Neuropediatrics 2015; 46(04): 248-260
DOI: 10.1055/s-0035-1550150
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Practical Recommendations for Robot-Assisted Treadmill Therapy (Lokomat) in Children with Cerebral Palsy: Indications, Goal Setting, and Clinical Implementation within the WHO-ICF Framework

Tabea Aurich (-Schuler),
Birgit Warken
2   Department of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Hauner Children's Hospital, Ludwig-Maximilians University of Munich, Munich, Germany
,
Judith V. Graser
1   Rehabilitation Center of the University Children's Hospital Zurich, Affoltern am Albis, Switzerland
,
Thilo Ulrich
3   Children's Center Mosbach, Mosbach, Germany
,
Ingo Borggraefe
2   Department of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Hauner Children's Hospital, Ludwig-Maximilians University of Munich, Munich, Germany
,
Florian Heinen
2   Department of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Hauner Children's Hospital, Ludwig-Maximilians University of Munich, Munich, Germany
,
Andreas Meyer-Heim
1   Rehabilitation Center of the University Children's Hospital Zurich, Affoltern am Albis, Switzerland
,
Hubertus J. A. van Hedel
1   Rehabilitation Center of the University Children's Hospital Zurich, Affoltern am Albis, Switzerland
,
A. Sebastian Schroeder
2   Department of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Hauner Children's Hospital, Ludwig-Maximilians University of Munich, Munich, Germany
4   German Center for Vertigo and Balance Disorders, University of Munich, Munich, Germany
› Author Affiliations
Further Information

Publication History

17 December 2014

13 February 2015

Publication Date:
26 May 2015 (online)

Abstract

Active participation and the highest level of independence during daily living are primary goals in neurorehabilitation. Therefore, standing and walking are key factors in many rehabilitation programs. Despite inconclusive evidence considering the best application and efficacy of robotic tools in the field of pediatric neurorehabilitation, robotic technologies have been implemented to complement conventional therapies in recent years. A group of experienced therapists and physicians joined in an “expert panel.” They compared their clinical application protocols, discussed recurring open questions, and developed experience-based recommendations for robot-assisted treadmill therapy (exemplified by the Lokomat, Hocoma, Volketswil, Switzerland) with a focus on children with cerebral palsy. Specific indications and therapeutic goals were defined considering the severity of motor impairments and the International Classification of Functioning, Disability and Health framework (ICF). After five meetings, consensus was found and recommendations for the implementation of robot-assisted treadmill therapy including postsurgery rehabilitation were proposed. This article aims to provide a comprehensive overview on therapeutical applications in a fast developing field of medicine, where scientific evidence is still scarce. These recommendations can help physicians and therapists to plan the child's individual therapy protocol of robot-assisted treadmill therapy.

Supplementary Material

 
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