Impact of robotic gait orthosis training on kinematic parameters in hemiplegic children

Background: gait disturbance is one of the most common consequences of hemiplegic cerebral palsy characterized by asymmetrical step length and reduced walking speed, robotic gait orthosis therapy is the most effective in gait training and enhance kinematic gait parameters. Purpose: to evaluate the effect of robotic gait orthosis on kinematic gait parameters in hemiplegic children. Patient and methods: 40 Cerebral palsy children with spastic hemiplegia ranged from 7 to 12 years old. They were selected from the outpatient clinic of Haven physical therapy center on 6th October city. They were allocated randomly in two groups (20 children each). Group I (control group): received a selected physical therapy program for 3 times weekly for 8 successive weeks. Group II (Study group): received the selected physical therapy program as the control group for 30 minutes in addition to Lokomat gait training for 30 minutes. This program was performed 3 times weekly for 8 successive weeks. Both 3-D kinematic gait analysis and robotic gait orthosis were carried out before and after intervention. Results: we found statistically significant increase in hip flexor (p=0.05) &hip extensor (p=0.018) & significant decreased in ankle at initial contact (p=0.001) &increase in single limb support (p=0.001) &decreased in cadence (p=0.020) and decreased in speed (p=0.020) at post treatment in study group compared to control group. Conclusion: Robotic gait orthosis is effective modalities in rehabilitation of children with hemiplegic cerebral palsied, combination between Lokomat and physical therapy program plays an important role in muscle strength and kinematic gait parameters thus improving patient gait pattern.