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Effects of a dual task on postural control during sit‐to‐stand movement in children with Down syndrome

robotics research has involved structured protocols including a specified number of sessions, number of repetitions, and pre and post-test outcomes. Conversely, clinical patients have individualized plans of care that take into consideration reimbursement limitations, clinical limitations, and personal treatment goals. Thus, the translation of research protocols into clinical practice has been challenging. One benefit of robotics rehabilitation is the opportunity to quantitatively measure motor performance within treatment sessions allowing a direct comparison of research and clinical outcomes. Study Design: Retrospective cohort study. Study Participants & Setting: Forty subjects included 21 research subjects (ages 4–11; 11 male, 10 female) and 19 clinical subjects (ages 4–27; 12 male, 7 female) with diagnoses of hemiplegic cerebral palsy were included in this study within Neurorehabilitation and Robotics at Indiana University Health. Materials/Methods: Subjects participated in upper extremity robotic rehabilitation using the MIT-Manus Shoulder-Elbow Robot. Subjects from the research cohort completed 16 intervention sessions (2 x week; 8 weeks) with a total of 1,024 repetitions of movement per session. Repetitions were divided into 3 treatment blocks of 320 repetitions and 4 assessments. Subjects in the clinical cohort completed intervention sessions based on his or her plan of care (number of sessions and repetitions per session varied by participant). During each intervention, both cohorts of subjects completed assessments tracking subject performance on a planar task without robotic assistance. Kinematics (movement time) from these records were extracted to assess subject’s motor performance and were analyzed using an ANOVA. Results: Results indicated a significant group by block interaction for movement time (F=10.4, p<0.001). The participants in the research cohort demonstrated a steady improvement over the course of the 16 treatment sessions, whereas there was more variability in the performance from the clinical participants. Despite this variability, clinical participants did significantly decrease movement times between their first and last session (F=4.9, p = 0.04) influenced by the number of treatment visits. Participants in the research group had a main effect for block (F=6.5, p =0.001) and treatment day (F=15.8, p<0.001). Conclusions/Significance: The results indicate that for individuals with cerebral palsy participating in upper extremity robotic rehabilitation, the number of visits and repetitions per session is important. While the participants from the clinic do make improvements over time, the comparison to the research data suggests that improvements could be steadier when delivering the treatment with a plan of care that more closely represents published research studies. D9 Effects of a dual task on postural control during sit-to-stand movement in children with Down syndrome