Robotic Gait Training for Individuals With Cerebral Palsy: A Systematic Review and Meta-Analysis

Objective: To identify the effects of robotic gait training practices in individuals with cerebral palsy. Data Sources: The search was performed in the following electronic databases: PubMed, Embase, Medline (OvidSP), Cochrane Database of Systematic Reviews, Web of Science, Scopus, Compendex, IEEE Xplore, ScienceDirect, Academic Search Premier, and Physiotherapy Evidence Database. Study Selection: Studies were included if they fulfilled the following criteria: (1) they investigated the effects of robotic gait training, (2) they involved patients with cerebral palsy, and (3) they enrolled patients classified between levels I and IV using the Gross Motor Function Classification System. Data Extraction: The information was extracted from the selected articles using the descriptive-analytical method. The Critical Review Form for Quantitative Studies was used to quantitate the presence of critical components in the articles. To perform the meta-analysis, the effects of the intervention were quantified by effect size (Cohen d). Data Synthesis: Of the 133 identified studies, 10 met the inclusion criteria. The meta-analysis showed positive effects on gait speed (.21 [.09,.51]), endurance (.21 [.06,.49]), and gross motor function in dimension D (.18 [-.10,.45]) and dimension E (0.12 [-.15,.40]). Conclusions: The results obtained suggest that this training benefits people with cerebral palsy, specifically by increasing walking speed and endurance and improving gross motor function. For future studies, we suggest investigating device configuration parameters and conducting a large number of randomized controlled trials with larger sample sizes and individuals with homogeneous impairment. (C) 2017 by the American Congress of Rehabilitation Medicine