Effects of robotic walking on bone and muscle health in youth with neuromotor impairments: a five-participant case series.
6 affiliations
- 1Biomedical Engineering Graduate Program, University of Calgary, Calgary, AB, Canada.
- 2Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
- 3McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada.
- 4Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
- 5Departments of Clinical Neurosciences and Pediatrics, University of Calgary, Calgary, AB, Canada.
- 6Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
Abstract
Introduction/background
Bone and muscle health is a significant concern among individuals with neuromotor impairments, especially those with the greatest functional limitations. This case series presents the bone and muscle adaptations in response to 13 to 14 weeks of robotic walking in children and adolescents with neuromotor impairments.Methods
To ensure that the intervention targeted functionally meaningful outcomes, the Canadian Occupational Performance Measure (COPM) was used to capture family-centered goals and motivations for participating in robotic walking. Peripheral quantitative computed tomography (pQCT) scans of the tibia assessed bone and muscle health at three locations: the 3% (trabecular bone), 38% (cortical bone), and 66% (muscle) of tibia length. Scans were acquired before and following robotic walking in five participants with the greatest functional limitations [Gross Motor Function Classification System (GMFCS) levels III -V and Functional Assessment Questionnaire (FAQ): Functional Walking Scale levels 1 -5; aged 4 -12 years]. Bone and muscle outcomes were converted to age-, sex-, and ethnicity-matched Z-scores relative to a typically developing population, and the change in pre- and post-intervention Z-scores was assessed. The least significant change (LSC) was calculated for each participant in bone parameter units, and a clinically relevant change was defined as one that exceeded both the LSC and the expected growth from available reference data.Results
In some participants, clinically relevant improvements were observed in trabecular bone mineral density (BMD) (three participants), total bone mineral content (one participant), and cortical BMD (one participant) following robotic walking, suggesting promising bone adaptations.Conclusions
Results underscore the need for larger longitudinal studies to explore the impacts of robotic walking across various GMFCS and FAQ levels.
Related
- Dysregulated microRNA–mRNA networks in SOD1G93A skeletal muscle reveal metabolic impairments in amyotrophic lateral sclerosis
- Robotic-arm-assisted versus conventional total knee replacement (RACER-Knee): a pragmatic, multicentre, participant-masked and assessor-masked, superiority, randomised controlled trial
- Effects of wearable lower-limb robotic exoskeleton–assisted gait training on balance, walking, and activities of daily living after stroke: a systematic review and meta-analysis
- Beyond functional disability: longitudinal joint trajectories of muscle strength and walking speed and their association with new-onset diabetes risk among older adults without ADL impairment
- Robotic repair of an esophago–left main bronchial fistula using a pedicled autologous pericardial patch and latissimus dorsi muscle flap: a novel technique after chemoradiotherapy for cT4b esophageal cancer
BibTeX
@article{hodgson2026effects,
title = {{Effects of robotic walking on bone and muscle health in youth with neuromotor impairments: a five-participant case series.}},
author = {Erin Hodgson and Jessica L Youngblood and Christa M Diot and Benjamin M Norman and Leigh Gabel and Elizabeth G Condliffe},
journal = {Frontiers in endocrinology},
year = {2026},
month = sep,
doi = {10.3389/fendo.2026.1916359},
url = {https://europepmc.org/article/MED/42845917},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effects of robotic walking on bone and muscle health in youth with neuromotor impairments: a five-participant case series.
AU - Erin Hodgson
AU - Jessica L Youngblood
AU - Christa M Diot
AU - Benjamin M Norman
AU - Leigh Gabel
AU - Elizabeth G Condliffe
PY - 2026
DA - 2026/09/23
JO - Frontiers in endocrinology
DO - 10.3389/fendo.2026.1916359
UR - https://europepmc.org/article/MED/42845917
AB - Introduction/background Bone and muscle health is a significant concern among individuals with neuromotor impairments, especially those with the greatest functional limitations. This case series presents the bone and muscle adaptations in response to 13 to 14 weeks of robotic walking in children and adolescents with neuromotor impairments.Methods To ensure that the intervention targeted functionally meaningful outcomes, the Canadian Occupational Performance Measure (COPM) was used to capture family-centered goals and motivations for participating in robotic walking. Peripheral quantitative computed tomography (pQCT) scans of the tibia assessed bone and muscle health at three locations: the 3% (trabecular bone), 38% (cortical bone), and 66% (muscle) of tibia length. Scans were acquired before and following robotic walking in five participants with the greatest functional limitations [Gross Motor Function Classification System (GMFCS) levels III -V and Functional Assessment Questionnaire (FAQ): Functional Walking Scale levels 1 -5; aged 4 -12 years]. Bone and muscle outcomes were converted to age-, sex-, and ethnicity-matched Z-scores relative to a typically developing population, and the change in pre- and post-intervention Z-scores was assessed. The least significant change (LSC) was calculated for each participant in bone parameter units, and a clinically relevant change was defined as one that exceeded both the LSC and the expected growth from available reference data.Results In some participants, clinically relevant improvements were observed in trabecular bone mineral density (BMD) (three participants), total bone mineral content (one participant), and cortical BMD (one participant) following robotic walking, suggesting promising bone adaptations.Conclusions Results underscore the need for larger longitudinal studies to explore the impacts of robotic walking across various GMFCS and FAQ levels.
SN - 1664-2392
ER -