Peer-reviewed article
Effects of Lokomat-based robotic-assisted gait training and physical therapy on gait quality in children with cerebral palsy: A severity-stratified analysis.
L Donno, V Cimolin, C Francia, L Molteni, G Andreoni et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how robotic-assisted gait training using Lokomat machines, combined with physical therapy, affects walking quality in 52 children with cerebral palsy over a 4-week program. Children received one robotic training session and one therapy session daily for 20 days each. The treatment produced specific changes in how children walked, with improvements varying depending on the severity of their motor impairment. Step length increased overall, and gait quality scores improved, particularly in children with greater walking difficulties at baseline.
Key points
- Step length significantly increased in the overall cerebral palsy group after treatment
- Gait Profile Score (a measure of overall gait quality) decreased post-treatment, with greater improvements in children with more severe baseline gait deviation
- Different kinematic changes occurred depending on GMFCS severity level: GMFCS-I showed proximal joint changes while GMFCS-III showed distal joint changes
- Gross Motor Function Measure-88 total scores did not change significantly, suggesting gait-specific measures are more sensitive than global motor function measures
- Lokomat-based robotic-assisted gait training produced severity-dependent and joint-specific kinematic improvements
Limitations
This is a retrospective observational study without a control or comparison group, so we cannot determine if improvements were due to the robotic training itself, the physical therapy, or the intensive 4-week rehabilitation program. The study measured changes over only 4 weeks, so longer-term effects are unknown.
Abstract
BACKGROUND: Robotic-assisted gait training (RAGT) is increasingly used in paediatric rehabilitation to promote intensive walking practice in children with cerebral palsy (CP). However, evidence regarding its effectiveness on gait quality remains limited. RESEARCH QUESTION: This retrospective observational study aims to: i) assess the effects of Lokomat-based RAGT and physical therapy (PT) on spatiotemporal gait parameters and overall gait quality; (ii) investigate whether treatment response differs by motor impairment severity, classified by the Gross Motor Function Classification System (GMFCS levels I, II, III). METHODS: The study included 52 children with CP (GMFCS levels I-III) who underwent a 4-week, 20-day rehabilitation program: each day, participants attended one Lokomat-based RAGT session and one conventional PT session, for 20 RAGT and 20 PT sessions overall. Instrumented gait analysis was performed before (T0) and after treatment (T1). Spatiotemporal parameters, Gait Profile Score (GPS), and Gait Variable Scores (GVS) were computed and compared across time and GMFCS subgroups. Gross motor function was assessed using the Gross Motor Function Measure-88 (GMFM-88) total score as complementary measure. RESULTS: GMFM-88 total scores and most spatiotemporal parameters did not change significantly. Step length significantly increased in the overall CP group. GPS decreased post-treatment, with greater relative improvements in children with greater baseline gait deviation. Significant kinematic changes varied by GMFCS level, shifting from predominantly proximal joints in GMFCS-I to mainly distal joints in GMFCS-III. SIGNIFICANCE: Lokomat-based RAGT combined with PT induces severity-dependent and joint-specific kinematic improvements in children with CP. These changes were detected by instrumented gait analysis and summary gait indices, whereas the GMFM-88 total score, a global gross motor function measure, may be less sensitive to gait-specific changes over 4 weeks. Therefore, these findings should be interpreted as evidence of gait-specific kinematic changes rather than proof that the intervention improves gait more than overall gross motor function.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Lokomat-based robotic-assisted gait training combined with conventional physical therapy delivered daily for 4 weeks (20 sessions of each)
- Population
- 52 children with cerebral palsy, GMFCS levels I-III (mild to moderate-severe motor impairment)
Key finding
Step length significantly increased in overall CP group
Donno et al. · PubMed (US National Library of Medicine) · 28 Aug 2026