effective modalities in rehabilitation of children with hemiplegic cerebral palsied, combination between Lokomat and physical therapy program plays an important role in muscle strength and kinematic gait parameters thus improving patient gait pattern.
References
Aicardi, J. (2009). Diseases of the nervous system in childhood (3rd ed.). MacKeith Press.
Alcobendas-Maestro, M., Esclarin-Ruz, A., Casado-López, R. M., Muñoz-González, A., Pérez-Mateos, G., González-Valdizán, E., et al. (2012). Lokomat robotic-assisted versus overground training with-in 3 to 6 months of incomplete spinal cord lesion: Randomized controlled trial. Neurorehabili-tation and Neural Repair, 26, 1058–1063.
Andreas, M., Ammann, R., Schmartz, A., et al. (2009). Improvement of walking abilities after robotic-assisted locomotion training in children with cerebral palsy. Archives of Disease in Childhood, 94, 615–620.
Baunsgaard, B., Nissen, U. V., & Christensen, B. (2016). Modified Ashworth Scale and spasm frequency score in spinal cord injury: Reliability and correlation. Spinal Cord, 54(9), 702–708.
Bonnyaud, C., Zory, R., Boudarham, J., et al. (2014). Effect of robotic restraint gait training versus con-ventional gait training on gait parameters in stroke patients. Experimental Brain Research, 232(1), 31–42.
Chen, G., Patten, C., Kothari, D., et al. (2005). Gait differences between individuals with post-stroke hem-iparesis and non-disabled controls at matched speeds. Gait & Posture, 22(1), 51–56.
Chitra, S., & Nandini, M. (2005). Cerebral palsy: Definition, classification, etiology and early diagnosis. Indian Journal of Pediatrics, 72, 865–868.
De Quatrain, I. A., Simon, S. R., Lauran’s, S., et al. (1996). Gait pattern in the early recovery period after stroke. The Journal of Bone and Joint Surgery, 78(10), 1506–1514.
Esquenazi, A., & Talaty, M. (2011). Gait analysis: Technology and clinical applications. Physical Medi-cine and Rehabilitation, 99–116.
Fernandes, M., Maifrino, L., Monte, K., et al. (2012). Effectiveness of resistance training exercises in spas-tic diplegic cerebral palsy: A systematic review. [Journal Name], 29(3), 125–128.
Frontera, W. R., & DeLisa, J. A. (2010). Human walking. In DeLisa’s physical medicine & rehabilitation: Principles and practice (5th ed., pp. 121–139). Lippincott Williams & Wilkins.
Graham, H. K., Rosenbaum, P., Paneth, N., et al. (2016). Cerebral palsy. Nature Reviews Disease Primers, 2, 15082. https://doi.org/10.1038/nrdp.2015.82
Guyatt, G., Walter, S., & Norman, G. (1987). Measuring change over time: Assessing the usefulness of evaluative instruments. Journal of Chronic Diseases, 40, 171–180.
Hassid, E., Rose, D., Commisarow, J., Guttry, M., & Dobkin, B. H. (1997). Improved gait symmetry in hemiplegic stroke patients induced by body weight-supported treadmill stepping. Neuroreha-bilitation and Neural Repair, 11, 21–26.
Hollis, M., & Fletcher-Cook, P. (1999). Practical exercise therapy (4th ed.).
Husemann, B., Müller, F., Krewer, C., et al. (2007). Effects of locomotion training with assistance of a robot-driven gait orthosis in hemiparetic patients after stroke. Stroke, 38, 349–354.
Kerrigan, D. C., Deming, L. C., & Holden, M. K. (1996). Knee recurvatum in gait: A study of associated knee biomechanics. Archives of Physical Medicine and Rehabilitation, 77(7), 645–650.
Lamontagne, A., & Fung, J. (2004). Faster is better: Implications for speed-intensive gait training after stroke. Stroke, 35(11), 2543–2548.
Levitt, S. (2004). Treatment of cerebral palsy and motor delay (4th ed.). Blackwell Scientific Publica-tions.
Mattson, M. P., & Leak, R. K. (2024). The hormesis principle of neuroplasticity and neuroprotection. Cell Metabolism, 36, 315–337. https://doi.org/10.1016/j.cmet.2023.12.022
Morone, G., Bragoni, M., Iosa, M., De Angelis, D., Venturiero, V., Coiro, P., et al. (2011). Who may benefit from robotic-assisted gait training? A randomized clinical trial in patients with sub-acute stroke. Neurorehabilitation and Neural Repair, 25, 636–644.
Pájaro, M., Shetye, R., Gallegos, J., Pons, J., Torricelli, D., et al. (2013). Robotic-assisted gait training in children with cerebral palsy in clinical practice. In Converging Clinical and Engineering Re-search on Neurorehabilitation (Vol. 1, pp. 29–33). Springer.
Palisano, R., Rosenbaum, P., Bartlett, D., & Livingston, M. (2008). Content validity of the expanded and revised Gross Motor Function Classification System. Developmental Medicine & Child Neurolo-gy, 50(10), 744–750.
Picelli, A., Melotti, C., Origano, F., Neri, R., Waldner, A., & Smania, N. (2013). Robot-assisted gait training versus equal intensity treadmill training in patients with mild to moderate Parkinson’s disease: A ran-domized controlled trial. Parkinsonism & Related Disorders, 19, 605–610.
Riener, R., Lunenburger, L., Maier, C., et al. (2010). Locomotor training in subjects with sensorimotor deficits: An overview of the robotic gait orthosis Lokomat. Journal of Healthcare Engineering, 1(2), 197–216.
Rose, J., & Gamble, J. G. (2006). Human walking (3rd ed.). Lippincott Williams & Wilkins.
Salem, Y., Lovelace-Chandler, V., Zabel, R., et al. (2010). Effects of prolonged standing on gait in cerebral palsy. Physical & Occupational Therapy in Pediatrics, 30(1).*
Sophie, L., Remo, R., & Susan, H. (2017). The effectiveness of robotic-assisted gait training for pediatric gait disorders: A systematic review. Journal of NeuroEngineering and Rehabilitation, 14, 1.
Van Nunen, M. P. M., Gerrits, K. H. L., De Haan, A., & Janssen, T. W. J. (2012). Exercise intensity of robot-assisted walking versus overground walking in non-ambulatory stroke patients. Journal of Re-habilita-tion Research and Development, 49, 1537–1546.
Westlake, K. P., & Patten, C. (2009). Pilot study of Lokomat versus manual-assisted treadmill training for locomotor recovery post-stroke. Journal of NeuroEngineering and Rehabilitation, 6, 18.
Winter, D. A., Gage, J. R., & Hicks, R. (1987). Gait patterns in spastic hemiplegia in children and young adults. The Journal of Bone and Joint Surgery, 69, 437–441.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Soaad Mohammed Ibrahim Elomda, Khaled Ahmed Momdouh, Faten Hassan Abdelazeem, Mohamed Ali Elshafey, Mohamed Serag Eldein Mahgoub Mostafa, Wagdy William Amin Younan

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and ensure the magazine the right to be the first publication of the work as licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of authorship of the work and the initial publication in this magazine.
- Authors can establish separate additional agreements for non-exclusive distribution of the version of the work published in the journal (eg, to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Is allowed and authors are encouraged to disseminate their work electronically (eg, in institutional repositories or on their own website) prior to and during the submission process, as it can lead to productive exchanges, as well as to a subpoena more Early and more of published work (See The Effect of Open Access) (in English).
This journal provides immediate open access to its content (BOAI, http://legacy.earlham.edu/~peters/fos/boaifaq.htm#openaccess) on the principle that making research freely available to the public supports a greater global exchange of knowledge. The authors may download the papers from the journal website, or will be provided with the PDF version of the article via e-mail.