[논문]Comparison of a robotic-assisted gait training program with a program of functional gait training for children with cerebral palsy: design and methods of a two group randomized controlled cross-over trial

Hilderley, Alicia J.; Fehlings, Darcy; Lee, Gloria W.; Wright, F. Virginia

doi:10.1186/s40064-016-3535-0

Comparison of a robotic-assisted gait training program with a program of functional gait training for children with cerebral palsy: design and methods of a two group randomized controlled cross-over trial 원문보기

SpringerPlus, v.5 no.1, 2016년, pp.1886 -

Hilderley, Alicia J. (Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, ON M4G 1R8 Canada) , Fehlings, Darcy (Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, ON M4G 1R8 Canada) , Lee, Gloria W. (Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, ON M4G 1R8 Canada) , Wright, F. Virginia (Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Rd, Toronto, ON M4G 1R8 Canada)

Abstract ▼ AI-Helper

BackgroundEnhancement of functional ambulation is a key goal of rehabilitation for children with cerebral palsy (CP) who experience gross motor impairment. Physiotherapy (PT) approaches often involve overground and treadmill-based gait training to promote motor learning, typically as free walking or with body-weight support. Robotic-assisted gait training (RAGT), using a device such as the Lokomat®Pro, may permit longer training duration, faster and more variable gait speeds, and support walking pattern guidance more than overground/treadmill training to further capitalize on motor learning principles. Single group pre-/post-test studies have demonstrated an association between RAGT and moderate to large improvements in gross motor skills, gait velocity and endurance. A single published randomized controlled trial (RCT) comparing RAGT to a PT-only intervention showed no difference in gait kinematics. However, gross motor function and walking endurance were not evaluated and conclusions were limited by a large PT group drop-out rate.Methods/designIn this two-group cross-over RCT, children are randomly allocated to the RAGT or PT arm (each with twice weekly sessions for eight weeks), with cross-over to the other intervention arm following a six-week break. Both interventions are grounded in motor learning principles with incorporation of individualized mobility-based goals. Sessions are fully operationalized through manualized, menu-based protocols and post-session documentation to enhance internal and external validity. Assessments occur pre/post each intervention arm (four time points total) by an independent assessor. The co-primary outcomes are gross motor functional ability (Gross Motor Function Measure (GMFM-66) and 6-minute walk test), with secondary outcome measures assessing: (a) individualized goals; (b) gait variables and daily walking amounts; and (c) functional abilities, participation and quality of life. Investigators and statisticians are blinded to study group allocation in the analyses, and assessors are blinded to treatment group. The primary analysis will be the pre- to post-test differences (change scores) of the GMFM-66 and 6MWT between RAGT and PT groups.DiscussionThis study is the first RCT comparing RAGT to an active gait-related PT intervention in paediatric CP that addresses gait-related gross motor, participation and individualized outcomes, and as such, is expected to provide comprehensive information as to the potential role of RAGT in clinical practice.Trial registration ClinicalTrials.gov NCT02196298Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-016-3535-0) contains supplementary material, which is available to authorized users.

주제어

참고문헌 (82)

Aurich Schuler T Warken B Graser JV Practical recommendations for robot-assisted treadmill therapy (Lokomat) in children with cerebral palsy: indications, goal setting, and clinical implementation within the WHO-ICF framework Neuropediatrics 2015 46 248 260 10.1055/s-0035-1550150 26011438

상세보기
Baker K Goggins J Xie H A randomized crossover trial of a wedged insole for treatment of knee osteoarthritis Arthr Rheumatol 2007 56 1198 1203 10.1002/art.22516

상세보기
Bar-Haim S Harries N Nammourah I Effectiveness of motor learning coaching in children with cerebral palsy: a randomized controlled trial Clin Rehabil 2010 24 1009 1020 10.1177/0269215510371428 20576667

상세보기
Bjornson KF Belza B Kartin D Ambulatory physical activity performance in youth with cerebral palsy and youth who are developing typically Phys Ther 2007 87 248 257 10.2522/ptj.20060157 17244693

상세보기
Bjornson KF Zhou C Stevenson R Walking activity patterns in youth with cerebral palsy and youth developing typically Disabil Rehabil 2014 36 1279 1284 10.3109/09638288.2013.845254 24160855

상세보기
Borggraefe I Kiwull L Schaefer JS Sustainability of motor performance after robotic-assisted treadmill therapy in children: an open, non-randomized baseline-treatment study Eur J Phys Rehabil Med 2010 46 125 131 20485217

상세보기
Borggraefe I Schaefer JS Klaiber M Robotic-assisted treadmill therapy improves walking and standing performance in children and adolescents with cerebral palsy Eur J Paediatr Neurol 2010 14 496 502 10.1016/j.ejpn.2010.01.002 20138788

상세보기
Bottos M Gericke C Ambulatory capacity in cerebral palsy: prognostic criteria and consequences for intervention Dev Med Child Neurol 2003 45 786 790 10.1111/j.1469-8749.2003.tb00890.x 14580136

상세보기
Bottos M Feliciangeli A Sciuto L Functional status of adults with cerebral palsy and implications for treatment of children Dev Med Child Neurol 2001 43 516 528 10.1017/S0012162201000950 11508917

상세보기
Brütsch K Schuler T Koenig A Influence of virtual reality soccer game on walking performance in robotic assisted gait training for children J Neuroeng Rehabil 2010 7 15 10.1186/1743-0003-7-15 20412572

상세보기
Castelli E Robotic movement therapy in cerebral palsy Dev Med Child Neurol 2011 53 481 10.1111/j.1469-8749.2011.03987.x 21506997

상세보기
Chan A-W Tetzlaff JM Gøtzsche PC SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials BMJ 2013 346 e7586 10.1136/bmj.e7586 23303884

상세보기
Chrysagis N Skordilis EK Stavrou N The effect of treadmill training on gross motor function and walking speed in ambulatory adolescents with cerebral palsy: a randomized controlled trial Am J Phys Med Rehabil 2012 91 747 760 10.1097/PHM.0b013e3182643eba 22902937

상세보기
Dobkin BH Duncan PW Should body weight-supported treadmill training and robotic-assistive steppers for locomotor training trot back to the starting gate? Neurorehabil Neural Repair 2012 26 308 317 10.1177/1545968312439687 22412172

상세보기
Druzbicki M Rusek W Snela S Functional effects of robotic-assisted locomotor treadmill therapy in children with cerebral palsy J Rehabil Med 2013 45 358 363 10.2340/16501977-1114 23450428

상세보기
Drużbicki M Rusek W Szczepanik M Assessment of the impact of orthotic gait training on balance in children with cerebral palsy Acta Bioeng Biomech 2010 12 53 58 21243970

상세보기
Eisenberg S Zuk L Carmeli E Katz-Leurer M Contribution of stepping while standing to function and secondary conditions among children with cerebral palsy Pediatr Phys Ther 2009 21 79 85 10.1097/PEP.0b013e31818f57f2 19214080

상세보기
Gibson BE Teachman G Wright V Children’s and parents’ beliefs regarding the value of walking: rehabilitation implications for children with cerebral palsy Child Care Health Dev 2012 38 61 69 10.1111/j.1365-2214.2011.01271.x 21696426

상세보기
Glazebrook CM Wright FV Measuring advanced motor skills in children with cerebral palsy: further development of the challenge module Pediatr Phys Ther 2014 26 201 213 10.1097/PEP.0000000000000035 24675120

상세보기
Haley SM Coster WJ Ludlow LH Pediatric evaluation of disability inventory (PEDI) 1992 San Antonio Pearson Clinical
Hanna SE Rosenbaum PL Bartlett DJ Stability and decline in gross motor function among children and youth with cerebral palsy aged 2 to 21 years Dev Med Child Neurol 2009 51 295 302 10.1111/j.1469-8749.2008.03196.x 19391185

상세보기
Harris PA Research electronic data capture (redcap)-planning, collecting and managing data for clinical and translational research BMC Bioinform 2012 13 A15 10.1186/1471-2105-13-S12-A15

상세보기
Hintze J NCSS and PASS 2001 Kaysville Number Cruncher Statistical Systems
Johnston TE Watson KE Ross SA Effects of a supported speed treadmill training exercise program on impairment and function for children with cerebral palsy Dev Med Child Neurol 2011 53 742 750 10.1111/j.1469-8749.2011.03990.x 21679357

상세보기
Kamath T Pfeifer M Banerjee-Guenette P Reliability of the motor learning strategy rating instrument for children and youth with acquired brain injury Phys Occup Ther Pediatr 2012 32 288 305 10.3109/01942638.2012.672551 22574628

상세보기
King GA McDougall J Palisano RJ Goal attainment scaling: its use in evaluating pediatric therapy programs Phys Occup Ther Pediatr 2000 19 31 52

상세보기
King GA Law M King S Measuring children’s participation in recreation and leisure activities: construct validation of the CAPE and PAC Child Care Health Dev 2007 33 28 39 10.1111/j.1365-2214.2006.00613.x 17181750

상세보기
Koenig A Wellner M Köneke S Virtual gait training for children with cerebral palsy using the Lokomat gait orthosis Stud Health Technol Inform 2008 132 204 209 18391287

상세보기
Koenig A Omlin X Bergmann J Controlling patient participation during robot-assisted gait training J Neuroeng Rehabil 2011 8 14 10.1186/1743-0003-8-14 21429200

상세보기
Law M Baptiste S McColl M The Canadian occupational performance measure: an outcome measure for occupational therapy Can J Occup Ther 1990 57 82 87 10.1177/000841749005700207 10104738

상세보기
Law M Russell D Pollock N A comparison of intensive neurodevelopmental therapy plus casting and a regular occupational therapy program for children with cerebral palsy Dev Med Child Neurol 1997 39 664 670 10.1111/j.1469-8749.1997.tb07360.x 9352727

상세보기
Lepage C Noreau L Bernard PM Association between characteristics of locomotion and accomplishment of life habits in children with cerebral palsy Phys Ther 1998 78 458 469 9597060

상세보기
Levac D Wishart L Missiuna C Wright V The application of motor learning strategies within functionally based interventions for children with neuromotor conditions Pediatr Phys Ther 2009 21 345 355 10.1097/PEP.0b013e3181beb09d 19923975

상세보기
Louis TA Lavori PW Bailar JC Polansky M Crossover and self-controlled designs in clinical research N Engl J Med 1984 310 24 31 10.1056/NEJM198401053100106 6689736

상세보기
Mayr A Kofler M Quirbach E Prospective, blinded, randomized crossover study of gait rehabilitation in stroke patients using the Lokomat gait orthosis Neurorehabil Neural Repair 2007 21 307 314 10.1177/1545968307300697 17476001

상세보기
McDougall J Wright V Rosenbaum P The ICF model of functioning and disability: incorporating quality of life and human development Dev Neurorehabil 2010 13 204 211 10.3109/17518421003620525 20450470

상세보기
McKeever P Rossen BE Scott H The significance of uprightness: parents’ reflections on children’s responses to a hands-free walker for children Disabil Soc 2013 28 380 392 10.1080/09687599.2012.714259

상세보기
McNee AE Will E Lin J-P The effect of serial casting on gait in children with cerebral palsy: preliminary results from a crossover trial Gait Posture 2007 25 463 468 10.1016/j.gaitpost.2006.08.002 17008098

상세보기
Meyer-Heim A van Hedel HJA Robot-assisted and computer-enhanced therapies for children with cerebral palsy: current state and clinical implementation Semin Pediatr Neurol 2013 20 139 145 10.1016/j.spen.2013.06.006 23948688

상세보기
Meyer-Heim A Borggraefe I Ammann-Reiffer C Feasibility of robotic-assisted locomotor training in children with central gait impairment Dev Med Child Neurol 2007 49 900 906 10.1111/j.1469-8749.2007.00900.x 18039236

상세보기
Meyer-Heim A Ammann-Reiffer C Schmartz A Improvement of walking abilities after robotic-assisted locomotion training in children with cerebral palsy Arch Dis Child 2009 94 615 620 10.1136/adc.2008.145458 19208675

상세보기
Miller L Marnane K Ziviani J Boyd RN The Dimensions of Mastery Questionnaire in school-aged children with congenital hemiplegia: test–retest reproducibility and parent–child concordance Phys Occup Ther Pediatr 2014 34 168 184 10.3109/01942638.2013.806978 23815262

상세보기
Moore JB Yin Z Hanes J Measuring enjoyment of physical activity in children: validation of the physical activity enjoyment scale J Appl Sport Psychol 2009 21 S116 S129 10.1080/10413200802593612 20209028

상세보기
Novak I Mcintyre S Morgan C A systematic review of interventions for children with cerebral palsy: state of the evidence Dev Med Child Neurol 2013 55 885 910 10.1111/dmcn.12246 23962350

상세보기
Oeffinger D Bagley A Rogers S Outcome tools used for ambulatory children with cerebral palsy: responsiveness and minimum clinically important differences Dev Med Child Neurol 2008 50 918 925 10.1111/j.1469-8749.2008.03150.x 19046185

상세보기
Oskoui M Coutinho F Dykeman J An update on the prevalence of cerebral palsy: a systematic review and meta-analysis Dev Med Child Neurol 2013 55 509 519 10.1111/dmcn.12080 23346889

상세보기
Pajaro-Blazquez M Shetye R Gallegos-Salazar J Bonato P Robotic-assisted gait training in children with cerebral palsy in clinical practice Converg Clin Eng Res Neurorehabil Biosyst Biorobot 2013 1 29 33 10.1007/978-3-642-34546-3_5
Palisano RJ Rosenbaum P Bartlett D Livingston MH Content validity of the expanded and revised Gross Motor Function Classification System Developmental Medicine & Child Neurology 2008 50 10 744 750 10.1111/j.1469-8749.2008.03089.x 18834387

상세보기
Park E-Y Kim W-H Structural equation modeling of motor impairment, gross motor function, and the functional outcome in children with cerebral palsy Res Dev Disabil 2013 34 1731 1739 10.1016/j.ridd.2013.02.003 23500167

상세보기
Park ES Park CI Kim JY Comparison of anterior and posterior walkers with respect to gait parameters and energy expenditure of children with spastic diplegic cerebral palsy Yonsei Med J 2001 42 180 184 10.3349/ymj.2001.42.2.180 11371104

상세보기
Peterson MD Gordon PM Hurvitz EA Chronic disease risk among adults with cerebral palsy: the role of premature sarcopoenia, obesity and sedentary behaviour Obes Rev 2013 14 171 182 10.1111/j.1467-789X.2012.01052.x 23094988

상세보기
Phelan SK Wright V Gibson BE Representations of disability and normality in rehabilitation technology promotional materials Disabil Rehabil 2014 36 2072 2079 10.3109/09638288.2014.891055 24564359

상세보기
Pool D Blackmore AM Bear N Valentine J Effects of short-term daily community walk aide use on children with unilateral spastic cerebral palsy Pediatr Phys Ther 2014 26 308 317 10.1097/PEP.0000000000000057 24979083

상세보기
Ravens-Sieberer U Auquier P Erhart M The KIDSCREEN-27 quality of life measure for children and adolescents: psychometric results from a cross-cultural survey in 13 European countries Qual Life Res 2007 16 1347 1356 10.1007/s11136-007-9240-2 17668292

상세보기
Russell DJ Wright M Rosenbaum PL Improved scaling of the gross motor function measure for children with cerebral palsy: evidence of reliability and validity Phys Ther 2000 80 873 885 10960935

상세보기
Russell DJ Rosenbaum PL Wright M Avery LM Gross motor function measure (GMFM-66 and GMFM-88) user’s manual 2013 2 Hoboken Wiley
Schindl MR Forstner C Kern H Hesse S Treadmill training with partial body weight support in nonambulatory patients with cerebral palsy Arch Phys Med Rehabil 2000 81 301 306 10.1016/S0003-9993(00)90075-3 10724074

상세보기
Scholtes VA Becher JG Beelen A Lankhorst GJ Clinical assessment of spasticity in children with cerebral palsy: a critical review of available instruments Dev Med Child Neurol 2006 48 64 73 10.1017/S0012162206000132 16359597

상세보기
Schroeder AS Homburg M Warken B Prospective controlled cohort study to evaluate changes of function, activity and participation in patients with bilateral spastic cerebral palsy after Robot-enhanced repetitive treadmill therapy Eur J Paediatr Neurol 2014 18 502 510 10.1016/j.ejpn.2014.04.012 24821475

상세보기
Schroeder AS Von Kries R Riedel C Patient-specific determinants of responsiveness to robot-enhanced treadmill therapy in children and adolescents with cerebral palsy Dev Med Child Neurol 2014 56 1172 1179 10.1111/dmcn.12564 25154424

상세보기
Schulz KF Altman DG Moher D CONSORT Group CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials J Clin Epidemiol 2010 63 834 840 10.1016/j.jclinepi.2010.02.005 20346629

상세보기
Senn S Cross-over trials in clinical research 2002 2 West Sussex Wiley
Sorsdahl AB Moe-Nilssen R Strand LI Test–retest reliability of spatial and temporal gait parameters in children with cerebral palsy as measured by an electronic walkway Gait Posture 2008 27 43 50 10.1016/j.gaitpost.2007.01.001 17300940

상세보기
Strifling KMB Lu N Wang M Comparison of upper extremity kinematics in children with spastic diplegic cerebral palsy using anterior and posterior walkers Gait Posture 2008 28 412 419 10.1016/j.gaitpost.2008.01.018 18406138

상세보기
Stuberg WA Considerations related to weight-bearing programs in children with developmental disabilities Phys Ther 1992 72 35 40 1728047

상세보기
Tefertiller C Pharo B Evans N Winchester P Efficacy of rehabilitation robotics for walking training in neurological disorders: a review J Rehabil Res Dev 2011 48 387 416 10.1682/JRRD.2010.04.0055 21674390

상세보기
Thompson P Beath T Bell J Test-retest reliability of the 10-metre fast walk test and 6-minute walk test in ambulatory school-aged children with cerebral palsy Dev Med Child Neurol 2008 50 370 376 10.1111/j.1469-8749.2008.02048.x 18355340

상세보기
Verschuren O Darrah J Novak I Health-enhancing physical activity in children with cerebral palsy: more of the same is not enough Phys Ther 2014 94 297 305 10.2522/ptj.20130214 24092902

상세보기
Wang M Reid D Virtual reality in pediatric neurorehabilitation: attention deficit hyperactivity disorder, autism and cerebral palsy Neuroepidemiology 2011 36 2 18 10.1159/000320847 21088430

상세보기
Wiart L Exploring mobility options for children with physical disabilities: a focus on powered mobility Phys Occup Ther Pediatr 2011 31 16 18 10.3109/01942638.2011.532452 21077754

상세보기
Williams EN Carroll SG Reddihough DS Investigation of the timed “Up & Go” test in children Dev Med Child Neurol 2005 47 518 524 10.1017/S0012162205001027 16108451

상세보기
Willoughby KL Dodd KJ Shields N A systematic review of the effectiveness of treadmill training for children with cerebral palsy Disabil Rehabil 2009 31 1971 1979 10.3109/09638280902874204 19874075

상세보기
Wong DL Baker CM Pain in children: comparison of assessment scales Pediatr Nurs 1988 14 9 17 3344163
Wood L Egger M Gluud LL Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study BMJ 2008 336 601 605 10.1136/bmj.39465.451748.AD 18316340

상세보기
World Health Organization International classification of functioning, disability and health (ICF) 2001 Geneva World Health Organization
World Health Organization (2007) International classification of functioning, disability, and health. Children and Youth Version: ICF-CY. World Health Organization
Wright FV Redekop S Koo I Reliability of a new observational gait scale for evaluation of outcomes related to botulinum toxin type-A injections in children with cerebral palsy Dev Med Child Neurol 2008 50 suppl4 32
Wright V Shircore LE Fehlings D Lee G Reliability of the challenge module for children with cerebral palsy in GMFCS Level I Dev Med Child Neurol 2012 54 30 79 22117564
Wright FV Rosenbaum P Fehlings D The Quality Function Measure: reliability and discriminant validity of a new measure of quality of gross motor movement in ambulatory children with cerebral palsy Dev Med Child Neurol 2014 56 770 778 10.1111/dmcn.12453 24702540

상세보기
Yelling M Lamb KL Swaine I Validity of a pictorial perceived exertion scale for effort estimation and effort production during stepping exercise in adolescent children Eur Phys Educ Rev 2002 8 157 175 10.1177/1356336X020082007

상세보기
Young NL Williams JI Yoshida KK Wright JG Measurement properties of the activities scale for kids J Clin Epidemiol 2000 53 125 137 10.1016/S0895-4356(99)00113-4 10729684

상세보기
Zwicker JG Mayson TA Effectiveness of treadmill training in children with motor impairments Pediatr Phys Ther 2010 22 361 377 10.1097/PEP.0b013e3181f92e54 21068636

상세보기

표제어: PCR

동의어: Packet Collision Rate

용어 설명 출처 목록 (6)

용어 설명: PCR은 세균 특이성이 있는 primer를 이용하여 적은 수의 세균이 있을지라도 쉽게 검출할 수 있는 유용한 방법이며, 이를 이용하여 구강 내 치면세균막이나 타액에서 직접 세균을 검출할 수 있게 되었다[8].

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증

Comparison of a robotic-assisted gait training program with a program of functional gait training for children with cerebral palsy: design and methods of a two group randomized controlled cross-over trial 원문보기

Abstract ▼ AI-Helper

주제어

참고문헌 (82)

이 논문을 인용한 문헌

관련 콘텐츠

원문 보기

원문 URL 링크

오픈액세스(OA) 유형

이 논문과 함께 이용한 콘텐츠

AI-Helper ※ AI-Helper는 오픈소스 모델을 사용합니다.

선택된 텍스트