scholarly journals Abnormal synergistic gait mitigation in acute stroke using an innovative ankle–knee–hip interlimb humanoid robot: a preliminary randomized controlled trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chanhee Park ◽  
Mooyeon Oh-Park ◽  
Amy Bialek ◽  
Kathleen Friel ◽  
Dylan Edwards ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Humanoid Robot ◽  
Controlled Trial ◽  
Gait Training ◽  
Recovery Phase ◽  
Stroke Recovery ◽  
Robot Assisted ◽  
Knee Joint Kinematics ◽  
Resistive Forces ◽  
Hemiparetic Stroke

AbstractAbnormal spasticity and associated synergistic patterns are the most common neuromuscular impairments affecting ankle–knee–hip interlimb coordinated gait kinematics and kinetics in patients with hemiparetic stroke. Although patients with hemiparetic stroke undergo various treatments to improve gait and movement, it remains unknown how spasticity and associated synergistic patterns change after robot-assisted and conventional treatment. We developed an innovative ankle–knee–hip interlimb coordinated humanoid robot (ICT) to mitigate abnormal spasticity and synergistic patterns. The objective of the preliminary clinical trial was to compare the effects of ICT combined with conventional physical therapy (ICT-C) and conventional physical therapy and gait training (CPT-G) on abnormal spasticity and synergistic gait patterns in 20 patients with acute hemiparesis. We performed secondary analyses aimed at elucidating the biomechanical effects of Walkbot ICT on kinematic (spatiotemporal parameters and angles) and kinetic (active force, resistive force, and stiffness) gait parameters before and after ICT in the ICT-C group. The intervention for this group comprised 60-min conventional physical therapy plus 30-min robot-assisted training, 7 days/week, for 2 weeks. Significant biomechanical effects in knee joint kinematics; hip, knee, and ankle active forces; hip, knee, and ankle resistive forces; and hip, knee, and ankle stiffness were associated with ICT-C. Our novel findings provide promising evidence for conventional therapy supplemented by robot-assisted therapy for abnormal spasticity, synergistic, and altered biomechanical gait impairments in patients in the acute post-stroke recovery phase.Trial Registration: Clinical Trials.gov identifier NCT03554642 (14/01/2020).

Abnormal Synergistic Gait Mitigation after Acute Stroke Using an Innovative Ankle-Knee-Hip Interlimb Humanoid Robot: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Chanhee Park ◽  
Mooyeon Oh-Park ◽  
Amy Bialek ◽  
Kathleen Friel ◽  
Dylan Edwards ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Humanoid Robot ◽  
Controlled Trial ◽  
Gait Training ◽  
Gait Patterns ◽  
Gait Biomechanics ◽  
Gait Kinematics ◽  
Abnormal Gait ◽  
Knee Joint Kinematics ◽  
Hemiparetic Stroke

Abstract Abnormal spasticity and associated synergistic patterns are the most common neuromuscular impairments affecting ankle-knee-hip interlimb coordinated gait kinematics and kinetics in patients with hemiparetic stroke. Although patients with hemiparetic stroke undergo various treatments to improve gait and movement, it remains unknown how spasticity and associated synergistic patterns change after robot-assisted and conventional treatment. We developed an innovative ankle-knee-hip interlimb coordinated humanoid robot (ICT) to mitigate abnormal spasticity and synergistic patterns. Our study aimed to compare the effects of ICT combined conventional physical therapy (ICT-C) and conventional physical therapy and gait training (CPT-G) on abnormal spasticity, synergistic gait patterns, and gait biomechanics in 20 patients with acute hemiparesis. The interventions were provided in 60-min sessions, 7 days/week, for 2 weeks. ICT-C demonstrated superior effects to CPT-G in knee joint kinematics, hip extensor and ankle dorsiflexor spasticity, hip, knee, ankle active force, knee and ankle resistive force, hip, knee, and ankle stiffness. Concurrently, the abnormal gait synergy was reduced in the ICT-C group. Our novel findings provided promising evidence of the ICT benefits as a successful intervention for abnormal spasticity and synergistic gait impairments in patients with acute hemiparetic stroke.Trial Registration: Clinical Trials.gov identifier NCT03554642 (14/01/2020)

Does robot-assisted gait training improve ambulation in highly disabled multiple sclerosis people? A pilot randomized control trial

2016 ◽  
Vol 23 (5) ◽  
pp. 696-703 ◽  
Author(s):  
Alessandra Pompa ◽  
Giovanni Morone ◽  
Marco Iosa ◽  
Luca Pace ◽  
Sheila Catani ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Outcome Measures ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Gait Training ◽  
Control Group ◽  
Robot Assisted ◽  
Robotic Training ◽  
Global Mobility ◽  
Pilot Randomized Control Trial

Background: Robotic training is commonly used to assist walking training in patients affected by multiple sclerosis (MS) with non-conclusive results. Objective: To compare the effect of robot-assisted gait training (RAGT) with that of conventional walking training (CWT) on gait competencies, global ability, fatigue and spasticity in a group of severely affected patients with MS. Methods: A pilot, single-blind randomized controlled trial was conducted in 43 severe (Expanded Disability Status Scale (EDSS) score of 6–7.5) and non-autonomous ambulant in-patients with MS. Experimental group performed 12 sessions of RAGT, whereas control group performed the same amount of CWT. Primary outcome measures were gait ability assessed by 2 minutes walking test and Functional Ambulatory Category; secondary outcomes were global ability (modified Barthel Index), global mobility (Rivermead Mobility Index), severity of disease (EDSS) and subjectively perceived fatigue (Fatigue Severity Scale). Results: The number of subjects who achieved a clinical significant improvement was significantly higher in RAGT than in CWT ( p < 0.05 for both primary outcome measures). RAGT also led to an improvement in all the other clinical parameters (global ability: p < 0.001, global mobility: p < 0.001, EDSS: p = 0.014 and fatigue: p = 0.001). Conclusions: RAGT improved the walking competencies in non-autonomous ambulant patients with MS, with benefits in terms of perceived fatigue.

scholarly journals Robot-assisted gait training to reduce pusher behavior

Neurology ◽  
2018 ◽  
Vol 91 (14) ◽  
pp. e1319-e1327 ◽  
Author(s):  
Jeannine Bergmann ◽  
Carmen Krewer ◽  
Klaus Jahn ◽  
Friedemann Müller
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
Gait Training ◽  
Class Ii ◽  
Control Group ◽  
Robot Assisted ◽  
Post Intervention ◽  
Subacute Stroke ◽  
Post Test

ObjectiveTo determine the effects of 2 weeks of intensive robot-assisted gait training (RAGT) on pusher behavior compared to nonrobotic physiotherapy (nR-PT).MethodsIn a single-blind, randomized, controlled trial with 2 parallel arms, we compared 2 weeks of daily RAGT (intervention group) with the same amount of nR-PT (control group). Patients with subacute stroke who had pusher behavior according to the Scale for Contraversive Pushing (SCP) were included. The primary research questions were whether changes in pusher behavior would differ between groups post intervention, and at a follow-up 2 weeks afterward (SCP and Burke Lateropulsion Scale, Class II evidence). Secondary outcomes included the Performance-Oriented Mobility Assessment, the Functional Ambulation Classification, and the Subjective Visual Vertical.ResultsThirty-eight patients were randomized. Thereof, 30 patients received the allocated intervention and were included in the analyses. RAGT led to a larger reduction of pusher behavior than nR-PT at post test (SCP: U = 69.00, r = −0.33, p = 0.037; Burke Lateropulsion Scale: U = 47.500, r = −0.50, p = 0.003) and at follow-up (SCP: U = 54.00, r = −0.44, p = 0.008). Pusher behavior had ceased in 6 of 15 participants in the intervention group and 1 of 15 participants in the control group at post test. At follow-up, 9 of 15 and 5 of 15 participants, respectively, no longer exhibited the behavior.ConclusionsTwo weeks of RAGT seems to persistently reduce pusher behavior, possibly by recalibrating the disturbed inner reference of verticality. The potential benefits of RAGT on pusher behavior and verticality perception require further investigation.Trial registrationGerman Clinical Trials Register (registration number: DRKS00003444).Classification of evidenceThis study provides Class II evidence that RAGT is beneficial to reduce pusher behavior in patients with stroke.

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