## 4 Discussion
It is possible that further adaptation was needed to reduce robotic assistance; nonetheless, for a 6-year-old child with cerebral palsy and GMFCS III, training might have been challenging. Therefore, RAGT should be tailored depending on the participant's condition, although for children with similar conditions to that of the study participant and require consistent training with a set protocol, choosing approximately 80% GF is likely to generate the most active participation. The study design was limited to a single participant because of the difficulty in recruiting children with cerebral palsy who were able to maintain a steady ROM despite decreasing GF. This study investigated the feasibility of a protocol for reducing robotic assistance in RAGT, and the present analyses show promise; however, a large sample size should be used in the future. Furthermore, only the EMG was measured during the sessions in which the GF was changed because it was not possible to predict when the participant would be sufficiently adapted to robotic guidance. As the participant was only 6 years old, the process of attaching the EMG sensor required some patience. If EMG sensors were attached at every session, more patience would have been required before performing RAGT for the participant. Nevertheless, it may be necessary to analyze the EMG patterns throughout the session after sufficient adaptation. As the EMG was recorded only during the sessions in which the GF was changed, the EMG data of the last 100 gait cycles from each session were extracted to consider the participant's adaptation. Therefore, the pattern clustering was performed for the last 100 steps of the session only. Despite having data from over 400 steps available (Table 1), analyzing only 100 steps was insufficient for clustering principal activation patterns. As the participant adapted to the repeated RAGT and improved her strength, she was able to undergo the next GF levels after only two sessions in the 85%, 75%, and 70% GF conditions. However, at the time the protocol was designed, the number of training sessions was set at 20; thus, it could not be confirmed whether the participant was fully adapted to the 70% GF condition after completing the last session. Hence, unlike the results of the other GF conditions, the results obtained at 70% GF may have occurred when the participant was not fully adapted. Stopping the RAGT when the participant was sufficiently adapted to the 70% GF condition to attempt the 65% GF condition might have different results than stopping the RAGT after a certain number of sessions while the participant was partially adapted to the 70% GF condition. Although a therapist with over 10 years of experience in pediatric rehabilitation determined when to adjust the GF based on the rate of perceived exertion and the participant's physical responses, such as breathing and sweating, it is uncertain whether the GF would have been reduced to 65% if there had been a 21 st session. This limitation can be improved by not ending the test when a set number of sessions is reached but rather when the participant has adapted to a GF level that is sufficiently low and close to the target level. This study found that gait quality and muscle use patterns improved during RAGT using the proposed protocol. However, these effects were not retained over the 4-week period after the post-assessment. This suggests either a lack of retention or a necessity of resistance by the robotic device to sustain the observed patterns. These findings imply the potential benefit of incorporating a form of post-training resistance to help maintain the effects of RAGT. They also emphasize the need for a longer RAGT duration with an appropriate dosage to optimize and retain rehabilitative outcomes. Further research is necessary to determine the optimal dosage and duration to retain the rehabilitative outcomes of RAGT in children with cerebral palsy.