ORIGINAL RESEARCH article
Front. Hum. Neurosci.
Sec. Motor Neuroscience
Volume 19 - 2025 | doi: 10.3389/fnhum.2025.1644585
This article is part of the Research TopicNeuromuscular and Kinematic Dynamics in Human Movement AdaptationView all 4 articles
Exoskeleton Therapy in Cerebral Palsy: Improved Gait Endurance Without Kinematic Change
Provisionally accepted
- 1Poznań University of Medical Sciences, Poznań, Poland
- 2Chang Gung Memorial Hospital, Taipei, Taiwan
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Cerebral palsy (CP) often leads to impairments in movement and posture, limiting functional mobility. Robotic-assisted gait training (RAGT) using powered exoskeletons has emerged as a novel approach to enhance gait in individuals with CP. However, evidence regarding its effectiveness, particularly in unassisted gait performance, remains limited and inconclusive.Methods: This study involved 44 ambulatory youth with bilateral hypertonic CP (GMFCS levels I-III), who underwent an intensive RAGT program using the EksoGT exoskeleton. The intervention consisted of 28 sessions (90 minutes each) over 8 weeks, with a 2-week mid-point break. Gait assessments were conducted before (T1) and after (T2) therapy using 3D motion analysis and the sixminute walk test (6MWT). Primary outcomes included spatiotemporal parameters, gait symmetry, gait deviation index (GDI), and walking endurance.Results: Following the exoskeleton training, participants demonstrated a statistically significant improvement in gait efficiency, with 6MWT distances increasing from 375 m to 418 m (p < 0.01). However, no significant changes were observed in gait symmetry, spatiotemporal parameters, or GDI scores, indicating no measurable effect on unassisted gait mechanics.Intensive exoskeleton therapy significantly improved walking endurance but did not alter gait symmetry or kinematics in independently ambulatory youth with hypertonic CP. These findings suggest that while exoskeleton-assisted training enhances functional endurance, its impact on gait pattern may be limited. Further research should explore its broader benefits on quality of life, participation, and psychosocial outcomes.
Keywords: robotic-assisted gait training, exoskeleton, Cerebral Palsy, Six-minute walk test, Gait
Received: 10 Jun 2025; Accepted: 28 Jul 2025.
Copyright: © 2025 Chmara, Brazevič, Jóźwiak, Chen and Manikowska. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Brian Po-Jung Chen, Chang Gung Memorial Hospital, Taipei, Taiwan
Faustyna Manikowska, Poznań University of Medical Sciences, Poznań, Poland
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