Research Study

Children with cerebral palsy

Combined passive stretching and active movement rehabilitation of lower-limb impairments in children with cerebral palsy using a portable robot.

Participant Characteristics

All participants completed 18 sessions of training with significant improvements:

  • Passive stretching was able to relax the stiff muscles:  ↑ PROM

  • ↑ Motor control:  ↑ AROM , ↑ strength and ↑ SCALE may be due to better control after muscles became less stiff

  • Biofeedback game-playing and repetition (motor learning)

  • Improvement of selective motor control also seen in foot and hip

  • Strengthening adopted in the study did not increase spasticity

Muscle Improvement

Measurable changes of Calf Muscle-Tendon Properties Induced by Stretching and Active Movement Training in Neurological Impairment

Muscle Length Improvement:

  • SOL fascicles  from 24.8±8.2 to 26.8±8.6 mm (**)

  • GM fascicles  from 40.2±6.6 to 41.5±5.9 mm (**)

  • Achilles tendon  from 55.7±9.9 to 52.6±9.4 mm (**)

Muscle Stiffness Improvement

  • SOL fascicular stiffness from 16.6±5.2 to 13.8±6.3 N/mm (*)

  • GM fascicular stiffness from 12.2±3.8 to 9.6±3.6 N/mm (**)

  • Achilles tendon stiffness from 86.8±16.9 to 114.4±16.0 N/mm (**)

Research References

  • Combined passive stretching and active movement rehabilitation of lower-limb impairments in children with cerebral palsy using a portable robot. Neurorehabilitation and Neural Repair. 25, 378-385, 2011.

  • Changes of Calf Muscle-Tendon Properties Induced by Stretching and Active Movement Training in Neurological Impairment. Journal of Applied Physiology, 111(2), 435-442, 2011

  • Reliability of the intelligent stretching device for ankle stiffness measurements in healthy individuals.  The Foot 20 (2010) 126–132

  • Does acute passive stretching increase muscle length in children with cerebral palsy?  Clinical Biomechanics 28 (2013) 1061–1067

  • Responses to static stretching are dependent on stretch intensity and duration. Clin Physiol Funct Imaging. 2014 Aug 27. doi: 10.1111/cpf.12186.

  • (Sukal-Moulton, T., Clancy, T., Zhang, L.-Q., and Gaebler-Spira, D.)
    Clinical application of a robotic ankle training program for cerebral palsy compared to the research laboratory application: Does it translate to practice? Arch Phys Med Rehab. 95, 1433-1440, 2014.