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.