Robotic-assisted treadmill training improves walking measures in children with spastic diplegic cerebral palsy
In a randomized controlled trial, 40 children aged 6 to 11 years with spastic diplegic cerebral palsy who could ambulate but had abnormal gait kinematics were studied. The intervention group received robotic-assisted treadmill gait training using Lokomat in addition to a regular physical therapy program based on the neurodevelopmental approach, while the comparator group received only the regular physical therapy program.
The group receiving the combined robotic training and therapy showed statistically significant improvement (p < 0.05) in all measured variables: walking speed, step length, step symmetry, and 6-minute walk test performance. Post-treatment mean values of all measured variables also showed significant differences between groups (p < 0.05), favoring the group that received robotic-assisted training.
Safety and tolerability data were not reported in the abstract, and the study did not report effect sizes, confidence intervals, or absolute numbers for the improvements. The clinical significance of the statistically significant findings remains unclear without these quantitative measures. While the RCT design suggests causal inference is possible, the abstract does not specify primary versus secondary outcomes or adjustments for multiple comparisons.
For clinical practice, these findings from a single RCT with modest sample size suggest robotic-assisted treadmill gait training could be considered as an additional therapeutic modality to improve walking performance in children with spastic diplegia. However, clinicians should interpret these results cautiously given the lack of reported safety data, effect sizes, and information about the sustainability of improvements.
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