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August 28, 2025
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Article

Effects of a Single Session of Robot-Assisted Gait Training vs. Aquatic Therapy, Immersion in Water, and Supported Standing on Post-Immediate Knee Musculoskeletal Conditions in Children with Cerebral Palsy: A Case Report

Publicated to:Applied Sciences-Basel. 15 (15): 8203- - 2025-07-23 15(15), DOI: 10.3390/app15158203

Authors: Ramiro Ferrando, Andres; Arnal-Gomez, Anna; Cortes-Amador, Sara; Gimeno Munoz, Noelia; Beltran Alos, Luis; Mur-Gimeno, Esther

Affiliations

Ctr Educ Especial Cruz Roja Valencia, C-Alboraya 6, Valencia 46010, Spain - Author
Univ Abat Oliba CEU, VITAE Escola Univ Esport, C-Balmes 209, Barcelona 08006, Spain - Author
Univ Valencia, Fac Physiotherapy, Dept Physiotherapy, C-Gasco Oliag 5, Valencia 46010, Spain - Author
Univ Valencia, Fac Physiotherapy, Dept Physiotherapy, Physiotherapy Mot Multispecialty Res Grp PTinMOTIO, C-Gasco Oliag 5, Valencia 46010, Spain - Author
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Abstract

Background: Aquatic therapy (AT), immersion in hot water, and supported standing are frequently used to manage spasticity, contractures, and joint retractions in children with cerebral palsy (CP). Recently, the use of exoskeletons has been offering a new treatment option for severe CP. This study aimed to compare the post-immediate effects of four treatments on spasticity, range of motion, and the heart rate of children with severe CP. Methods: Three children with spastic CP (levels IV and V GMFCS) received a single 30-min session in consecutive weeks of robot-assisted gait training (RAGT), AT, supported standing, and immersion in hot water. Post-immediate assessments included knee flexor spasticity (modified Ashworth scale, MAS, and modified Tardieu scale, MTS); knee range of motion (ROM, in degrees (degrees)); and heart rate (HR). Results: AT and supported standing induced greater reductions in spasticity based on MAS scores. RAGT demonstrated superior spasticity reduction using MTS and yielded the greatest improvement in popliteal angle (mean increase: 27 degrees). AT and RAGT induced a 14 beats-per-minute change in HR, indicating moderate cardiovascular engagement. Conclusions: RAGT appears particularly effective in improving spasticity and ROM in children with severe CP. Nonetheless, conventional treatments still offer an effective option when addressing spasticity.

Keywords

Aquatic therapyCase reporCase reportCerebral palsyHeart rateMotor functionQuality-of-lifeRange of motionRecommendationsReliabilityRobot-assisted gait trainingSpasticitySysteTardieu scale

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Applied Sciences-Basel due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2025, it was in position 50/175, thus managing to position itself as a Q2 (Segundo Cuartil), in the category Engineering, Multidisciplinary. Notably, the journal is positioned en el Cuartil Q2 para la agencia Scopus (SJR) en la categoría .

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-10-21:

  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 1 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

    It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

    • The work has been submitted to a journal whose editorial policy allows open Open Access publication.

    Leadership analysis of institutional authors

    There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: Last Author (Mur-Gimeno, Esther).