Vpliv vadbe z roboti na hojo pri otrocih s cerebralno paralizo – pregled literature : diplomsko delo

Urbančič, Špela (author), Puh, Urška (mentor), Grapar Žargi, Tina (comentor), Rugelj, Darja (reviewer)

Uvod: Pri otrocih s cerebralno paralizo se kot dodatek k standardni vadbi hoje uporablja vadba hoje s pomočjo robota (RAGT), ki temelji na principih motoričnega učenja in plastičnosti možganov. Robotski opornici prevzameta otrokovo težo, kar omogoča bolj enakomerno in tekočo hojo in zmanjša napor terapevtov. Namen: Namen diplomskega dela je bil pregledati raziskave o vplivu rehabilitacije z robotom na hojo pri otrocih s cerebralno paralizo. Metode dela: Raziskovalne članke smo iskali v angleščini in slovenščini v zbirkah PubMed, Science Direct, Web of Science in Cinahl. Rezultati: V končni izbor je bilo izbranih šest randomiziranih kontroliranih raziskav, objavljenih med letoma 2011 in 2018. Preiskovanci so uporabljali naprave Lokomat Pediatric®, Robotic treadmill 3D CaLT, sobno kolo Motomed gracile, eliptični trenažer Cardiokids in GaitTrainer GT I. Programi terapij v kliničnem okolju so trajali od 10 do 20 terapij; en program, ki je bil izvajan doma, je trajal 60 terapij. Ugotovili so, da vadba hoje s pomočjo robota pozitivno vpliva na hitrost hoje in dolžino koraka pri večini raziskav, na hitrost hoje pri treh statistično pomembno, na dolžino koraka pa pri dveh. Tri raziskave so preučevale vpliv vadbe hoje s pomočjo robota na grobe motorične sposobnosti (GMFM). Dve sta vključevali Robotic Treadmill 3D CaLT (z asistenco in z uporom), ena pa Lokomat Pediatric®. Na komponento D so bili učinki pri vseh treh pozitivni, na komponento E pa pri dveh, pri terapiji z Lokomat Pediatric® in pri terapiji z Robotic treadmill 3D CaLT z asistenco. Razprava in zaključek: Pregledane raziskave kažejo pozitivni učinek na hojo in grobe motorične sposobnosti. Kot najboljša se je izkazala naprava Lokomat Pediatric®. Kljub temu so učinki primerljivi običajni vadbi hoje, zato bi lahko bila vadba hoje s pomočjo robota uporabljena kot dodatna terapija nevrofizioterapevtskim obravnavam. Obstoječih raziskav je malo; vzorci so nehomogeni; dejavnikov, ki vplivajo na rezultate, je zelo veliko. Potrebne bi bile nadaljnje študije, ki bi postavile smernice za vadbo hoje s pomočjo robota.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, cerebralna paraliza, rehabilitacija, vadba hoje s pomočjo robota, hoja
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [Š. Urbančič]
• Year: 2020
• Number of pages: 33 str.
• PID: 20.500.12556/RUL-116695
• UDC: 615.8
• COBISS.SI-ID: 18069763
• Publication date in RUL: 04.06.2020

Secondary language

• Language: English
• Title: The effect of robotic-assisted training on gait for children with cerebral palsy – literature review : diploma work

Abstract

Introduction: In children with cerebral palsy, robotic-assisted training (RAGT) is used in addition to standard gait training. It is based on the principles of motor learning and brain plasticity. Robotic braces take on the child's weight which allows steadier and more fluent walking and reduces the therapist’s effort. Purpose: The purpose of this bachelor’s thesis was to review the research on the effect of robot rehabilitation on walking in children with cerebral palsy. Methods: We searched for research articles in English and Slovenian in PubMed, Science Direct, Web of Science, and Cinahl databases. Results: Six randomized controlled trials published between 2011 and 2018 were included. Children used Lokomat Pediatric®, Robotic treadmill 3D CaLT, Motomed gracile cycling device, Cardiokids elliptical trainer, and GaitTrainer GT I. In a study, subjects were trained at home and in all others in a controlled clinical setting. Therapeutic programs in controlled clinical settings consisted of 10 to 20 therapies while one program which was performed at home included 60 therapies. The main results showed that robotic-assisted gait training had a positive effect on walking speed and step length in most studies with the statistically significant improvement shown in three and step length in two studies. Three studies examined the effect of robotic-assisted gait training on gross motor skills (GMFM). Two of them used Robotic Treadmill 3D CaLT (with assistance and resistance), one of them used Lokomat Pediatric®. For component D, the effects were positive in all three and, for component E in two of them, for therapy with Lokomat Pediatric® and for therapy with Robotic treadmill 3D CaLT z asistenco. Discussion and conclusion: The reviewed studies showed a positive effect on walking and gross motor skills. The Lokomat Pediatric® proved to be the best. However, the effects remain comparable to conventional gait training. Therefore, robotic-assisted gait training could be used as a supplementary therapy to standard neurophysiotherapy treatment. Since there is a lack of existing studies, heterogeneity of samples, and since there are many possible existing factors possibly influencing the results, further studies would be necessary to set the conclusions and provide valid guidelines for robotic-assisted gait training.

• Keywords: diploma theses, physiotherapy, cerebral palsy, rehabilitation, robotic-assisted gait training, gait