Robotic Orthotics Aid Gait in Kids with Cerebral Palsy

The wearable technology, akin to motorized leg braces, help children with physical disabilities extend their knees as they walk. 

By | August 24, 2017

FUNCTIONAL & APPLIED BIOMECHANICS SECTION, REHABILITATION MEDICINE DEPARTMENT, NATIONAL INSTITUTES OF HEALTH CLINICAL CENTERWearable robotic “exoskeletons” improved the gait of children with cerebral palsy, scientists report in a small study published yesterday (August 23) in Science Translational Medicine.

The bespoke orthotics, custom-fitted to the children’s legs, helped extend the kids’ knees properly while they walked and corrected their crouched postures from a tendency to over-flex their knees. The devices improved knee extension in six of the seven children assessed, with effects “similar to or greater than those reported from invasive surgical interventions,” the researchers write in their report.

“It may be useful for some of those kids, but more severe kids may not benefit,” Bruce Dobkin, director of the Neurological Rehabilitation and Research Program at the University of California, Los Angeles, tells STAT. He was not involved in the work.

In the trial, seven children ages five to 19 went through four practice sessions, each a couple of hours long, over the course of two or three months. The investigators examined them for walking ability and muscle function on the third and final days of the study.

“We want to transfer the walking patterns we see with the exoskeleton to walking without the exoskeleton,” coauthor Thomas Bulea of the National Institutes of Health tells STAT. “If we can correct or treat this crouch gait at a young age, then throughout their life, we may be able to increase their mobility.” Additional studies are needed to assess whether long-term training with robotic exoskeletons will indeed improve movement and posture in the absence of the devices. 

The walking abilities of children with cerebral palsy— a movement disorder thought to be caused by early life nervous system damage—often deteriorate over time, but not because the disease progressively attacks their nerves, the authors write. Rather, their stamina and muscle strength wither away as their initial injuries prevent them from walking properly. 

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