Mobile robotic walker enables precision moderately intense exercise and environmental exploration in a child with cerebral palsy GMFCS IV: assessment of use, user experience and quantitative impact in a home and hospital based setting.

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.