Robotic Physiotherapy Systems

Robotic Physiotherapy Systems for Children: Complete Guide | PediaDevices

Robotic physiotherapy systems are advanced rehabilitation devices that use robotic technology to help children with physical disabilities improve their movement, strength, and function. These devices work alongside traditional physical therapy to provide repetitive, controlled exercises that support recovery and development.

What are Robotic Physiotherapy Systems?

Robotic physiotherapy systems are specialized medical devices that use motors, sensors, and computer technology to assist children during rehabilitation exercises. These systems help move the arms, legs, or other body parts in controlled patterns, similar to how a physiotherapist would guide movement manually.

These devices combine mechanical support with interactive games and visual feedback to make therapy more engaging and effective for children. The robot does not work alone but supports the work of trained therapists and healthcare providers.

How They Work

Robotic systems work by:

Supporting the weight of the child's limbs or body
Guiding movements in specific patterns
Measuring how much effort the child is putting in
Adjusting the level of help based on the child's abilities
Providing immediate feedback through games or visual displays
Recording progress over time for the therapy team to review

Purpose and Uses

Primary Purposes

Robotic physiotherapy systems are designed to:

Improve walking ability and gait patterns
Strengthen weak muscles in arms and legs
Increase range of motion in joints
Develop better balance and coordination
Enhance hand and finger movements
Support children who cannot stand or walk independently
Provide high-intensity, repetitive training that is difficult to achieve manually

Where They Are Used

These systems are typically found in:

Specialized pediatric rehabilitation centers
Children's hospitals with rehabilitation departments
Neurological rehabilitation facilities
Outpatient therapy clinics
Academic medical centers

Conditions Treated

Robotic therapy helps children with:

Cerebral palsy
Traumatic brain injury
Spinal cord injury
Stroke
Incomplete paraplegia
Guillain-Barre syndrome
Other neurological or orthopedic conditions affecting movement

Important: Robotic therapy is used together with traditional physiotherapy, not as a replacement. It adds to the total amount of therapy a child receives.

Types of Robotic Physiotherapy Systems

Based on Body Part

Lower Limb Systems (Legs and Walking)

Lokomat: The most widely used robotic gait training system. It consists of motorized leg braces attached to a treadmill with a harness system that supports body weight. Available in pediatric versions for smaller children.

Innowalk: A training device that allows children who cannot walk or stand to perform full-body exercises in an upright position. The motion is similar to using a cross-trainer.

Walkbot and Robogait: Gait training robots that help children practice walking movements with computer-controlled assistance.

Anklebot: Focuses specifically on ankle and foot movements needed for standing and walking.

Upper Limb Systems (Arms and Hands)

Armeo Spring: A non-motorized arm support system that uses spring mechanisms to reduce the effect of gravity, allowing children to practice arm movements and reaching tasks.

Armeo Power: A motorized version for children with very limited arm movement.

AMADEO: Specialized for hand and finger rehabilitation, helping with grasping techniques and finger movements.

DIEGO: An arm therapy system that helps build function and independence with daily tasks.

Based on Design Type

Type	Description	Examples
Exoskeletons	Wearable robots that fit around the body like a skeleton, moving specific joints	Lokomat, Ekso
End-Effectors	Devices that hold only the end point (hand or foot) and allow more natural movement	Gait Trainer, some arm robots
Support Systems	Devices that reduce gravity's effect on limbs	Armeo Spring, Bioness Vector

Based on Therapy Mode

Passive Mode: Robot moves the limbs for the child
Active-Assistive Mode: Child tries to move, robot helps when needed
Active Mode: Child does the work, robot only measures performance
Resistive Mode: Robot provides gentle resistance to strengthen muscles

How to Use Robotic Physiotherapy Systems

Note: These systems must only be operated by trained healthcare professionals. This guide is for understanding the process, not for independent use.

Before Starting Therapy

Step 1: Medical Evaluation

Doctor evaluates if robotic therapy is suitable
Physical therapist assesses child's abilities and needs
Team sets specific goals for therapy
Parents receive explanation of what to expect

Step 2: Preparation

Child should use bathroom before session
Wear comfortable, fitted clothing (long pants for leg systems)
Avoid loose clothing with thick seams or buttons on sides
Wear same shoes for each session
Bring any prescribed braces or orthoses
Child may wear sports bra or athletic supporter for comfort

During a Typical Session

Step 3: Fitting and Setup (10-15 minutes)

Therapist helps child into harness or device
Adjusts all straps and supports for proper fit
Ensures child is comfortable and safe
Sets up computer programs and games
Programs robot settings based on child's needs

Step 4: Active Therapy (20-45 minutes)

Child performs exercises guided by the robot
Often includes games or virtual reality to maintain interest
Therapist monitors child constantly
Adjusts difficulty level as needed
Provides encouragement and feedback
Takes breaks if child becomes tired

Step 5: Cool Down and Review (5-10 minutes)

Gradually reduce intensity
Carefully remove child from device
Check skin for any pressure marks
Review progress with parents
Schedule next session

Typical Treatment Schedule

Aspect	Typical Duration
Session Length	45-60 minutes total
Active Training Time	20-45 minutes
Frequency	2-3 times per week
Program Duration	4-12 weeks

Who Can Use These Systems

General Criteria

Children may be suitable for robotic therapy if they:

Are typically 4 years old or older (varies by device)
Can communicate pain or discomfort
Can tolerate standing or sitting for required time
Have adequate range of motion in joints
Meet weight and height requirements for the device
Do not have conditions that prevent safe use

Size Requirements

For safety and effectiveness, children must fit within device specifications:

Lokomat Pediatric: Upper leg length 21-35 cm
Lokomat Adult: Upper leg length 35-47 cm
Weight: Usually 10-135 kg (varies by device)
Height: Device-specific, often 150-200 cm

Precautions and Safety Guidelines

Warning: Robotic therapy systems must only be used under the direct supervision of trained healthcare professionals in appropriate medical settings.

When NOT to Use (Contraindications)

Robotic therapy should not be used if the child has:

Unstable fractures or severe osteoporosis
Severe spasticity limiting joint movement
Fixed joint contractures preventing proper positioning
Open wounds or pressure sores in contact areas
Severe heart or lung problems
Active infections or inflammatory conditions
Severe pain that worsens with movement
Weight or size outside device limits
Inability to communicate discomfort

Use with Caution (Risk Factors)

Extra monitoring needed if child has:

Mild to moderate spasticity
Decreased skin sensation
Thin or sensitive skin
Cognitive limitations
Balance problems
Seizure disorders (well-controlled may be acceptable)
Need for feeding tubes or IV lines
Risk of spontaneous movements

Safety Measures During Use

Always have trained therapist present
Emergency stop buttons easily accessible
Proper fitting of all harnesses and supports
Regular skin checks during and after therapy
Monitor vital signs if indicated
Watch for signs of fatigue or distress
Keep communication open with child
Ensure all safety straps are secured
Maintain equipment according to manufacturer guidelines

Potential Side Effects

Most children tolerate robotic therapy well, but minor side effects may include:

Muscle soreness (similar to after exercise)
Temporary fatigue
Mild skin redness at contact points
Occasional dizziness (usually brief)

These usually resolve quickly. Report any concerns to the therapy team.

Signs to Stop Immediately

Stop therapy and notify medical staff if child experiences:

Severe pain or discomfort
Difficulty breathing
Excessive fatigue or weakness
Skin breakdown or bleeding
Dizziness or nausea that does not resolve
Anxiety or extreme distress
Any unusual symptoms

Benefits and Effectiveness

Proven Benefits

Improves walking speed and endurance
Enhances balance and postural control
Increases muscle strength
Better motor function in arms and legs
Improved ability to perform daily activities
Provides more intensive therapy than possible manually
Consistent, repeatable movements support motor learning
Games and feedback increase child engagement
Measurable tracking of progress
Reduces physical burden on therapists

What Research Shows

Studies indicate that robotic therapy:

Is safe when properly supervised
Works best when combined with traditional therapy
Shows improvements in gross motor function
Can help children at various ability levels
Is particularly beneficial for intensive training periods
May promote changes in brain activity patterns

Important Understanding: Robotic therapy is not superior to traditional therapy on its own, but it provides valuable additional treatment time and allows for intensive, repetitive practice that complements regular therapy sessions.

Frequently Asked Questions

Will the robot hurt my child?

No. When properly used, these systems are very safe. Therapists carefully adjust settings for each child. The robot cannot force movements beyond safe limits, and emergency stops are always available.

Can robotic therapy replace regular physiotherapy?

No. Robotic therapy is designed to supplement traditional therapy, not replace it. It provides additional intensive practice alongside regular treatment.

How long before we see results?

This varies by child and condition. Some children show improvements within 4-6 weeks, while others may take longer. Progress is measured throughout treatment.

Is robotic therapy painful?

The therapy itself should not be painful. Children may experience mild muscle soreness similar to after exercise, which is normal and temporary.

What if my child is afraid of the machine?

Therapists are trained to introduce the equipment gradually. Many systems include games and colorful displays to make therapy fun and less intimidating for children.

Are these systems covered by insurance?

Coverage varies by insurance plan and location. Check with your insurance provider and the treatment facility about coverage and costs.

Can my child use a robotic system at home?

Currently, most robotic therapy systems are only available in clinical settings due to their complexity, cost, and need for professional supervision.

How many sessions are needed?

Typical programs run 2-3 sessions per week for 4-12 weeks. The exact number depends on the child's condition, goals, and response to treatment.

Will results be permanent?

Gains from robotic therapy can be lasting, especially when continued with regular therapy and home exercises. Ongoing physical activity helps maintain improvements.

What age is appropriate for robotic therapy?

Most systems require children to be at least 4-5 years old, but this depends on the specific device and the child's size and ability to follow instructions.

How to Keep the Device Safe

For Healthcare Facilities

Follow manufacturer maintenance schedules strictly
Conduct regular safety inspections
Keep detailed service and calibration records
Train all staff thoroughly before use
Update software as recommended
Check emergency stop functions regularly
Inspect harnesses, straps, and padding for wear
Clean and sanitize between patients
Store in clean, dry environment
Report any malfunctions immediately

Daily Safety Checks

Before each use, therapists should verify:

All safety features are functioning
No visible damage to equipment
Harnesses and straps are intact
Software starts correctly
Emergency stops work properly
Padding is clean and secure
All adjustable parts move smoothly

Cleaning and Hygiene

Clean contact surfaces after each patient
Use appropriate medical-grade disinfectants
Follow manufacturer cleaning guidelines
Replace padding when worn or soiled
Ensure complete drying before next use
Wash harnesses regularly as directed

What Parents and Caregivers Should Know

Preparing Your Child

Explain the therapy in simple, positive terms
Show pictures or videos if available
Visit the facility beforehand if possible
Emphasize the games and fun aspects
Be honest that it requires effort but should not hurt
Encourage questions and address fears

During Treatment

Arrive on time and prepared
Bring required clothing and equipment
Communicate any changes in child's condition
Ask questions if you do not understand something
Provide encouragement and support
Follow therapist instructions
Report any concerns immediately

After Sessions

Watch for any unusual symptoms
Help child with any prescribed home exercises
Monitor skin condition where device touched
Maintain regular therapy schedule
Keep appointments with therapy team
Celebrate progress, even small gains

Remember: You are an important part of the therapy team. Your observations and feedback help therapists provide the best care for your child.

Working with the Healthcare Team

Who Is Involved

Pediatric Neurologist or Rehabilitation Physician: Diagnoses condition and prescribes therapy
Physical Therapist: Operates equipment and designs treatment plan
Occupational Therapist: May work with upper limb systems
Biomedical Engineers: Maintain and adjust equipment
Nurses: Monitor medical aspects during therapy
Parents/Caregivers: Support and continue care at home

Questions to Ask Your Team

What specific goals will we work toward?
How long will treatment last?
What should I expect during and after sessions?
Are there exercises we should do at home?
How will progress be measured?
What signs should I watch for at home?
Who do I contact if I have concerns?
What happens after the program ends?

Future Developments

Robotic physiotherapy continues to advance with:

Lighter, more portable devices
Better virtual reality integration
Artificial intelligence for personalized treatment
More natural movement patterns
Improved feedback systems
Potential for home-based systems
Better adaptation for younger children

Additional Resources

Professional Organizations

American Physical Therapy Association (APTA)
International Society of Pediatric Neurorehabilitation
Rehabilitation Engineering and Assistive Technology Society of North America (RESNA)

Official Manufacturer Resources

Hocoma - Manufacturer of Lokomat and Armeo systems
Tyromotion - Manufacturer of AMADEO and DIEGO
Contact local rehabilitation centers for specific device availability

Medical Disclaimer

This guide is for informational and educational purposes only and is not intended as medical advice. Robotic physiotherapy systems are medical devices that must be used only under the supervision of qualified healthcare professionals in appropriate clinical settings.

Always consult with your child's doctor, physical therapist, or other qualified healthcare provider before starting any new treatment program. Do not disregard professional medical advice or delay seeking it because of information found on this website.

The information provided is based on current research and clinical practice but may not apply to every child or situation. Individual results vary based on many factors including the child's condition, age, overall health, and adherence to the treatment program.

If your child experiences any adverse effects during or after robotic therapy, contact your healthcare provider immediately. In case of emergency, call your local emergency number.

Reviewed by: Pediatrician, PediaDevices Medical Team

Last Updated: February 2026

Labels: Special-Needs

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