Disclosures: Sarah H. Evans, MD: Ipsen Pharmaceuticals (Products/Services: No) (Consultant/Advisory Board)

Case Diagnosis: 2 patients with cerebral palsy and decreased motor control across the ankle joint who used a rehabilitation robot for therapy

Case Description: Two female patients with hemiplegia secondary to cerebral palsy. Both patients participated in 3 studies, each using an iteration of PedBOT, a three degree of freedom robot with programmable assistance and resistance, to determine whether individualized repetitive task specific training while playing video games would improve range of motion, strength and/or motor control of the foot across the ankle joint. One patient is an adolescent; the other is a latency aged child.

Setting: Pediatric robotic rehabilitation lab and patient homes

Assessment/Results: Both subjects enrolled in each of three studies to assess the usefulness of PedBOT. Both patients were compliant with each study. Both improved in range of motion, strength and motor control in each of the settings/studies. Parents were happy having access to the robot as part of a home exercise program. Patients enjoyed performing therapy while playing a video game, but asked for more engaging games.

Discussion: Children with gait deviations due to atypical movement of the foot across the ankle joint require physical therapy that includes home exercise. Compliance with home exercise programs is notoriously poor for children in physical therapy, despite evidence that a single hour of “therapy homework” per week improves function for children with disabilities. Robot-assisted therapy provides intensive physical task-specific training. Gamefied therapy is more engaging than standard therapy in home exercise programs..

Conclusion: Rehabilitation robotics associated with gamefication of therapy improves outcome in adults with hemplegia secondary to stroke. It is likely the same principles apply to pediatric rehabilitation. Improvement in compliance with a home exercise program will lead to improved functional outcome. PedBOT has the potential to increase compliance with home exercise by making it fun and lead to better control of the foot across the ankle joint.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/iterative-development-of-a-robot-for-use-in-pediatric-rehabilitation/