Dynamics of Statokinetic Gait Parameters in Toddlers and Children of Preschool Age with Cerebral Palsy on the Background of Exoskeleton-assisted Rehabilitation

Background. Robotic mechanotherapy is one of the most relevant and promising areas in modern neurorehabilitation. The possibilities of using exoskeletons in the rehabilitation of children of early and preschool age are currently insufficiently studied. The aim of the study is to evaluate the effectiveness of using exoskeletons to correct motor stereotypes and form walking patterns in children of early and preschool age with motor disorders. Materials and methods. The patients were divided into 3 groups: group I consisted of 29 patients with cerebral palsy of preschool age who received traditional rehabilitation procedures, group II — 29 preschool children with cerebral palsy, whose rehabilitation complex included trainings with the ExoAtlet Bambini exoskeleton, and group III — 14 toddlers, whose rehabilitation program included training with a small ExoAtlet Sofia exoskeleton. To analyze the data, modern scales, tests, and hardware and software data were used to assess changes in biomechanical parameters and performance indicators of a particular muscle group. Results . A clinical assessment against the background of a complex of rehabilitation measures using an exoskeleton by the end of rehabilitation showed a significant improvement in vertical posture, walking, and postural control in general. Correlation analysis conducted at the end of rehabilitation revealed statistically significant relationships between the total number of exoskeleton training sessions, the dynamics of the Hauser index (p = 0.033 in group II, p = 0.045 in group III), and the dynamics of the timed “Up and Go” test (p = 0.038 in group II, p = 0.49 in group III). Conclusion. The usage of an exoskeleton leads to a statistically significant improvement in the postural control of patients in the study who received a full course of individualized comprehensive rehabilitation using an exoskeleton. The results of the comparative analysis demonstrated not only the higher efficiency of exoskeleton-assisted rehabilitation in toddlers and preschool children compared with traditional methods, but also allowed us to identify key factors predicting the success of this technology for this category of patients.