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ORIGINAL RESEARCH article

Front. Pediatr.
Sec. Pediatric Orthopedics
Volume 12 - 2024 | doi: 10.3389/fped.2024.1447512
This article is part of the Research Topic Exoskeleton Gait Training View all 7 articles

The efficiency and use of a reciprocating system aid for standing and walking in children affected by severe Cerebral Palsy

Provisionally accepted
Priscilla Avaltroni Priscilla Avaltroni 1Yury Ivanenko Yury Ivanenko 1Carla Assenza Carla Assenza 2Hilenia Catania Hilenia Catania 2Michele Coluccini Michele Coluccini 3Giovanni Morone Giovanni Morone 4Daniela Morelli Daniela Morelli 2Germana Cappellini Germana Cappellini 1*
  • 1 Laboratory of Neuromotor Physiology, Santa Lucia Foundation (IRCCS), Rome, Italy
  • 2 Department of Pediatric Neurorehabilitation, Santa Lucia Foundation (IRCCS), Rome, Italy
  • 3 Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Stella Maris, Pisa, Italy
  • 4 Department of Life, Health and Environmental Sciences, University of L'Aquila, L’Aquila, Abruzzo, Italy

The final, formatted version of the article will be published soon.

    Cerebral Palsy (CP) is a leading cause of childhood motor disability, making independent walking a crucial therapeutic goal. Robotic assistive devices offer potential to enhance mobility, promoting community engagement and quality of life. This is an observational report of 22 cases of children with CP in which we evaluated the Moonwalker exoskeleton (a dynamic moving aid system) usability, functional changes, and caregivers' perspectives based on the International Classification of Functioning (ICF). All children (aged 2-8 yrs, with a severe gait impairment and inability to use a conventional walker) underwent Moonwalker training for 20 sessions, followed by home use for five months. Post-treatment, majority of children showed improved endurance assessed by the 10meter walk test, with no negative effects on trunk control. Many of them achieved rather remarkable results reaching a velocity of ≥0.5 m/s given the constraints of the walking exoskeleton and the children's size, while at admission all children walked at a speed of less than 0.5 m/s. Several positive environmental factors and family adherence were noted, as assessed by ICF in a subgroup of children. This study on a sample of children demonstrated that the Moonwalker exoskeleton allows walking and training at home in children with severe CP, enhancing development, social interaction, and endurance, while being well-received by families.

    Keywords: Locomotion, Children with cerebral palsy, robotic assistive devices, exoskeleton, Rehabilitation

    Received: 11 Jul 2024; Accepted: 21 Nov 2024.

    Copyright: © 2024 Avaltroni, Ivanenko, Assenza, Catania, Coluccini, Morone, Morelli and Cappellini. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Germana Cappellini, Laboratory of Neuromotor Physiology, Santa Lucia Foundation (IRCCS), Rome, Italy

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.