Upright Participation for Learners with Physical Disabilities: A Pilot Randomized Crossover Effectiveness-Implementation Trial of Robot-assisted Walking in Schools
Year: 2026
Type: preprint
Study design: Clinical Trial
Abstract: Background School-based implementation of robot-assisted walking may support increased physical and social participation for children with physical disabilities, but evidence from an adequately powered trial is needed. This pilot study evaluated implementation strategies and study procedures to inform a future definitive trial. Methods Participants were randomized to 12-weeks of robot-assisted walking or control, with subsequent crossover to the other condition. In the intervention arm, targeted dose was 75 minutes of robot-assisted walking, spread across three days/week. Implementation strategies for the child’s classroom team included educational materials, centralized technical assistance, school champions, and on-going training. Implementation strategy evaluation focused on intervention protocol feasibility (i.e., weekly device use, troubleshooting) and fidelity (documentation of implementation strategy modifications). Preliminary estimates participation goal changes were obtained using the Canadian Occupational Performance Measure (COPM) ‘Performance’ scale (/10). Results Eight children with neurodevelopmental physical disabilities participated (mean age 3.5, SD 0.5 years). Device use varied from 2.1 to 4.3 days/week (median 3.3) with a range of 48 to 96 minutes/week (median 80). Target use of ≥ 3 days/week was achieved for 66% of weeks and met the ≥75-minute target for 33% of weeks. Troubleshooting occurred in 18.5% of sessions. Two implementation strategies were modified to improve feasibility. COPM mean change was 3.56 (SD 1.07) for robot-assisted walking and 2.11 (SD 2.41) for control (d z =0.74). Conclusions This pilot study provided preliminary evidence regarding both the feasibility of robot-assisted walking implementation in schools and its potential effectiveness for children with physical disabilities. Findings support progression to a definitive trial.
Source: medRxiv
Institutions: University of Calgary, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, Alberta Children's Hospital, University of Ottawa, Children's Hospital of Eastern Ontario, University of Toronto, Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, University of Alberta, Women and Children’s Health Research Institute
Language: English
Subfield: Occupational Therapy
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7223106859