Evaluation of a robotic orthosis for the rehabilitation of the locomotion in children suffering from cerebral palsy.

This project is about the use of a robotic device for the rehabilitation of locomotion in children suffering from cerebral palsy. This multidisciplinary research will grant the candidate an experience in biomechanical research, with the use of technologies at the edge of clinical rehabilitation.

Cerebral palsy is the main factor of locomotion troubles in children. In North America, about 3 children in 1000 are born with this disorder . Current rehabilitation methods consist in the repetition of motor tasks such as walking, in order to reconstruct the neural network. Movements are often assisted by physiotherapists. Nevertheless, the use of robotic devices is emerging to assist the physiotherapist in locomotion rehabilitation.

Some studies highlighted that robotic orthoses reproducing the walking pattern on a treadmill are efficient to improve the locomotion in people suffering from cerebral palsy. Our research center in pediatric rehabilitation has recently acquired a Lokomat: a gait therapy device that enables to reproduce the walk on a treadmill with a robotic gait orthosis which can relieve bodyweight. Although the effect of Lokomat training in adult patients is documented, little investigation has been conducted on a children population. The benefits in paediatric rehabilitation remain unknown.

Some studies pointed out that the hip kinematics and the level of thigh muscle activation was different during or after training with Lokomat in healthy and cerebral palsied children. However, due to the small number of participants and the reliability of the kinematic measurements, results should be regarded with caution. Moreover, to the best of our knowledge, the effect of Lokomat training on the contribution of each lower limb joint during walking in cerebral palsied children has never been studied. Finally, even if the Lokomat enables a relief of bodyweight from 0% to 100%, there are no actual recommendations concerning this adjustment. However, rehabilitation could be optimized through a subject-specific training protocol.

Consequently, it seems relevant to get a better understanding of the factors underlying the locomotion of cerebral palsied children in order to optimize the Lokomat training and the rehabilitation efficiency.
The candidate will work on two projects led by two postdoctoral fellows. The objectives are to:
1) Evaluating the ability of the Lokomat to reproduce the kinematic of walking performed by a healthy child;
2) Determining the effects of Lokomat training on joint kinematics and kinetics, as well as the motor control mechanisms (through electromyography and electroencephalography) underlying the relearning of locomotion in cerebral palsied children

Recommendations deriving from this study will directly benefit the rehabilitation of cerebral palsy in children. Moreover, despite the clinical relevancy of the Lokomat, this apparatus is unusual in Canada, only one team located at the University of Vancouver (BC), has already published a scientific article using the Lokomat. Hence, this project will also give the opportunity to the candidate to get involved in a multidisciplinary team and to be trained on a new emerging rehabilitation device.

Faculty Supervisor:

Mickael Begon










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