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Weinberger, R.; Warken, B.; König, H.; Vill, K.; Gerstl, L.; Borggraefe, I.; Heinen, F.; Kries, R. von; Schröder, A. S. (2019): Three by three weeks of robot-enhanced repetitive gait therapy within a global rehabilitation plan improves gross motor development in children with cerebral palsy - a retrospective cohort study. In: European Journal of Paediatric Neurology, Vol. 23, No. 4: pp. 581-588
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Aim: To assess the improvement in gross motor function following three blocks of a three-week, intensive robot-enhanced treadmill therapy (ROBERT-Program). Method: retrospective chart review in a before-after interventional trial in children with cerebral palsy attending a university hospital outpatient rehabilitation centre. Patients received three blocks of a three-week, 12 sessions ROBERT-Program over a mean period of 24 months. Outcome measures were block specific and cumulative improvement in GMFM 66, D and E. Longterm GMFM 66 improvements were compared to the individuals' expected increment as derived from previously published GMFM-66 percentiles. 95% confidence intervals (CI) and paired t-test were calculated. Results: 20 children (8 GMFCS Level II;12 GMFCS Level III, mean age 5.9 years (CI: [5.0;6.7])) were treated. For each block a significant increase in motor performance in similar size could be observed without deterioration between blocks. The cumulative improvement during 21 months observation period was: 6.5 (CI: [4.8;8.2]) in GMFM 66, which represents a clinically meaningful effect size of 3.6 (CI: [1.4;5.8]) above the expected improvement. Interpretation: Progressive clinically meaningful improvement in motor performance for three blocks of ROBERT-Program was observed. Cumulative GMFM 66 improvements exceeded the individuals' age-specific expected course. (C) 2019 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.