PURPOSE: Investigating initial usage and tolerance of an untethered paediatric mobile Robotic Gait Trainer (RGT)within home and hospital settings, in a 5-year-old child with mixed tone spastic quadriplegic Cerebral Palsy, GMFCS IV. Secondary objectives included parent proxy and therapist qualitative feedback on RGT use. MATERIALS AND METHODS: Single participant mixed-method observational case study to assess use of a paediatric mobile RGT over 6-weeks. Minimum goal was to complete 3-weekly 20-minute or longer training sessions, hospital or home-based. RESULTS: 7 hospital-based and 18 home-based sessions were completed with no adverse effects; each session was approximately 30-minutes regardless of setting. Average step counts in hospital and home sessions were 857 and 881, respectively. Mild heart rate elevation was achieved. Distance walked over 2 min with a manual walker increased from 0.3 m pre-intervention to 1.5 m post-intervention. Total Spinal Alignment Range of Motion Measure (SAROMM) score improved significantly, decreasing from 42 to 30 with range improvement at the knees (-5), ankle (-5) and upper extremities (-4). A modest but clinically insignificant decrease in hip range (+2) was noted. MAS Hamstring spasticity score improved from 3, pre-intervention to 2 post intervention. Qualitative feedback included themes of ease of transfer in/out of the device, and comfortable use. Improvements to RGT functionality including independent steering were suggested. Potential for social integration and neuroplasticity were highlighted. CONCLUSION: In a single participant, a paediatric mobile robotic walker improved exercise participation with heart rate reaching moderate exercise ranges, high step counts in short sessions, and walking endurance and functional capacity.
Alazem et al. (Thu,) studied this question.