Upper limb robot-assisted therapy in cerebral palsy: a single-blind randomized controlled trial

Neurorehabil Neural Repair. 2015 Feb;29(2):183-92. doi: 10.1177/1545968314541172. Epub 2014 Jul 11.

Abstract

Background: Several pilot studies have evoked interest in robot-assisted therapy (RAT) in children with cerebral palsy (CP).

Objective: To assess the effectiveness of RAT in children with CP through a single-blind randomized controlled trial.

Patients and methods: Sixteen children with CP were randomized into 2 groups. Eight children performed 5 conventional therapy sessions per week over 8 weeks (control group). Eight children completed 3 conventional therapy sessions and 2 robot-assisted sessions per week over 8 weeks (robotic group). For both groups, each therapy session lasted 45 minutes. Throughout each RAT session, the patient attempted to reach several targets consecutively with the REAPlan. The REAPlan is a distal effector robot that allows for displacements of the upper limb in the horizontal plane. A blinded assessment was performed before and after the intervention with respect to the International Classification of Functioning framework: body structure and function (upper limb kinematics, Box and Block test, Quality of Upper Extremity Skills Test, strength, and spasticity), activities (Abilhand-Kids, Pediatric Evaluation of Disability Inventory), and participation (Life Habits).

Results: During each RAT session, patients performed 744 movements on average with the REAPlan. Among the variables assessed, the smoothness of movement (P < .01) and manual dexterity assessed by the Box and Block test (P = .04) improved significantly more in the robotic group than in the control group.

Conclusions: This single-blind randomized controlled trial provides the first evidence that RAT is effective in children with CP. Future studies should investigate the long-term effects of this therapy.

Keywords: Disability and Health; International Classification of Functioning; cerebral palsy; kinematics; motor learning; pediatrics; rehabilitation; robotics.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomechanical Phenomena
  • Cerebral Palsy / physiopathology
  • Cerebral Palsy / rehabilitation*
  • Child
  • Disability Evaluation
  • Humans
  • Learning
  • Psychomotor Performance / physiology
  • Robotics* / methods
  • Single-Blind Method
  • Treatment Outcome
  • Upper Extremity* / physiopathology