Spatial-temporal analysis and clinical gait findings: comparison of two treatment modalities in children with cerebral palsy–spastic hemiplegia. Preliminary report

introduction: Cerebral palsy is the most common cause of disability among children. The main concerns of parents are the acquisition and improvement of gait. The aim of this study was to compare long-term results of the effect of two modalities of gait training. methods: Quantitative measurement of gait and clinical assessment of the gross motor function classification system and Modified Ashworth Scale were performed in 14 patients with cerebral palsy/spastic hemiplegia. Subjects were randomly assigned to two treatment groups: the first one using a driven gait orthosis (Lokomat) and the second, gait training on a long a rail within a hydrotherapy tank. Measurements and assessments as described above were performed immediately and 1 year after conclusion of treatment. results: A significant change was observed according to the gross motor function classification system (GMFCS) from II to I among children (p = 0.042) and a positive correlation between the functional shape of the gait and the GMFCS (r = 0.54, p = 0.042). Patients on Lokomat training improved on gait symmetry over patients on conventional therapy (p ≤0.05). After a 1-year follow-up, this intervention showed a tendency to retain the gait patterns only in patients treated with the Lokomat. Conclusions: Benefit obtained with either modality was evident for both groups. However, residual effects observed in the group treated with the Lokomat, either in clinical assessment or gait parameters, were more promising than for patients undergoing conventional therapy. Due to the sample size used in this study, results are inconclusive and further long-term research is needed on this subject.