Summary
Background: Acquired brain injury (ABI) may result in lifelong impairment of physical, cognitive,
and psychosocial functions. Several rehabilitative treatments are often needed to
support walking recovery, thus participants’ engagement becomes a crucial aspect,
especially when patients are children. In the last few years, traditional physiotherapy
(PT) has been flanked by innovative technologies for rehabilitation in the fields
of robotics and Virtual Reality (VR). Preliminary results have shown interesting perspectives
in the use of a VR system, the GRAIL (Gait Real-time Analysis Interactive Lab), in
improving walking abilities in a small group of children with ABI, although further
insights are needed about its use as rehabilitative tool in the pediatric population.
Objectives: To evaluate the efficacy of a rehabilitation treatment on a GRAIL system for the
improvement of walking abilities, in a group of children suffering from ABI.
Methods: 12 children with ABI (study group – SG; mean age = 12.1 ± 3.8 years old) underwent
a 10-session treatment with the GRAIL, an instrumented multi-sensor platform based
on immersive VR for gait training and rehabilitation in engaging VR environments.
Before (T0) and at the end of the treatment (T1), the participants were assessed by
means of functional scales (Gross Motor Function Measure (GMFM), Functional Assessment
Questionnaire (FAQ), 6-Minute Walk Test (6minWT) and the 3D-Gait Analysis, over ground
(OGA) and on GRAIL (GGA).
Results: All the participants completed the rehabilitative treatment. The functional evaluations
showed an improvement in Gross Motor abilities (GMFM-88, p = 0.008), especially in
standing (GMFM-D, p = 0.007) and walking (GMFM-E, p = 0.005), an increase of the endurance
(6minWT, p = 0.002), and enhanced autonomy in daily life activities (FAQ, p = 0.025).
OGA identified a significant decrease of the Gillette Gait Index for the impaired
side and a general increase of symmetry. GGA showed improvements in spatiotemporal
parameters and joints range of motion that moved towards normality and symmetry recovery.
Conclusions: A 10-session treatment with GRAIL on children with ABI led to improvements in their
walking abilities and enhanced their engagement during the training. This is desirable
when long life impairments are faced and children’s motor functions have to be regained
and it supports the leading role that VR might have in the rehabilitation field.
Keywords
GRAIL - gait rehabilitation - pediatric - hemiplegia