{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T03:46:31Z","timestamp":1793936791187,"version":"4.8.0"},"reference-count":27,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Cerebral palsy (CP) is the most common developmental motor disorder in children. Robot-assisted gait training (RAGT) using a wearable robot can provide intensive overground walking experience.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate the effectiveness of overground RAGT in children with CP using an untethered, torque-assisted, wearable exoskeletal robot.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This multicenter, single-blind randomized clinical trial was conducted from September 1, 2021, to March 31, 2023, at 5 rehabilitation institutions in Korea. Ninety children with CP in Gross Motor Function Classification System levels II to IV were randomized.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n The RAGT group underwent 18 sessions of RAGT during 6 weeks, whereas the control group received standard physical therapy for the same number of sessions during the same period.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome and Measures<\/jats:title>\n The primary outcome measure was the Gross Motor Function Measure 88 (GMFM-88) score. Secondary outcome measures were the GMFM-66, Pediatric Balance Scale, selective control assessment of the lower extremity, Pediatric Evaluation of Disability Inventory\u2013Computer Adaptive Test (PEDI-CAT), 6-minute walking test scores (distance and oxygen consumption), muscle and fat mass via bioelectrical impedance analysis, and gait parameters measured via 3-dimensional analysis. All assessments were performed for all patients at baseline, at the end of the 6-week intervention, and after the 4-week follow-up.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of the 90 children (mean [SD] age, 9.51 [2.48] years; 49 [54.4%] male and 41 [45.6%] female) in the study, 78 (86.7%) completed the intervention, with 37 participants (mean [SD] age, 9.57 [2.38] years; 19 [51.4%] male) and 41 participants (mean [SD] age, 9.32 [2.37] years; 26 [63.4%] male) randomly assigned to the RAGT and control groups, respectively. Changes in the RAGT group significantly exceeded changes in the control group in GMFM-88 total (mean difference, 2.64; 95% CI, 0.50-4.78), GMFM-E (mean difference, 2.70; 95% CI, 0.08-5.33), GMFM-66 (mean difference, 1.31; 95% CI, 0.01-2.60), and PEDI-CAT responsibility domain scores (mean difference, 2.52; 95% CI, 0.42-4.63), indicating independence in daily living at postintervention assessment. At the 4-week follow-up, the RAGT group showed significantly greater improvements in balance control (mean difference, 1.48; 95% CI, 0.03-2.94) and Gait Deviation Index (mean difference, 6.48; 95% CI, 2.77-10.19) compared with the control group.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this randomized clinical trial, overground RAGT using a wearable robot significantly improved gross motor function and gait pattern. This new torque-assisted wearable exoskeletal robot, based on assist-as-needed control, may complement standard rehabilitation by providing adequate assistance and therapeutic support to children with CP.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n CRIS<\/jats:ext-link>\n Identifier:\n KCT0006273<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.22625","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T11:02:32Z","timestamp":1721646152000},"page":"e2422625","source":"Crossref","is-referenced-by-count":49,"title":["Overground Gait Training With a Wearable Robot in Children With Cerebral Palsy"],"prefix":"10.1001","volume":"7","author":[{"given":"Ja Young","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Ki","family":"Kim","sequence":"additional","affiliation":[{"name":"Department and Rehabilitation Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juntaek","family":"Hong","sequence":"additional","affiliation":[{"name":"Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hankyul","family":"Park","sequence":"additional","affiliation":[{"name":"Department and Rehabilitation Medicine, Seoul Rehabilitation Hospital, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-seung","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongho","family":"Park","sequence":"additional","affiliation":[{"name":"George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta"},{"name":"Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, Atlanta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-Keun","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School and Hospital, Gwangju, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,7,22]]},"reference":[{"key":"zoi240723r1","first-page":"8","article-title":"A report: the definition and classification of cerebral palsy April 2006.","volume":"109","author":"Rosenbaum","year":"2007","journal-title":"Dev Med Child Neurol Suppl"},{"issue":"1","key":"zoi240723r2","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.neuroscience.2004.07.024","article-title":"Effects of sensorimotor restriction and anoxia on 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