Virtual reality combined with robot-assisted gait training to improve walking ability of children with cerebral palsy: A randomized controlled trial

BACKGROUND: Children with cerebral palsy (CP) have disorders of posture and movement and which can limit physical activities such as walking OBJECTIVE: This study aims to investigate the effectiveness of virtual reality (VR) combined with robot-assisted gait training (RAGT) on walking ability in children with CP and clarify the most effective degree of weight reduction. METHODS: Sixty CP children were recruited and randomly allocated into four different groups. The control group received conventional physical therapy (n = 15), and task groups performed VR combined with RAGT with 15% (Group A, n = 15) /30% (Group B, n = 15) /45% (Group C, n = 15) weight loss. All participants were given 50 min of therapy per session four times a week for 12 weeks and were assessed pre-and post-test with the surface electromyography (EMG), the Modified Ashworth Scale, the Gross Motor Function Measure (GMFM) dimension E and D, and Six-Minute Walking Test (6-MWT). RESULTS: All indicators had improved significantly in each group after the intervention (P < 0.05). The result of our study demonstrated that the more effective impacts of VR combined with RAGT on walking ability compared to the control group (P < 0.05), and 30% of weight loss had the best improvement in CP children (P < 0.01). CONCLUSIONS: VR combined RAGT can effectively improve walking ability in children with CP, especially when the weight loss is 30%.