PDF herunterladen
Journal of Pediatric Neurology 2024; 22(03): 194-201
DOI: 10.1055/s-0043-1769737
Original Article

Comparison of the Effectiveness of Conventional Physiotherapy Methods and Robot-Assisted Gait Training after Botulinum Toxin Injection of Lower Extremities in Children with Cerebral Palsy: Prospective Randomized Controlled Study

Ayşe Güç 
1   Kayseri Egitim ve Arastirma Hastanesi, Kayseri, Turkey
,
Mehtap Aykaç Çebiçci
2   Kayseri City Hospital, Turkey Physical Therapy and Rehabilitation Clinic
,
Serap Tomruk Sütbeyaz
2   Kayseri City Hospital, Turkey Physical Therapy and Rehabilitation Clinic
,
Havva Talay Çalış
2   Kayseri City Hospital, Turkey Physical Therapy and Rehabilitation Clinic
,
Hanife Abakay
3   Yozgat Bozok University, Yozgat
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
    Lizenzen und Reprints

Abstract

There are increasing numbers of studies regarding robot-assisted gait training thanks to technological developments and whether it is superior to conventional physiotherapy methods draws attention. This study aimed to compare the effectiveness of conventional physiotherapy methods and robot-assisted gait training in children with cerebral palsy receiving botulinum toxin injection of lower extremities. A total of 28 patients who were followed up in our clinic and had received botulinum toxin injection of lower extremities in the last month were randomized into two groups in the study. First group received conventional physiotherapy (range of joint motion [ROM], stretching, gait training, etc.), and the other group received robot-assisted gait training. The study population was evaluated pre- and posttreatment regarding their ROM, spasticity, gross motor function, balance, functional independence, and gait analyses. When we look at the responses of the patients before and after treatment, a statistically significant change was observed in all fields when comparing before treatment with after treatment (p <  0.05), but there was no statistically significant difference between the groups. We find that both conventional physiotherapy methods and robot-assisted treatments after botulinum toxin injection of lower extremities in children with cerebral palsy were efficient; however, one of both methods was not superior to the other. In addition, further large-scale studies with long-term follow-ups on the comparison of treatment methods are needed.

Keywords

Botulinum toxin - cerebral palsy - robot-assisted walking training


Publikationsverlauf

Eingereicht: 21. Februar 2023

Angenommen: 28. April 2023

Artikel online veröffentlicht:
26. Juni 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Barry MJ. Physical therapy interventions for patients with movement disorders due to cerebral palsy. J Child Neurol 1996; 11 (Suppl. 01) S51-S60
    CrossrefPubMedSuche in Google Scholar
  • 2 El-Etribi MA, Salem ME, El-Shakankiry HM, El-Kahky AM, El-Mahboub SM. The effect of botulinum toxin type—a injection on spasticity, range of motion and gait patterns in children with spastic diplegic cerebral palsy: an Egyptian study. Int J Rehabil Res 2004; 27 (04) 275-281
    CrossrefPubMedSuche in Google Scholar
  • 3 Reddihough DS, King JA, Coleman GJ. et al. Functional outcome of botulinum toxin A injections to the lower limbs in cerebral palsy. Dev Med Child Neurol 2002; 44 (12) 820-827
    CrossrefPubMedSuche in Google Scholar
  • 4 Meyer-Heim A, Ammann-Reiffer C, Schmartz A. et al. Improvement of walking abilities after robotic-assisted locomotion training in children with cerebral palsy. Arch Dis Child 2009; 94 (08) 615-620
    CrossrefPubMedSuche in Google Scholar
  • 5 Schroeder AS, Homburg M, Warken B. et al. 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 (04) 502-510
    CrossrefPubMedSuche in Google Scholar
  • 6 Camargo CH, Teive HA, Zonta M. et al. Botulinum toxin type A in the treatment of lower-limb spasticity in children with cerebral palsy. Arq Neuropsiquiatr 2009; 67 (01) 62-68
    CrossrefPubMedSuche in Google Scholar
  • 7 Scholtes VA, Dallmeijer AJ, Knol DL. et al. Effect of multilevel botulinum toxin a and comprehensive rehabilitation on gait in cerebral palsy. Pediatr Neurol 2007; 36 (01) 30-39
    CrossrefPubMedSuche in Google Scholar
  • 8 Wang RL, Zhou ZH, Xi YC, Wang QN, Wang NH, Huang Z. [Preliminary study of robot-assisted ankle rehabilitation for children with cerebral palsy]. Beijing Da Xue Xue Bao 2018; 50 (02) 207-212
    PubMedSuche in Google Scholar
  • 9 Löwing K, Bexelius A, Brogren Carlberg E. Activity focused and goal directed therapy for children with cerebral palsy—do goals make a difference?. Disabil Rehabil 2009; 31 (22) 1808-1816
    CrossrefPubMedSuche in Google Scholar
  • 10 Cohen-Holzer M, Katz-Leurer M, Reinstein R, Rotem H, Meyer S. The effect of combining daily restraint with bimanual intensive therapy in children with hemiparetic cerebral palsy: a self-control study. NeuroRehabilitation 2011; 29 (01) 29-36
    CrossrefPubMedSuche in Google Scholar
  • 11 Gilliaux M, Renders A, Dispa D. et al. Upper limb robot-assisted therapy in cerebral palsy: a single-blind randomized controlled trial. Neurorehabil Neural Repair 2015; 29 (02) 183-192
    CrossrefPubMedSuche in Google Scholar
  • 12 Smania N, Bonetti P, Gandolfi M. et al. Improved gait after repetitive locomotor training in children with cerebral palsy. Am J Phys Med Rehabil 2011; 90 (02) 137-149
    CrossrefPubMedSuche in Google Scholar
  • 13 Shumway-Cook A, Hutchinson S, Kartin D, Price R, Woollacott M. Effect of balance training on recovery of stability in children with cerebral palsy. Dev Med Child Neurol 2003; 45 (09) 591-602
    CrossrefPubMedSuche in Google Scholar
  • 14 Damiano DL, Abel MF. Functional outcomes of strength training in spastic cerebral palsy. Arch Phys Med Rehabil 1998; 79 (02) 119-125
    CrossrefPubMedSuche in Google Scholar
  • 15 Yazıcı M, Livanelioğlu A, Gücüyener K, Tekin L, Sümer E, Yakut Y. Effects of robotic rehabilitation on walking and balance in pediatric patients with hemiparetic cerebral palsy. Gait Posture 2019; 70: 397-402
    CrossrefPubMedSuche in Google Scholar
  • 16 Drużbicki M, Rusek W, Szczepanik M, Dudek J, Snela S. Assessment of the impact of orthotic gait training on balance in children with cerebral palsy. Acta Bioeng Biomech 2010; 12 (03) 53-58
    PubMedSuche in Google Scholar
  • 17 Duncan B, Shen K, Zou LP. et al. Evaluating intense rehabilitative therapies with and without acupuncture for children with cerebral palsy: a randomized controlled trial. Arch Phys Med Rehabil 2012; 93 (05) 808-815
    CrossrefPubMedSuche in Google Scholar
  • 18 Matsuda M, Iwasaki N, Mataki Y. et al. Robot-assisted training using Hybrid Assistive Limb® for cerebral palsy. Brain Dev 2018; 40 (08) 642-648
    CrossrefPubMedSuche in Google Scholar
  • 19 Borggraefe I, Kiwull L, Schaefer JS. et al. 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 (02) 125-131
    PubMedSuche in Google Scholar
  • 20 Romei M, Montinar A, Piccinini L. et al. Efficacy of robotic-assisted gait training compared with intensive task-oriented physiotherapy for children with Cerebral Palsy. In 2012 4th IEEE RAS & EMBS International Conference on Biomedical Robotics and Biomechatronics (BioRob) 2012: 1890-1894
    PubMedSuche in Google Scholar
  • 21 Klobucká S, Klobucký R, Kollár B. Effect of robot-assisted gait training on motor functions in adolescent and young adult patients with bilateral spastic cerebral palsy: a randomized controlled trial. NeuroRehabilitation 2020; 47 (04) 495-508
    CrossrefPubMedSuche in Google Scholar
  • 22 Carmick J. Clinical use of neuromuscular electrical stimulation for children with cerebral palsy, Part 1: Lower extremity. [published correction appears in Phys Ther 1993 Nov;73(11):809] Phys Ther 1993; 73 (08) 505-513
    CrossrefPubMedSuche in Google Scholar
  • 23 Wissel J, Heinen F, Schenkel A. et al. Botulinum toxin A in the management of spastic gait disorders in children and young adults with cerebral palsy: a randomized, double-blind study of “high-dose” versus “low-dose” treatment. Neuropediatrics 1999; 30 (03) 120-124
    Thieme ConnectPubMedSuche in Google Scholar
  • 24 Ueno T, Watanabe H, Kawamoto H. et al. Feasibility and safety of Robot Suit HAL treatment for adolescents and adults with cerebral palsy. J Clin Neurosci 2019; 68: 101-104
    CrossrefPubMedSuche in Google Scholar
  • 25 Drużbicki M, Rusek W, Snela S. et al. Functional effects of robotic-assisted locomotor treadmill thearapy in children with cerebral palsy. J Rehabil Med 2013; 45 (04) 358-363
    CrossrefPubMedSuche in Google Scholar