CASE STUDY
The impact of robot-assisted treadmill therapy on urinary incontinence rates in a child with lower limb paresis – a single case study
1
Department of Therapeutic Sciences, University of Cooperative Education, Darmstadt, Germany
2
Department of Therapy and Social Work, Fresenius University of Applied Sciences, Interprofessional Health Care in Pediatrics, Frankfurt, Germany
Submission date: 2023-02-18
Acceptance date: 2024-04-11
Publication date: 2025-06-18
Corresponding author
Michael Wilhelm Jung
University of Cooperative Education, Campus Darmstadt, Poststr. 4-6, D-64293, Darmstadt, Germany.
University of Cooperative Education, Campus Darmstadt, Poststr. 4-6, D-64293, Darmstadt, Germany.
Physiother Quart. 2025;33(2):80-84
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Bladder incontinence is a daily challenge for spinal cord injury patients. An initial single case study showed the positive effects of robot-assisted gait training in an adult with this issue. The current study aimed to evaluate possible correlations between Lokomat®Pro treatment and incontinence in a seven-year-old boy with incomplete paraplegia at T10 caused by meningoencephalitis.
Methods:
The study used an A-B-A-B-A-E design and observed the patient over a 17-week period. The intervention involved two 4-week blocks with the Lokomat®Pro interspersed by a wash-out phase of 3 weeks, with a final 5-week wash-out phase. Follow-up analysis included the Janda muscle function test, the 10-meter walk test (in crawling), surface sensitivity assessment, and the Patient Specific Functional Scale (PSFS) combined with the Canadian Occupational Performance Measure (COPMa-kids) at each measurement time point. The patient also received 60 min of standardised gait training daily.
Results:
The results show a positive relationship between therapy and muscle function, with an impressive increase in bladder maximum filling volume. Furthermore, nocturnal diaper wetting disappeared under therapy, with the patient able to sleep through the night without the need for a diaper change. In addition, stool consistency returned to normal during treatment.
Conclusions:
The therapy proved an effective treatment by reducing incontinence and positively influencing muscles. Subsequent studies, with more cases, should aim to confirm these effects.
Bladder incontinence is a daily challenge for spinal cord injury patients. An initial single case study showed the positive effects of robot-assisted gait training in an adult with this issue. The current study aimed to evaluate possible correlations between Lokomat®Pro treatment and incontinence in a seven-year-old boy with incomplete paraplegia at T10 caused by meningoencephalitis.
Methods:
The study used an A-B-A-B-A-E design and observed the patient over a 17-week period. The intervention involved two 4-week blocks with the Lokomat®Pro interspersed by a wash-out phase of 3 weeks, with a final 5-week wash-out phase. Follow-up analysis included the Janda muscle function test, the 10-meter walk test (in crawling), surface sensitivity assessment, and the Patient Specific Functional Scale (PSFS) combined with the Canadian Occupational Performance Measure (COPMa-kids) at each measurement time point. The patient also received 60 min of standardised gait training daily.
Results:
The results show a positive relationship between therapy and muscle function, with an impressive increase in bladder maximum filling volume. Furthermore, nocturnal diaper wetting disappeared under therapy, with the patient able to sleep through the night without the need for a diaper change. In addition, stool consistency returned to normal during treatment.
Conclusions:
The therapy proved an effective treatment by reducing incontinence and positively influencing muscles. Subsequent studies, with more cases, should aim to confirm these effects.
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