Abstract

Objective: To examine the effect of various forms of training interventions, with and without virtual reality, on the initia- tion and maintenance of active participation during robot- assisted gait training.
Design: Intervention study at the Rehabilitation Centre Af- foltern a. A., University Children’s Hospital, Zurich. Subjects: Ten patients (5 males, mean age 12.47 years, stand- ard deviation 1.84 years) with different neurological gait disorders and 14 healthy children (7 males, mean age 11.76 years, standard deviation 2.75 years).
Methods: All participants walked in the driven gait ortho- sis Lokomat® in 4 different randomly-assigned conditions. Biofeedback values calculated during swing phases were the primary outcome measure and secondary outcomes were derived from a questionnaire assessing the participant’s mo- tivation.
Results: Findings revealed a significant main effect for train- ing condition in all participants (p<0.001), for patients (p<0.05) and for healthy controls (p<0.01). Overall, both virtual reality-assisted therapy approaches were equally the most effective in initiating the desired active participation in all children, compared with conventional training condi- tions. Motivation was very high and differed between the groups only in the virtual navigation condition.
Conclusion: Novel virtual reality-based training conditions represent a valuable approach to enhance active partici- pation during robot-assisted gait training in patients and healthy controls.