Patient‐specific determinants of responsiveness to robot‐enhanced treadmill therapy in children and adolescents with cerebral palsy

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Abstract
Aim: The aim of the study was to evaluate patient‐specific determinants of responsiveness to robot‐enhanced repetitive treadmill therapy (ROBERT) in patients with early‐developed movement disorders.Method: Patients were treated over 12 sessions during a 3‐week period. Gross Motor Function Measure‐66 (GMFM‐66) scores 1 day before ROBERT were compared with scores recorded 1 day after ROBERT. The association of GMFM‐66 baseline score, age, sex, aetiology, and add‐on botulinum toxin therapy to response to treatment was assessed.Results: Eighty‐three patients aged between 4 and 18 years (48 males, 35 females; mean age 10y 8mo, SD 6y 1mo; Gross Motor Function Classification System level I [n=12], II [n=21], III [n=35], IV [n=10], and V [n=1]) were each treated for a total of 7.2 (SD 1.9) treadmill walking hours. Aetiology was bilateral spastic cerebral palsy (BS‐CP; n=69), unilateral CP (n=3), ataxic CP (n=3), hereditary spastic paraparesis (n=6), and genetic syndrome including spasticity (n=2). Meaningful improvements were observed in GMFM‐66 (+2.5; 95% CI 2.0–3.0), GMFM‐D (+5.2; 95% CI 3.6–6.8), and GMFM‐E (+4.0; 95% CI 2.8–5.3). There was a high inter‐individual variability in treatment response. After multivariable adjustment, the improvements in GMFM‐66 and GMFM‐E scores were positively associated with the GMFM‐66 baseline score. The effect on GMFM‐D improvement was inversely associated with age.Interpretation: Gross motor abilities at baseline and age were identified as relevant determinants for the high degree of interpersonal variability in response to ROBERT.
Funding Information
  • Bundesministerium für Forschung, Technologie und Raumfahrt (01 EO 0901)

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