Neuropediatrics 2011; 42 - P030
DOI: 10.1055/s-0031-1274002

Is the Gross Motor Function Measure (GMFM 66) a sensitive tool to represent the therapeutic improvement after robotic assisted treadmill training? A controlled study about the therapeutic effect of Lokomat® therapy

SA Schröder 1, MC Homburg 2, JS Schäfer 2, B Warken 2, K Huß 2, F Heinen 2, I Borggräfe 2
  • 1Dr. von Haunersches Kinderspital, Neuropädiatrie, München, Germany
  • 2Dr. von Haunersches Kinderspital, Ludwig-Maximilians-Universität München, Pädiatrische Neurologie, Entwicklungsneurologie und Sozialpädiatrie, München, Germany

Introduction: Robotic assisted treadmill training with the Lokomat® gains increasing use as intensified functional therapy training in children with cerebral palsy. The Gross Motor Function Measure (GMFM 66) is frequently applied to monitor the outcome of this training. Controlled data on the improvement of motor function after Lokomat® therapy is missing. Aim of this study was to evaluate different tests concerning their responsiveness to change after Lokomat® therapy.

Methods: Each patient was evaluated three times: three weeks in advance, immediately before as well as immediately after an intensified therapy block in the Lokomat® with 12 trainings during a three week period. The evaluated test were GMFM 66 (Dimension D=Standing and E=Walking, Running and Jumping as separate analysis), 6 minutes walking test, and 10 meter walking test. All patients were children with bilateral spastic cerebral palsy (BSCP). Statistical analysis was performed using the Wilcoxon matched-Pairs Signed-Ranks Test.

Results: During 6/2009–9/2010 15 patients (11 male) with BSCP were evaluated each for three times. Distribution of GMFCS Levels: I: n=4; II: n=3; III: n=7; IV: n=1; age 11,9 years (Mean; SD=5,1, range=5,6–21,8J), bodyweight 37kg (MW; SD=18, range=15–60kg. There was no significant difference in all test results when looking at the two pre training evaluations. GMFM 66 and Dimensions D and E showed a significant improvement when comparing the post training evaluation with both pre training evaluations. All other test did not show any significant change within the three evaluation periods. Within a sub group of 5 patients, who received their first Lokomat®training, there also was only a significant improvement in the GMFM 66 and its sub dimensions D and E and no change within the other evaluation tests.

Conclusion: The GMFM 66 is a sensitive evaluation tool to detect groß motor improvement in children with bilateral spastic cerebral palsy due to robotic assisted treadmill training.