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Wearable Adaptive Resistance Training Improves Ankle Strength, Walking Efficiency and Mobility in Cerebral Palsy: A Pilot Clinical Trial

Benjamin C. Conner, Nushka M. Remec, Elizabeth K. Orum, Emily M. Frank, Zachary F. Lerner

2020IEEE Open Journal of Engineering in Medicine and Biology48 citationsDOIOpen Access PDF

Abstract

GOAL: To determine the efficacy of wearable adaptive resistance training for rapidly improving walking ability in children with cerebral palsy (CP). METHODS: Six children with spastic CP (five males, one female; mean age 14y 11mo; three hemiplegic, three diplegic; Gross Motor Function Classification System [GMFCS] levels I and II) underwent ten, 20-minute training sessions over four weeks with a wearable adaptive resistance device. Strength, speed, walking efficiency, timed up and go (TUG), and six-minute walk test (6MWT) were used to measure training outcomes. RESULTS: Participants showed increased average plantar flexor strength (17 ± 8%, p = 0.02), increased preferred walking speed on the treadmill (39 ± 25%, p = 0.04), improved metabolic cost of transport (33 ± 9%, p = 0.03), and enhanced performance on the timed up and go (11 ± 9%, p = 0.04) and six-minute walk test (13 ± 9%, p = 0.04). CONCLUSIONS: The observed increase in preferred walking speed, reduction in metabolic cost of transport, and improved performance on clinical tests of mobility highlights the potentially transformative nature of this novel therapy; the rate at which this intervention elicited improved function was 3 - 6 times greater than what has been reported previously.

Topics & Concepts

Cerebral palsyPhysical medicine and rehabilitationResistance trainingWearable computerAnklePhysical therapyMedicineComputer scienceSurgeryEmbedded systemCerebral Palsy and Movement DisordersBalance, Gait, and Falls PreventionBotulinum Toxin and Related Neurological Disorders