Influence of Robotic Neurorehabilitation in Cerebral Palsy on Motor Function and Gait

Background and aim: Cerebral palsy (CP) is a nonprogressive neurological disorder characterized by permanent developmental disorders of movement and posture. One of the most common goals of rehabilitation is the treatment of gait disorders. Ataxic gait disorder tends to worsen in the adolescent period. Research indicates a positive therapeutic effect of the combined application of conventional rehabilitation, robotic neurorehabilitation (RNR) and virtual reality, but there is no consensus on the length of treatment and frequency of application. The aim of this case report was to contribute to the definition of the RNR protocol for the treatment of ataxic gait disorder in adolescents with CP. Case report: In a female child with an ataxic form of CP who was on regular conventional kinesitherapy in the age period between 13 to 15 years, robotic-assisted gait training (RAGT) was applied for the treatment of gait disorders. The rehabilitation protocol lasted 10 weeks, 5 times a week, and included individual, conventional kinesitherapy for 30 min and RAGT for 30 min. Combined RNR treatment was conducted once a year in the period between July and September. The results of the therapeutic evaluation revealed that the functional motor level remained unchanged, while the improved functional motor status for the category of standing and gait was maintained during treatment between the patient's 13 and 15 years age. In their 15th year, independent gait over a shorter distance (14 m) was achieved, as well as a normal gait frequency (83 steps/minute), with a desirable duration of the left leg support phase of 65% and 70% for the right leg support phase. Conclusions: The results of our research indicate that the application of conventional kinesitherapy and RAGT, over the period of 10 weeks a year, can have a positive effect on improving the postural and locomotor functions of ataxic gait in adolescents with CP.