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Measurement of muscle stiffness using robotic assisted gait orthosis in children with cerebral palsy: a proof of concept


Schmartz, A C; Meyer-Heim, A D; Müller, R; Bolliger, M (2011). Measurement of muscle stiffness using robotic assisted gait orthosis in children with cerebral palsy: a proof of concept. Disability and Rehabilitation, 6(1):29-37.

Abstract

Purpose. To evaluate the feasibility and reliability of a novel stiffness assessment tool implemented in the driven gait orthosis Paediatric Lokomat; to investigate the influence of single robotic-assisted gait training (RAGT) on muscle stiffness in children with cerebral palsy (CP). Methods. Ten children with spastic CP conducted a single standard RAGT session and stiffness was assessed before and after the RAGT. Nine of the ten subjects were tested twice on the same day to investigate test-retest reliability, intraclass correlation coefficients (ICCs), standard error of measurement (SEM), coefficient of variation of the method error (CV(ME)) and resistive torques during passive leg movements (stiffness in Nm/ degrees ) were calculated. Results. ICCs showed high reliability (0.83-0.97) for hip and knee movements. SEM and CV(ME) indicated 0.028-0.085 Nm/ degrees , 9.5-23.0% of test-retest variability in hip and 0.018-0.064 Nm/ degrees , 13.3-43.5% in knee measures. Using the assessment tool, a significant decrease in muscle stiffness in participants, especially in children with high levels of muscle tone, could be shown after a single session of RAGT. Conclusions. The assessment tool L-STIFF is a feasible tool for automated measurement of stiffness in children with CP, but it is not sensitive enough to record small changes in muscle tone.

Purpose. To evaluate the feasibility and reliability of a novel stiffness assessment tool implemented in the driven gait orthosis Paediatric Lokomat; to investigate the influence of single robotic-assisted gait training (RAGT) on muscle stiffness in children with cerebral palsy (CP). Methods. Ten children with spastic CP conducted a single standard RAGT session and stiffness was assessed before and after the RAGT. Nine of the ten subjects were tested twice on the same day to investigate test-retest reliability, intraclass correlation coefficients (ICCs), standard error of measurement (SEM), coefficient of variation of the method error (CV(ME)) and resistive torques during passive leg movements (stiffness in Nm/ degrees ) were calculated. Results. ICCs showed high reliability (0.83-0.97) for hip and knee movements. SEM and CV(ME) indicated 0.028-0.085 Nm/ degrees , 9.5-23.0% of test-retest variability in hip and 0.018-0.064 Nm/ degrees , 13.3-43.5% in knee measures. Using the assessment tool, a significant decrease in muscle stiffness in participants, especially in children with high levels of muscle tone, could be shown after a single session of RAGT. Conclusions. The assessment tool L-STIFF is a feasible tool for automated measurement of stiffness in children with CP, but it is not sensitive enough to record small changes in muscle tone.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2011
Deposited On:09 Nov 2010 17:04
Last Modified:05 Apr 2016 14:15
Publisher:Informa Healthcare
ISSN:0963-8288
Publisher DOI:https://doi.org/10.3109/17483107.2010.509884
PubMed ID:20690863
Permanent URL: https://doi.org/10.5167/uzh-35861

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