Robotic Ankle Training Improves Sensorimotor Functions in Children with Cerebral Palsy-A Pilot Study

Area of Science:

• Rehabilitation Medicine
• Pediatric Neurology
• Biomechanics

Background:

• Children with cerebral palsy (CP) exhibit sensorimotor impairments, including weakness, spasticity, and proprioceptive deficits, which significantly impact motor control and mobility.
• Proprioceptive dysfunction is a key factor exacerbating the motor control and mobility challenges faced by children with CP.

Purpose of the Study:

• To investigate the proprioceptive deficits in the lower extremities of children with CP.
• To evaluate the effectiveness of robotic ankle training (RAT) in improving proprioception and clinical impairments in children with CP.

Main Methods:

• A 6-week robotic ankle training (RAT) program involving passive stretching and active movement was administered to eight children with CP.
• Pre- and post-training assessments included ankle proprioception, clinical evaluations, and biomechanical analyses, with comparisons made to eight typically developing children (TDC).
• The training consisted of 18 sessions (3 sessions/week over 6 weeks), with each session including 20 minutes of passive stretching and 20-30 minutes of active movement training.

Main Results:

• Children with CP demonstrated significantly inferior ankle proprioceptive acuity compared to TDC, both in dorsiflexion (3.60 ± 2.28° vs. 0.94 ± 0.43°, p=0.027) and plantar flexion (-3.72 ± 2.38° vs. -0.86 ± 0.48°, p=0.012).
• Following RAT, significant improvements were observed in children with CP, including increased dorsiflexion strength (3.61 ± 3.75 Nm to 7.48 ± 2.75 Nm, p=0.018) and plantar flexion strength (-11.89 ± 7.04 Nm to -17.61 ± 6.81 Nm, p=0.043).
• Ankle range of motion (AROM) in dorsiflexion also improved significantly (5.58 ± 13.18° to 15.97 ± 11.21°, p=0.028), while proprioceptive acuity showed a trend towards improvement.

Conclusions:

• Robotic ankle training (RAT) is a promising intervention for enhancing sensorimotor functions in the lower extremities of children with CP.
• The interactive and motivating nature of RAT can effectively engage children in rehabilitation, leading to improved clinical outcomes and sensorimotor performance.
• RAT demonstrates potential for improving both motor and sensory aspects of lower extremity function in children diagnosed with cerebral palsy.