Impact of robot‐assisted gait training on pulmonary function in children with cerebral palsy: Breathing while walking

Technology can be an extremely valuable tool for coping with disabilities such as cerebral palsy (CP).In this context, over the last decade, a growing interest in robot-assisted gait training (RAGT) has emerged in pediatric CP care.While randomized studies have long been conducted in adult stroke patients, only recent studies have focused on the CP population. 1 Conducting randomized studies in pediatric rehabilitation remains a challenge, due to the required human and technical investments, the intensity and duration of rehabilitation, the selection and homogeneity of participants to select, the rehabilitation programs or techniques being compared, and the primary and secondary end points considered to demonstrate an effect.Despite heterogeneous study designs, initial randomized studies have demonstrated clinical improvement mostly in neuromotor parameters such as endurance, walking speed, gait balance, and Gross Motor Function Measure (GMFM) sub-scores, as well as quality of life. 1 While CP mainly affects the neuromotor system, its impact is much broader, affecting vital, sensory, or cognitive functions and overall quality of life.Currently, there is no established evidence regarding the benefits of RAGT in improving respiratory function in children with CP, even though respiratory issues represent a major, often critical, concern for these children.In this context, the paper by Zhang et al. 2 is a highimpact study that focused on a pediatric population with CP moderate-to-severe impairment, who are particularly at risk of respiratory complications.This study provides encouraging respiratory results on tidal volume, time to peak tidal expiratory flow as a proportion of expiratory time, and minute ventilation, following RAGT compared to respiratory exercises.It also confirms the neuromotor and quality of life improvements observed in previous randomized studies