## 4 Discussion
### Robotic Devices  
The increasing number of studies on neurological disabilities in children has paralleled the number of devices developed. However, most of the devices included in the present review were initially intended for adult users, with limited possibility to be adapted to child biomechanics, as they do not provide the possibility of adjusting the size, weight, and forces delivered. Despite this limited number of devices developed for the paediatric population, several studies have shown that their use can offer relevant opportunities to promote children's sensorimotor recovery and prevent disease progression. The wide range of subjects' heights during childhood has possibly affected the diffusion of standard devices and has fostered the development of several customized robots. One of the main characteristics in pediatric rehabilitation is the patients' continuous development and change in terms of anthropometric measures and rehabilitation needs. Consequently, developmental neuromotor rehabilitation is often a process that supports children from birth to adulthood. The devices' description in terms of technical features was limited in most of the included studies. Noteworthy, as previously suggested, it is conceivable that improving the reporting on robots' characteristics in clinical trials may help other researchers and clinicians be aware of these technologies' full potential and use them appropriately [12]. The knowledge of each robot training modalities and other technical aspects such as wearability or number of DoFs is crucial to understanding devices' best implementations in clinical practice. Moreover, in most of the literature examined, there was no clear distinction between assistive and purely rehabilitative devices (replacement of a function vs recovery of a function). While some devices were explicitly developed for rehabilitation, showing interactive features and adaptability to patient impairments, other devices seem to be designed with the original aim to reduce disability in impaired patients rather than being a rehabilitative tool. A significant example of the latter is the Ekso GT (Ekso Bionics, Richmond, CA, USA) [42]. Although provided with different treatment modalities to match the subject's level of impairment, the device is poorly interactive. It does not properly provide task-oriented training per-se, which is an essential feature for inducing functional improvement and fostering neuroplasticity. A remarkable attempt to describe the functioning of the rehabilitation robot used in their trial is represented by the study from [41]. In their study, the authors have evaluated new control modes by assessing leg muscle activation patterns and intensity and heart rate while walking with the Lokomat device. Specifically, two new control modes were introduced: the \"Path Control\" mode, which allows the patient to walk within a virtual tunnel surrounding the ideal movement trajectory, and the \"FreeD\", which was developed to support weight shifting through the mediolaterally moveable pelvis and leg cuffs. Results indicate that the former seems promising for adolescent patients undergoing neurorehabilitation, as it increases proximal leg muscle activity while facilitating a physiological muscle activation. Overall, the present review findings suggest an urgent need for new devices specifically designed and developed for children. Meeting this need is crucial for the development of this field and might improve rehabilitation. It would be essential to involve both engineers and therapists during the design stage, as regards technological innovation. This collaboration can provide both technical and clinical requirements with the aim of designing and programming devices increasingly suitable for rehabilitation aims and the needs of clinical relevance, always keeping the engagement and comfort of the child as the central reference point.