Study found wearable robotic exoskeleton could alleviate crouch gait in children with cerebral palsy


Researchers from the Centers for Disease Control and Prevention reported that cerebral palsy (CP) limited mobility and independence of the children throughout their lives. The study was published in the journal Science Translational Medicine. 

Cerebral palsy, the most common movement disorder in children, caused by neurological damage before, during or after birth. In the U.S., approximately 500,000 children had CP. Nearly, 60% of children with the disorder could walk independently. But the children had crouch gait (a pathological walking pattern characterized by excessive knee bending) which caused an abnormally high level of stress on the knee. Crouch gait caused knee pain and progressive loss of function. It was often treated through invasive orthopedic surgery.

Assistant Professor of Mechanical Engineering Zach Lerner and associates evaluated a novel robotic exoskeleton, a leg brace powered by small motors, for the treatment of crouch gait and examined the improvement of crouch gait in children with cerebral palsy after wearing the exoskeleton.

In the multi-week trial, seven children of age 5-19 years wore robotic exoskeletons that designed to increase their ability to extend their knees at specific phases in the walking cycle. Then the children participated in several practice sessions. At the end of the trial, walking posture was improved in six of the seven children equivalent to outcomes reported from invasive orthopedic surgery.

The study outcomes supported the use of wearable exoskeletons as a treatment approach to improve walking in children with CP, said Lerner.

The exoskeleton was safe and well tolerated, and all the children were able to walk independently with the device. The exoskeleton dynamically changed the posture of children by introducing bursts of knee extension assistance during discrete portions of the walking cycle that maintained or increased knee extensor muscle activity.

Lerner said, "Our results suggest that powered knee exoskeletons should be investigated as an alternative to or in conjunction with existing treatments for crouch gait, including orthopedic surgery, muscle injections, and physical therapy."

Lerner aimed to decrease mobility and improve function in people with neuromuscular and musculoskeletal disabilities through innovations in mechanical and biomedical engineering. From the study findings, the researchers would work to conduct longer-term exoskeleton interventions to take place at home and in the community.