Specific Instructions Are Important: A Cross-sectional Study on Device Parameters and Instruction Types While Walking With a Robot in Children and Adolescents.

Objective: The aim of the study is to evaluate how gait kinematics and muscle activity during robot-assisted gait training are affected by different combinations of parameter settings and a number of instruction types, ranging from no instructions to goal-specific instructions.

Design: Robots for gait therapy provide a haptic guidance, but too much guidance can limit the active participation. Therapists can stimulate this active participation either with instructions or by adapting device parameters.

1D-Convolutional Neural Networks can Quantify Therapy Content of Children and Adolescents Walking in a Robot-Assisted Gait Trainer.

Therapy content, consisting of device parameter settings and therapy instructions, is crucial for an effective robot-assisted gait therapy program. Settings and instructions depend on the therapy goals of the individual patient. While device parameters can be recorded by the robot, therapeutic instructions and associated patient responses are currently difficult to capture.

The FreeD module's lateral translation timing in the gait robot Lokomat: a manual adaptation is necessary.

Background: Pelvic and trunk movements are often restricted in stationary robotic gait trainers. The optional FreeD module of the driven gait orthosis Lokomat offers a combined, guided lateral translation and transverse rotation of the pelvis and may therefore support weight shifting during walking. However, from clinical experience, it seems that the default setting of this timing does not correspond well with the timing of the physiological pelvic movement during the gait cycle.

Within- and between-therapist agreement on personalized parameters for robot-assisted gait therapy: the challenge of adjusting robotic assistance.

Background: Stationary robotic gait trainers usually allow for adjustment of training parameters, including gait speed, body weight support and robotic assistance, to personalize therapy. Consequently, therapists personalize parameter settings to pursue a relevant therapy goal for each patient. Previous work has shown that the choice of parameters influences the behavior of patients.

Accuracy of Sensor-Based Measurement of Clinically Relevant Motor Activities in Daily Life of Children With Mobility Impairments.

Objective: This study aimed to determine the accuracy of 3 sensor configurations and corresponding algorithms deriving clinically relevant outcomes of everyday life motor activities in children undergoing rehabilitation. These outcomes were identified in 2 preceding studies assessing the needs of pediatric rehabilitation. The first algorithm estimates the duration of lying, sitting, and standing positions and the number of sit-to-stand transitions with data from a trunk and a thigh sensor.

Health-enhancing physical activity interventions in non-ambulatory people with severe motor impairments - a scoping review.

Purpose: Non-ambulatory people with severe motor impairments due to chronic neurological diagnoses are forced into a sedentary lifestyle. The purpose of this scoping review was to understand the type and amount of physical activity interventions performed in this population as well as their effect.

Methods: PubMed, Cochran and CINAHL Complete were systematically searched for articles describing physical activity interventions in people with a chronic, stable central nervous system lesion.

Clustering trunk movements of children and adolescents with neurological gait disorders undergoing robot-assisted gait therapy: the functional ability determines if actuated pelvis movements are clinically useful.

Introduction: Robot-assisted gait therapy is frequently used for gait therapy in children and adolescents but has been shown to limit the physiological excursions of the trunk and pelvis. Actuated pelvis movements might support more physiological trunk patterns during robot-assisted training. However, not every patient is expected to react identically to actuated pelvis movements.

Markerless motion tracking to quantify behavioral changes during robot-assisted gait training: A validation study.

Measuring kinematic behavior during robot-assisted gait therapy requires either laborious set up of a marker-based motion capture system or relies on the internal sensors of devices that may not cover all relevant degrees of freedom. This presents a major barrier for the adoption of kinematic measurements in the normal clinical schedule. However, to advance the field of robot-assisted therapy many insights could be gained from evaluating patient behavior during regular therapies.

Acceptability of wearable inertial sensors, completeness of data, and day-to-day variability of everyday life motor activities in children and adolescents with neuromotor impairments.

Monitoring the patients' motor activities in a real-world setting would provide essential information on their functioning in daily life. In this study, we used wearable inertial sensors to monitor motor activities of children and adolescents with congenital and acquired brain injuries. We derived a set of clinically meaningful performance measures and addressed the following research questions: Is the target population willing to wear the sensors in their habitual environment? Which factors lead to missing data, and can we avoid them? How many measurement days are needed to obtain reliable estimates of the children's and adolescents' motor performance? The study participants wore our sensor system for seven consecutive days during waking hours.

Sensor-based outcomes to monitor everyday life motor activities of children and adolescents with neuromotor impairments: A survey with health professionals.

In combination with appropriate data processing algorithms, wearable inertial sensors enable the measurement of motor activities in children's and adolescents' habitual environments after rehabilitation. However, existing algorithms were predominantly designed for adult patients, and their outcomes might not be relevant for a pediatric population. In this study, we identified the needs of pediatric rehabilitation to create the basis for developing new algorithms that derive clinically relevant outcomes for children and adolescents with neuromotor impairments.

Accuracy and comparison of sensor-based gait speed estimations under standardized and daily life conditions in children undergoing rehabilitation.

Background: Gait speed is a widely used outcome measure to assess the walking abilities of children undergoing rehabilitation. It is routinely determined during a walking test under standardized conditions, but it remains unclear whether these outcomes reflect the children's performance in daily life. An ankle-worn inertial sensor provides a usable opportunity to measure gait speed in the children's habitual environment.

Robot-assisted gait training: more randomized controlled trials are needed! Or maybe not?

I was encouraged by the recent article by Kuo et al. entitled "Prediction of robotic neurorehabilitation functional ambulatory outcome in patients with neurological disorders" to write an opinion piece on the possible further development of stationary robot-assisted gait training research. Randomized clinical trials investigating stationary gait robots have not shown the superiority of these devices over comparable interventions regarding clinical effectiveness, and there are clinical practice guidelines that even recommend against their use.

Settings matter: a scoping review on parameters in robot-assisted gait therapy identifies the importance of reporting standards.

Background: Lokomat therapy for gait rehabilitation has become increasingly popular. Most evidence suggests that Lokomat therapy is equally effective as but not superior to standard therapy approaches. One reason might be that the Lokomat parameters to personalize therapy, such as gait speed, body weight support and Guidance Force, are not optimally used.

Concurrent Validity of Different Sensor-Based Measures: Activity Counts Do Not Reflect Functional Hand Use in Children and Adolescents With Upper Limb Impairments.

Objective: To investigate the concurrent validity of 4 different outcome measures to determine daily functional hand use with wrist-worn inertial sensors in children with upper limb impairments. We hypothesized that the commonly used activity counts are biased by walking and wheeling activities, while measures that exclude arm movements during these periods with activity detection algorithms or by limiting the analysis to a range of functional forearm elevation would lead to more valid estimates of daily hand use.

Design: Concurrent validity study with video-based observations of functional hand use serving as the criterion measure.

Systematic review on the application of wearable inertial sensors to quantify everyday life motor activity in people with mobility impairments.

Background: Recent advances in wearable sensor technologies enable objective and long-term monitoring of motor activities in a patient's habitual environment. People with mobility impairments require appropriate data processing algorithms that deal with their altered movement patterns and determine clinically meaningful outcome measures. Over the years, a large variety of algorithms have been published and this review provides an overview of their outcome measures, the concepts of the algorithms, the type and placement of required sensors as well as the investigated patient populations and measurement properties.

ICF mobility and self-care goals of children in inpatient rehabilitation.

Aim: To develop a detailed priority list of family-centred rehabilitation goals on the activity level within the International Classification of Functioning, Disability and Health (ICF) chapters d4 'Mobility' and d5 'Self-care' in a paediatric population with a broad range of health conditions.

Method: Twenty-two months after implementing a systematic, family-centred, goal-setting process, the rehabilitation goals of 212 inpatients were retrospectively allocated to the most detailed level of ICF categories by two independent researchers. The overall frequencies of these goals were calculated and stratified by health condition, functional independence, and age.

An Increase in Kinematic Freedom in the Lokomat Is Related to the Ability to Elicit a Physiological Muscle Activity Pattern: A Secondary Data Analysis Investigating Differences Between Guidance Force, Path Control, and FreeD.

Robot-assisted gait therapy is a fast-growing field in pediatric neuro-rehabilitation. Understanding how these constantly developing technologies work is a prerequisite for shaping clinical application. For the Lokomat, two new features are supposed to increase patients' movement variability and should enable a more physiological gait pattern: and .

Pediatric Rehabilitation Therapies Differ in Intensity: A Pilot Study to Highlight the Implications for Dose-Response Relationships.

Objective: When investigating dose-response relationships in rehabilitation studies, dose is often equated with duration of therapy. However, according to the American College of Sports Medicine, dose consists of the factors frequency, intensity, time, and type. Thereby, especially quantification of intensity needs improvement to have a more precise estimate of the dose.

Correction to: The FreeD module for the Lokomat facilitates a physiological movement pattern in healthy people - a proof of concept study.

The original article [1] contains an error whereby the legends of Figs. 3 and 4 are erroneously swapped. As such, the correct configuration of these legends can be seen in the same figures below instead.

The FreeD module for the Lokomat facilitates a physiological movement pattern in healthy people - a proof of concept study.

Background: A contralateral pelvic drop, a transverse rotation and a lateral translation of the pelvis are essential features of normal human gait. These motions are often restricted in robot-assisted gait devices. The optional FreeD module of the driven gait orthosis Lokomat (Hocoma AG, Switzerland) incorporates guided lateral translation and transverse rotation of the pelvis.

Protocol of a systematic review on the application of wearable inertial sensors to quantify everyday life motor activity in people with mobility impairments.

Background: People with mobility impairments may have difficulties in everyday life motor activities, and assessing these difficulties is crucial to plan rehabilitation interventions and evaluate their effectiveness. Wearable inertial sensors enable long-term monitoring of motor activities in a patient's habitual environment and complement clinical assessments which are conducted in a standardised environment. The application of wearable sensors requires appropriate data processing algorithms to estimate clinically meaningful outcome measures, and this review will provide an overview of previously published measures, their underlying algorithms, sensor placement, and measurement properties such as validity, reproducibility, and feasibility.

Signal Processing in Functional Near-Infrared Spectroscopy (fNIRS): Methodological Differences Lead to Different Statistical Results.

Even though research in the field of functional near-infrared spectroscopy (fNIRS) has been performed for more than 20 years, consensus on signal processing methods is still lacking. A significant knowledge gap exists between established researchers and those entering the field. One major issue regularly observed in publications from researchers new to the field is the failure to consider possible signal contamination by hemodynamic changes unrelated to neurovascular coupling (i.

Translation, reliability, and clinical utility of the Melbourne Assessment 2.

Objective: The aims were to (i) provide a German translation of the Melbourne Assessment 2 (MA2), a quantitative test to measure unilateral upper limb function in children with neurological disabilities and (ii) to evaluate its reliability and aspects of clinical utility.

Methods: After its translation into German and approval of the back translation by the original authors, the MA2 was performed and videotaped twice with 30 children with neuromotor disorders. For each participant, two raters scored the video of the first test for inter-rater reliability.