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Cerebral palsy (CP) is a permanent neurological disorder that frequently causes motor impairments, balance dysfunction, and reduced mobility in children. Robotic-assisted gait training (RAGT) has shown promise for improving gait and motor function, but little is known about how neuroplasticity adaptation influence outcomes. This study evaluated the individualized effects of a four-week RAGT program in two pediatric CP patients (GMFCS level 2 and level 5) using multimodal monitoring. Functional near-infrared spectroscopy (fNIRS) signal was recorded at the first RAGT session (T0), sixth session (T1), and twelfth session (T2), to assess cerebral plasticity as well as robotic torque outputs to assess leg (hip and knee) muscle force improvements. Clinical assessments (Modified Ashworth Scale, GMFM-88, WeeFIM®, PedsQL™ CP Module) complemented these measures. The GMFCS level 5 patient, despite severe initial limitations, demonstrated greater improvements, with enhanced prefrontal cortical activation, reduced robotic assistance torque, and decreased spasticity, alongside modest functional gains. In contrast, the GMFCS level 2 patient showed subtler fNIRS variation and torque reduction, reflecting a more stable neuromotor profile. These preliminary findings underscore the value of integrating neurovascular metrics to personalize pediatric neurorehabilitation. Real-time monitoring of brain responses, beyond motor performance alone, may help optimizing RAGT by ensuring interventions are functionally effective.

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Neurofunctional and Biomechanical Adaptations to Robotic-Assisted Gait Therapy in Cerebral Palsy: A Double Case Study

  • 会议论文

  • 发表日期：

    2026年

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  • Francesco Romano,
  • Elena Campilii,
  • David Perpetuini,
  • Emanuele Francesco Russo,
  • Maria Teresa Gatta,
  • Marta Di Nicola,
  • Arcangelo Merla,
  • Antimo Moretti,
  • Francesca Gimigliano,
  • Giovanni Morone,
  • Irene Ciancarelli,
  • Teresa Paolucci,
  • Daniela Cardone

摘要

Cerebral palsy (CP) is a permanent neurological disorder that frequently causes motor impairments, balance dysfunction, and reduced mobility in children. Robotic-assisted gait training (RAGT) has shown promise for improving gait and motor function, but little is known about how neuroplasticity adaptation influence outcomes. This study evaluated the individualized effects of a four-week RAGT program in two pediatric CP patients (GMFCS level 2 and level 5) using multimodal monitoring. Functional near-infrared spectroscopy (fNIRS) signal was recorded at the first RAGT session (T0), sixth session (T1), and twelfth session (T2), to assess cerebral plasticity as well as robotic torque outputs to assess leg (hip and knee) muscle force improvements. Clinical assessments (Modified Ashworth Scale, GMFM-88, WeeFIM®, PedsQL™ CP Module) complemented these measures. The GMFCS level 5 patient, despite severe initial limitations, demonstrated greater improvements, with enhanced prefrontal cortical activation, reduced robotic assistance torque, and decreased spasticity, alongside modest functional gains. In contrast, the GMFCS level 2 patient showed subtler fNIRS variation and torque reduction, reflecting a more stable neuromotor profile. These preliminary findings underscore the value of integrating neurovascular metrics to personalize pediatric neurorehabilitation. Real-time monitoring of brain responses, beyond motor performance alone, may help optimizing RAGT by ensuring interventions are functionally effective.