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Electromechanically assisted walking in patients with cerebral palsy: A meta-analysis

  • Kim, Kwonhoi (Team of physical therapy, Catholic University Uijeongbu ST Mary's Hosipital) ;
  • Lee, Sukmin (Department of Physical Therapy, College of Health and Welfare, Sahmyook University)
  • Received : 2021.02.02
  • Accepted : 2021.03.16
  • Published : 2021.03.31

Abstract

Objective: This review aims to analyze the effects of electromechanically assisted walking in patients with cerebral palsy(CP). Design: A systematic review and meta-analysis. Methods: We reviewed systematically using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist guidelines. The inclusion criteria for this study were all CP patients. The intervention was electromechanically assisted walking. The outcome measures included gait parameters, function, spasticity. Studies excluded from this review were excluded from the review if they were non-English languages and if the study was not published as a full report, and if they were not randomized controlled trials (RCTs) designs. The RevMan 5.4 program was used to evaluate and explain the results. The risk of bias was evaluated independently by two reviewers. The quantitative meta-analysis, including mean differences (MD) and associated standard deviations (SD) from baseline and follow-up assessments, were recorded. Results: A total of 634 articles were searched. Two hundred eighty-nine duplicate articles were excluded, and 345 of 634 originals were left for selection. Of these 74 papers, 44 were out of topic, and 19 reported no mean or standard deviation values. And one was a non-experimental study. Finally, ten studies were included. All 10 RCTs of electromechanically assisted walking were analyzed. The meta-analysis showed a significant improvement in gait cycle (95% CI (confidence intervals), 0.09 to 0.19, I2=0%), Gross Motor Function Measure (GMFM) D (95% CI, 3.27 to 13.17, I2=0%) and GMFM E (95% CI, 0.22 to 6.41, I2=0%). Conclusions: Electromechanically assisted training helps in walking in patients with CP.

Keywords

References

  1. Booth ATC, Buizer AI, Meyns P, Oude Lansink ILB, Steenbrink F, van der Krogt MM. The efficacy of functional gait training in children and young adults with cerebral palsy: a systematic review and metaanalysis. Dev Med Child Neurol. 2018;60:866-83. https://doi.org/10.1111/dmcn.13708
  2. Aisen ML, Kerkovich D, Mast J, Mulroy S, Wren TA, Kay RM, et al. Cerebral palsy: clinical care and neurological rehabilitation. Lancet Neurol. 2011;10:844-52. https://doi.org/10.1016/S1474-4422(11)70176-4
  3. Baram Y, Lenger R. Gait improvement in patients with cerebral palsy by visual and auditory feedback. Neuromodulation. 2012;15:48-52; discussion https://doi.org/10.1111/j.1525-1403.2011.00412.x
  4. Moreau NG, Bodkin AW, Bjornson K, Hobbs A, Soileau M, Lahasky K. Effectiveness of Rehabilitation Interventions to Improve Gait Speed in Children With Cerebral Palsy: Systematic Review and Meta-analysis. Phys Ther. 2016;96:1938-54. https://doi.org/10.2522/ptj.20150401
  5. Meyer-Heim A, Ammann-Reiffer C, Schmartz A , Schafer J, Sennhauser FH, Heinen F, et al. Improvement of walking abilities after robotic-assisted locomotion training in children with cerebral palsy. Arch Dis Child. 2009;94:615-20. https://doi.org/10.1136/adc.2008.145458
  6. Plasschaert F, Jones K, Forward M. The effect of simulating weight gain on the energy cost of walking in unimpaired children and children with cerebral palsy. Arch Phys Med Rehabil. 2008;89:2302-8. https://doi.org/10.1016/j.apmr.2008.05.023
  7. Chakraborty S, Nandy A, Kesar TM. Gait deficits and dynamic stability in children and adolescents with cerebral palsy: A systematic review and meta-analysis. Clin Biomech (Bristol, Avon). 2020;71:11-23. https://doi.org/10.1016/j.clinbiomech.2019.09.005
  8. Neto HP, Grecco LA, Duarte NA, Christovao TC, Franco de Oliveira LV, Dumont AJ, et al. Immediate Effect of Postural Insoles on Gait Performance of Children with Cerebral Palsy: Preliminary Randomized Controlled Double-blind Clinical Trial. J Phys Ther Sci. 2014;26:1003-7. https://doi.org/10.1589/jpts.26.1003
  9. Borggraefe I, Schaefer JS, Klaiber M, Dabrowski E, Ammann-Reiffer C, Knecht B, et al. Robotic-assisted treadmill therapy improves walking and standing performance in children and adolescents with cerebral palsy. Eur J Paediatr Neurol. 2010;14:496-502. https://doi.org/10.1016/j.ejpn.2010.01.002
  10. Smania N, Bonetti P, Gandolfi M, Cosentino A, Waldner A, Hesse S, et al. Improved gait after repetitive locomotor training in children with cerebral palsy. Am J Phys Med Rehabil. 2011;90:137-49. https://doi.org/10.1097/PHM.0b013e318201741e
  11. Yazici M, Livanelioglu A, Gucuyener K, Tekin L, Sumer E, Yakut Y. Effects of robotic rehabilitation on walking and balance in pediatric patients with hemiparetic cerebral palsy. Gait Posture. 2019;70: 397-402. https://doi.org/10.1016/j.gaitpost.2019.03.017
  12. Alazem H, McCormick A, Nicholls SG, Vile E, Adler R, Tibi G. Development of a robotic walker for individuals with cerebral palsy. Disabil Rehabil Assist Technol. 2020;15:643-51. https://doi.org/10.1080/17483107.2019.1604827
  13. Rose J, Cahill-Rowley K, Butler EE. Artificial Walking Technologies to Improve Gait in Cerebral Palsy: Multichannel Neuromuscular Stimulation. Artif Organs. 2017;41:E233-E9. https://doi.org/10.1111/aor.13058
  14. Carvalho I, Pinto SM, Chagas DDV, Praxedes Dos Santos JL, de Sousa Oliveira T, Batista LA. Robotic Gait Training for Individuals With Cerebral Palsy: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil. 2017;98:2332-44. https://doi.org/10.1016/j.apmr.2017.06.018
  15. Lefmann S, Russo R, Hillier S. The effectiveness of robotic-assisted gait training for paediatric gait disorders: systematic review. J Neuroeng Rehabil. 2017;14:1. https://doi.org/10.1186/s12984-016-0214-x
  16. Moreno-De-Luca A, Ledbetter DH, Martin CL. Genetic [corrected] insights into the causes and classification of [corrected] cerebral palsies. Lancet Neurol. 2012;11:283-92. https://doi.org/10.1016/S1474-4422(11)70287-3
  17. Wallard L, Dietrich G, Kerlirzin Y, Bredin J. Robotic-assisted gait training improves walking abilities in diplegic children with cerebral palsy. Eur J Paediatr Neurol. 2017;21:557-64. https://doi.org/10.1016/j.ejpn.2017.01.012
  18. Grecco LA, Zanon N, Sampaio LM, Oliveira CS. A comparison of treadmill training and overground walking in ambulant children with cerebral palsy: randomized controlled clinical trial. Clin Rehabil. 2013;27:686-96. https://doi.org/10.1177/0269215513476721
  19. Druzbicki M, Rusek W, Snela S, Dudek J, Szczepanik M, Zak E, et al. Functional effects of robotic-assisted locomotor treadmill thearapy in children with cerebral palsy. J Rehabil Med. 2013;45: 358-63. https://doi.org/10.2340/16501977-1114
  20. Su IY, Chung KK, Chow DH. Treadmill training with partial body weight support compared with conventional gait training for low-functioning children and adolescents with nonspastic cerebral palsy: a two-period crossover study. Prosthet Orthot Int. 2013;37:445-53. https://doi.org/10.1177/0309364613476532
  21. Tarakci D, Ersoz Huseyinsinoglu B, Tarakci E, Razak Ozdincler A. Effects of Nintendo Wii-Fit((R)) video games on balance in children with mild cerebral palsy. Pediatr Int. 2016;58:1042-50. https://doi.org/10.1111/ped.12942
  22. Alabdulwahab SS, Al-Gabbani M. Transcutaneous electrical nerve stimulation of hip adductors improves gait parameters of children with spastic diplegic cerebral palsy. NeuroRehabilitation. 2010;26: 115-22. https://doi.org/10.3233/NRE-2010-0542
  23. Arya BK, Mohapatra J, Subramanya K, Prasad H, Kumar R, Mahadevappa M. Surface EMG analysis and changes in gait following electrical stimulation of quadriceps femoris and tibialis anterior in children with spastic cerebral palsy. Annu Int Conf IEEE Eng Med Biol Soc. 2012;2012:5726-9.
  24. Ho CL, Holt KG, Saltzman E, Wagenaar RC. Functional electrical stimulation changes dynamic resources in children with spastic cerebral palsy. Phys Ther. 2006;86:987-1000. https://doi.org/10.1093/ptj/86.7.987
  25. Ibrahim MM, Eid MA, Moawd SA. Effect of whole-body vibration on muscle strength, spasticity, and motor performance in spastic diplegic cerebral palsy children. The egyptian journal of medical human genetics. 2014;15:173-9. https://doi.org/10.1016/j.ejmhg.2014.02.007
  26. El-Shamy SM, Eid MA, El-Banna MF. Effect of extracorporeal shock wave therapy on gait pattern in hemiplegic cerebral palsy: a randomized controlled trial. Am J Phys Med Rehabil. 2014;93:1065-72. https://doi.org/10.1097/PHM.0000000000000133
  27. Damiano DL, Stanley CJ, Ohlrich L, Alter KE. Task-Specific and Functional Effects of Speed-Focused Elliptical or Motor-Assisted Cycle Training in Children With Bilateral Cerebral Palsy: Randomized Clinical Trial. Neurorehabil Neural Repair. 2017;31: 736-45. https://doi.org/10.1177/1545968317718631
  28. Mehrholz J, Thomas S, Werner C, Kugler J, Pohl M, Elsner B. Electromechanical-assisted training for walking after stroke. Cochrane Database Syst Rev. 2017;5:CD006185.
  29. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al. Cochrane Handbook for Systematic Reviews of Interventions. 2nd ed. Chichester, UK: John Wiley & Sons; 2019.
  30. Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, et al. Grading quality of evidence and strength of recommendations. BMJ. 2004;328:1490. https://doi.org/10.1136/bmj.328.7454.1490