The effects of robot assisted therapy on upper limb functions and gait parameters in cerebral palsy: A randomized controlled trial.

BACKGROUND: The aim of this study was to examine the effects of upper extremity robotic-assisted training applied in addition to conventional physiotherapy on upper extremity functions and gait parameters. METHODS: This randomized controlled trial compared robotic-assisted training plus conventional physiotherapy (study group) with conventional physiotherapy alone (control group). Participants in both groups received conventional physiotherapy three times per week for six weeks, while the study group additionally received 30-minute Armeo Spring sessions three times per week. Outcomes included upper-extremity range of motion, unimanual and bimanual function, selective motor control, trunk control, gait parameters, and functional independence. Changes from baseline were compared between groups using independent t-tests or Mann-Whitney U tests, as appropriate. RESULTS: 31 participants were divided into study (n = 16) and control (n = 15) group. Between-group comparisons of changes from baseline favored the study group for several upper-limb outcomes. Improvements were greater for wrist flexion (mean change 10.37±6.99° vs 1.13±3.02°), forearm supination (median change 17.5° [IQR 16.0] vs 2.0° [IQR 5.0]), and total Jebsen-Taylor Hand Function Test time (mean change -37.67±24.47 s vs -9.30±12.22 s,). Between-group differences also favored RAT for the stance phase of the unaffected side (mean change 2.56±3.03% vs -0.93±2.18%,). No between-group difference was observed for trunk control. CONCLUSIONS: The addition of upper extremity robotic rehabilitation to conventional physiotherapy not only improved upper extremity functions but also positively influenced gait parameters.