Potential for Improving Speech Function in Children With Cerebral Palsy Through Rehabilitation Using Robotic Devices and Biofeedback

BACKGROUND: Studies involving robotic devices have demonstrated high potential in rehabilitation, including children with cerebral palsy. In addition to functional restoration of hand motor skills, a probable improvement in speech abilities were observed. This phenomenon requires evidence-based experimental substantiation, including the organization of neurorehabilitation sessions.

AIM: This study aimed to assess the impact of neurotraining sessions using a noninvasive brain–computer–hand exoskeleton interface on the level of speech abilities in children with cerebral palsy, depending on the success of interaction with the neurointerface.

MATERIAL AND METHODS: The study included a group of patients diagnosed with cerebral palsy and dysarthria: 18 girls aged 11.11 ± 0.69 years and 30 boys aged 9.5 ± 0.55 years (p = 0.064). In addition to the standard rehabilitation program, 10 sessions were conducted using the brain–computer–hand exoskeleton complex. Upon completion of each session, the success coefficient of interaction with the neurointerface was automatically generated. Speech abilities before and after the neurorehabilitation course (10 sessions) were assessed using the following methods: oral praxis and articulation, phoneme pronunciation, and sentences based on pictures. The control group consisted of 30 children with cerebral palsy and dysarthria (12 girls, 10.58 ± 0.69 years; 18 boys, 11 ± 0.65 years; p = 0.891). Patients in the control group only participated in the standard rehabilitation program. Statistical analysis was performed using GraphPad Prism 8. The Shapiro–Wilk test was used to assess the normality of distribution. Multiple statistical analysis was performed using the Kruskal–Wallis method and Dunn’s test. Pairwise comparisons were performed using the Student t-test, Wilcoxon test, and Mann–Whitney U-test. Differences were considered statistically significant at p < 0.05.

RESULTS: Participants in the experimental group were divided into two subgroups: the first demonstrated a gradual increase in the success coefficient and was classified as “successful.” The second subgroup showed variability in values approximating the baseline (session 1) and was classified as “unsuccessful.” Among the 12 “successful” girls, the success coefficient increased from 0.33 (0.29; 0.36) at session 1 to 0.44 (0.43; 0.61) at session 10 (p = 0.0007); among the 19 “successful” boys—from 0.33 (0.31; 0.39) to 0.50 (0.46; 0.57) (p = 0.0000017). No change in the success coefficient was observed in the “unsuccessful” subgroup. The “successful” participants demonstrated a significantly greater median increase (2–2.5 points) in speech assessment scores compared with both “unsuccessful” participants (0–2 points) and controls (0–1 point).

CONCLUSION: A significant improvement in speech abilities was observed during neurorehabilitation sessions in participants who showed an increasing success coefficient.