The effect of gait enhancer mechanism on functional balance and endurance of walking in children with Cerebral Palsy

The purpose of this study was to investigate the effectiveness of Gait Enhancer Mechanism on functional balance and walking endurance in children with cerebral palsy. We designed a new gait trainer according to Theo Jansen mechanism. Two separated Jansen linkages were placed on both sides of a frame and were connected to the lower limb at the ankle joint by a plate under foot. This experimental research organized in a single subject system, A-B-A design for four children with spastic diplegic cerebral palsy from level III of gross motor function classification system. This method includes repetitive measures in three phases, baseline and intervention and then maintenance. All the participants received conventional occupational therapy during the study period. They had 18 gait training sessions, 3 times per week, with Gait Enhancer Mechanism for 30 minutes in intervention phase. Pediatric balance scale and 6-Minute walk test were performed to evaluate functional balance and walking endurance, respectively. Results were considered by visual graphs and statistically by measuring Non-overlap indices and Cohen's d. The results indicated significant improvement in both functional balance and covered distance in 6-Minute walk test. Cohen's d which represents the effect size was greater than 0.8 for all subjects. Functional balance and walking endurance were improved in children with cerebral palsy following gait training with Gait Enhancer Mechanism besides conventional occupational therapy.