Paediatric robotic gait training

The paediatric configuration uses shorter leg segments, lighter forces and a harness sized for a child, so that gait training can start from around four years old depending on leg length rather than age alone. Body-weight support, speed and robot assistance are set the same way as in adults but within ranges appropriate to a growing skeleton.

Screen-based games are driven by the child's own stepping, which is what makes the repetition possible. A child will not keep practising walking simply because they were asked to; they will complete the practice while playing a game that happens to require correct steps.

Most often cerebral palsy, where the goal is improving gait quality and endurance rather than producing walking that was never going to develop. Also spinal cord injury, acquired brain injury, spina bifida, and neuromuscular conditions where walking is deteriorating.

Suitability depends on leg length, joint range, cooperation and the absence of severe contracture or hip instability. Children with significant hip subluxation are assessed by an orthopaedic surgeon first, because loading an unstable hip is not neutral.

Robotic gait training in cerebral palsy can improve walking speed and endurance, but in trials the extra gain over conventional physiotherapy has been modest or absent 12. It does not change the underlying condition and it will not make a child who is at GMFCS level IV walk independently.

We will tell you what we think is achievable before you travel, based on the assessment, and we will say when we think a block will not add enough to justify it.

Sessions are shorter, the harness and leg cuffs are sized for the child, and the screen games are what hold attention long enough for the repetitions to accumulate. A bored child produces poor-quality steps.

A parent is present and is shown what is being trained, because the walking practice that continues at home between blocks is what carries the gain forward.

The main evidence comes from trials comparing robotic gait training with conventional physiotherapy in children with cerebral palsy. A 2026 systematic review of 15 randomised trials with 542 children found that the two produced similar improvements in most movement, walking and balance measures, with a modest extra gain for the robot in walking endurance and speed 1. An earlier meta-analysis of 8 trials with 188 participants found no greater benefit than standard care for walking distance, walking speed, or standing and walking skills 2.

The trials are small and use very different schedules, and reviewers describe the evidence as weak and inconsistent 3. In practice, the robot is one way of delivering a large amount of walking practice rather than a better kind of practice.