Robot-assisted gait training for respiratory function and quality of life in children with cerebral palsy: A randomized crossover trial.

Aim

To compare the effects of robot-assisted gait training (RAGT) to respiratory training on respiratory function and quality of life in non-ambulatory cerebral palsy.

Method

In this randomized crossover trial, 22 children (13 males, nine females; mean age 5 years 10 months [SD 2 years 10 months], range 2 years 10 months-12 years 6 months) with cerebral palsy (classified in Gross Motor Function Classification System levels III-V) completed 6 weeks of RAGT and 6 weeks of respiratory training, separated by a 4-week washout. Assessments included tidal breathing parameters, accelerometer-based physical activity, the Caregiver Priorities & Child Health Index of Life with Disabilities, and the 88-item Gross Motor Function Measure.

Results

Compared to respiratory training, RAGT yielded significantly greater improvements in tidal volume (RAGT 1.32 [1.12] vs respiratory training 0.51 [1.43], p < 0.001), time to peak tidal expiratory flow as a proportion of expiratory time (RAGT 4.82 [0.60] vs respiratory training 3.62 [0.60], p = 0.033), and minute ventilation (RAGT 0.44 [1.94] vs respiratory training 0.16 [1.66], p = 0.006), although these effects predominantly returned to baseline by the 4-week follow-up. Additionally, RAGT significantly reduced sedentary behaviour and increased light physical activity, as well as improved caregiver-reported mobility and gross motor function. No serious adverse events were reported.

Interpretation

RAGT may be considered a potential short-term adjunct for improving respiratory function in non-ambulatory cerebral palsy.