Integrating robotic-assisted gait training into an inpatient physiotherapy program for children with subacute acquired brain injury: a feasibility study and characterization of session ingredients
Bibliographic record
Abstract
While robotic-assisted gait training (RAGT) may permit earlier exposure to ambulation for children with subacute acquired brain injury (ABI), little is known about its associated viability. Our feasibility study focused on RAGT (Lokomat) use in this population. 8-week single-group pre-/post-test study integrated RAGT into an inpatient physiotherapy (PT) program (3 PT sessions/week plus 2 RAGT sessions/week). Twenty-four youth (14 males), mean age 13.7 years (SD = 3.6) participated. Six walked independently (4 devices) at baseline; 18 were pre-ambulatory. Nineteen completed the targeted 10-16 RAGT sessions. One child was withdrawn post-syncopic episode during acclimatization, and two children withdrew after 2-3 sessions due to RAGT-related discomfort with no follow-up assessment. Across four feasibility areas, 58% (Acceptability) to 100% (Safety) of indicators were met. Session characterization showed progression of Lokomat speed and reduced weight-support, and physiotherapists’ use of motor learning strategies. Physiotherapists rated Lokomat ease of use as 7.6/10 and perceived child engagement as 7.2/10. Post-intervention, 15 of the 21 children re-assessed were independently ambulatory (5 devices). Gross Motor Function Measure-88 mean increase was 19.7% points. Canadian Occupational Performance Measure mean gain was 2.5 points/10. PT+RAGT was feasible for 21 of 24 children and associated with large motor gains and goal accomplishment. Treadmill-based robotic-assisted gait training (RAGT) is a viable and safe intervention to use with children during the subacute phase of acquired brain injury.Setting RAGT-specific Goal Attainment Scaling goals provides structure and focus to RAGT treatment sessions.Clinicians should reflect on the child’s engagement, goals, and progress to determine the appropriate time to discontinue RAGT.Clinicians enhance the motor learning strategies content of RAGT treatment sessions beyond the repetitive practice, physical guidance, and augmentative feedback that is inherently part of the RAGT device. Treadmill-based robotic-assisted gait training (RAGT) is a viable and safe intervention to use with children during the subacute phase of acquired brain injury. Setting RAGT-specific Goal Attainment Scaling goals provides structure and focus to RAGT treatment sessions. Clinicians should reflect on the child’s engagement, goals, and progress to determine the appropriate time to discontinue RAGT. Clinicians enhance the motor learning strategies content of RAGT treatment sessions beyond the repetitive practice, physical guidance, and augmentative feedback that is inherently part of the RAGT device.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".