Contributions and Limitations of Lokomat ^® on Gait Rehabilitation of Children With Cerebral Palsy: A Systematic Review

Aims Cerebral palsy (CP) is a group of permanent disorders affecting movement and posture. In children, impaired walking limits daily activities and social participation. Robot-assisted gait training (RAGT), particularly with the Lokomat® is increasingly used in CP rehabilitation. However, evidence in children with CP remains limited. The objective of this review is to describe the extent of the effectiveness of the Lokomat® for CP children.Methods This systematic review followed PRISMA guidelines. Seven databases were consulted and the search strategy was conducted with related keywords: (1) CP, (2) pediatric, (3) RAGT - Lokomat®. Study quality was assessed using the Cochrane Collaboration’s Tool and PEDro scale.Results Of 59 full-text articles reviewed, 33 were included. Seventeen reported improved mobility, two noted better balance with Lokomat®. Five studies have shown an impact on gait performance due to higher motivation and a feeling of pleasure during treatments. Finally, five studies reported improvement in gait parameters and one in motor function with Lokomat®. However, the studies showed a heterogeneity in the intervention protocols.Conclusions While RAGT with Lokomat® appears to improve locomotion and motor function in children with CP, the heterogeneity of protocols and the limited methodological quality of several studies prevent clear clinical recommendations.