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Home-based versus laboratory-based robotic ankle training for children with cerebral palsy: a pilot randomized comparative trial
Chen K, Wu Y-N, Ren Y, Liu L, Gaebler-Spira D, Tankard K, Lee J, Song W, Wang M, Zhang L-Q
Archives of Physical Medicine and Rehabilitation 2016 Aug;97(8):1237-1243
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To examine the outcomes of a home-based robotic rehabilitation and compare it to a laboratory-based robotic rehabilitation for the treatment of impaired ankles in children with cerebral palsy DESIGN: A randomized comparative trial design comparing a home-based training group and a laboratory-based training group. SETTING: Home versus a laboratory within a research hospital PARTICIPANTS: Forty-one children with cerebral palsy with Gross Motor Function Classification System level I, II or III were randomly assigned to two groups. The children in the home-based and laboratory-based groups were 8.7 +/- 2.8 (mean +/- standard deviation) (n = 23) and 10.7 +/- 6.0 (n = 18) years old, respectively. INTERVENTIONS: Six-week combined passive stretching and active movement intervention of impaired ankle in a laboratory or home environment with a portable rehabilitation robot. PRIMARY OUTCOME MEASURES: Active dorsiflexion range of motion (as the primary outcome), mobility (6-minute walk test and timed up and go), balance (Pediatric Balance Scale), Selective Motor Control Assessment of the Lower Extremity (SCALE), spasticity Modified Ashworth Scale (MAS), passive range of motion, strength and joint stiffness. RESULTS: Significant improvements were found for the home-based group in all biomechanical outcome measures except for passive range of motion and all clinical outcomes except the MAS. The laboratory-based group also showed significant improvements in all of the biomechanical outcome measures and all clinical outcome measures except the MAS. There were no significant differences in the outcome measures between the two groups. CONCLUSION: These findings suggest that translation of repetitive, goal directed, biofeedback training through motivating games from the laboratory into the home environment is feasible. The benefits of home-based robotic therapy were similar to those of laboratory-based robotic therapy.

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