Promoting Functional Neck Motion in Patients with Cerebral Palsy using a Robotic Neck Brace

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Project Summary Cerebral Palsy (CP) is a non-progressive damage in the fetal or developing brain that causes movement and posture disorders. The Gross Motor Functional Classification System (GMFCS) is used to determine the level of functional independence in CP from I-V. Those more severely involved are classified as GMFCS-V with severe motor deficits to control the head and trunk in sitting position. They require assistive technology, with extensive personal and environmental adaptations, to be able to participate in the community. Head control is also an important postural deficit in people with CP GMFCS-IV. A robotic neck brace has been recently developed by our Robotics and Rehabilitation (ROAR) Laboratory at Columbia University. Our pilot data with healthy individuals confirms that this robotic brace can be used for both assistance and training. These results are highly encouraging and set the stage for this proposal. We believe that this technological innovation can be adapted to significantly improve head-neck control of those with CP. In this 2-year project, we will perform single-session studies in a cohort of people with CP GMFCS IV-V to characterize their head-neck control. We will then test a multi-session training program designed to maximize functional head control in this CP sub-population. The specific aims are: Aim 1: To characterize head control impairments in children with CP, GMFCS IV-V, with a robotic neck brace. Aim 2: To test the feasibility of a multi-session motor training with a robotic neck brace to promote postural head control in children with CP, GMFCS IV-V.