Combined passive stretching and active movement rehabilitation of lower-limb impairments in children with cerebral palsy using a portable robot

Yi Ning Wu, Miriam Hwang, Yupeng Ren, Deborah Gaebler-Spira, Li Qun Zhang*

*Corresponding author for this work

Research output: Contribution to journalArticle

63 Scopus citations

Abstract

Background. Ankle impairments are closely associated with functional limitations in children with cerebral palsy (CP). Passive stretching is often used to increase the range of motion (ROM) of the impaired ankle. Improving motor control is also a focus of physical therapy. However, convenient and effective ways to control passive stretching and motivate active movement training with quantitative outcomes are lacking. Objective. To investigate the efficacy of combined passive stretching and active movement training with motivating games using a portable rehabilitation robot. Methods. Twelve children with mild to moderate spastic CP participated in robotic rehabilitation 3 times per week for 6 weeks. Each session consisted of 20 minutes of passive stretching followed by 30 minutes of active movement training and ended with 10 minutes of passive stretching. Passive ROM (PROM), active ROM (AROM), dorsiflexor and plantarflexor muscle strength, Selective Control Assessment of the Lower Extremity, and functional outcome measures (Pediatric Balance Scale, 6-minute walk, and Timed Up-and-Go) were evaluated before and after the 6-week intervention. Results. Significant increases were observed in dorsiflexion PROM (P = .002), AROM (P = .02), and dorsiflexor muscle strength (P = .001). Spasticity of the ankle musculature was significantly reduced (P = .01). Selective motor control improved significantly (P = .005). Functionally, participants showed significantly improved balance (P = .0025) and increased walking distance within 6 minutes (P = .025). Conclusions. Passive stretching combined with engaging in active movement training was of benefit in this pilot study for children with CP. They demonstrated improvements in joint biomechanical properties, motor control performance, and functional capability in balance and mobility.

Original languageEnglish (US)
Pages (from-to)378-385
Number of pages8
JournalNeurorehabilitation and Neural Repair
Volume25
Issue number4
DOIs
StatePublished - May 1 2011

Keywords

  • Ankle
  • Cerebral palsy
  • Robotic rehabilitation
  • Selective motor control

ASJC Scopus subject areas

  • Rehabilitation
  • Neurology
  • Clinical Neurology

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