scholarly journals The effect of pelvic movements of a gait training system for stroke patients: a single blind, randomized, parallel study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Choonghyun Son ◽  
Anna Lee ◽  
Junkyung Lee ◽  
DaeEun Kim ◽  
Seung-Jong Kim ◽  
...  
Keyword(s):  
Stride Length ◽  
Stance Phase ◽  
Walking Speed ◽  
Gait Training ◽  
Training System ◽  
Transverse Plane ◽  
Gait Rehabilitation ◽  
Stroke Patients ◽  
Pelvic Movement ◽  
Robotic Gait

Abstract Background Aging societies lead to higher demand for gait rehabilitation as age-related neurological disorders such as stroke and spinal cord injury increase. Since conventional methods for gait rehabilitation are physically and economically burdensome, robotic gait training systems have been studied and commercialized, many of which provided movements confined in the sagittal plane. For better outcomes of gait rehabilitation with more natural gait patterns, however, it is desirable to provide pelvic movements in the transverse plane. In this study, a robotic gait training system capable of pelvic motions in the transverse plane was used to evaluate the effect of the pelvic motions on stroke patients. Method Healbot T, which is a robotic gait training system and capable of providing pelvic movements in the transverse plane as well as flexion/extension of the hip and knee joints and adduction/abduction of the hip joints, is introduced and used to evaluate the effect of the pelvic movement on gait training of stroke patients. Gait trainings in Healbot T with and without pelvic movements are carried out with stroke patients having hemiparesis. Experiment Twenty-four stroke patients with hemiparesis were randomly assigned into two groups and 23 of them successfully completed the experiment except one subject who had dropped out due to personal reasons. Pelvis-on group was provided with pelvic motions whereas no pelvic movement was allowed for pelvis-off group during 10 sessions of gait trainings in Healbot T. Electromyography (EMG) signals and interaction forces as well as the joint angles of the robot were measured. Gait parameters such as stride length, cadence, and walking speed were measured while walking on the ground without assistance of Healbot T after gait training on 1st, 5th, and 10th day. Result Stride length significantly increased in both groups. Furthermore, cadence and walking speed of the pelvis-on group were increased by 10.6% and 11.8%. Although interaction forces of both groups except the thighs showed no differences, EMG signals from gluteus medius of the pelvis-on group increased by 88.6% during stance phase. In addition, EMG signals of biceps femoris, gastrocnemius medial, and gastrocnemius lateral of the pelvis-on group increased whereas EMG signals of the pelvis-off group except gastrocnemius lateral showed no difference after gait trainings. Conclusion Gait training using a robotic gait training system with pelvic movements was conducted to investigate the effects of lateral and rotational pelvic movements in gait training of stroke patients. The pelvic movements affected to increase voluntary muscle activation during the stance phase as well as cadence and walking speed. Clinical trial registration KCT0003762, 2018-1254, Registered 28 October 2018, https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=14310&ltype=&rtype=

scholarly journals The Effect of Pelvic Movements of a Gait Training System for Stroke Patients

2021 ◽  
Author(s):  
Choonghyun Son ◽  
Anna Lee ◽  
Junkyung Lee ◽  
DaeEun Kim ◽  
Seung-Jong Kim ◽  
...  
Keyword(s):  
Stance Phase ◽  
Gait Training ◽  
Training System ◽  
Transverse Plane ◽  
Gait Rehabilitation ◽  
Stroke Patients ◽  
Interaction Forces ◽  
Flexion Extension ◽  
Pelvic Movement ◽  
Robotic Gait

Abstract Background: Aging societies lead to higher demand for gait rehabilitation as age-related neurological disorders such as stroke increase. Since conventional methods for gait rehabilitation are physically and economically burdensome, robotic gait training systems have been studied and commercialized, many of which provided movements confined in the sagittal plane. For better outcomes of gait rehabilitation with more natural gait patterns, however, it is desirable to provide pelvic movements in the transverse plane. In this study, a robotic gait training system capable of pelvic motions in the transverse plane was used to evaluated the effect of the pelvic motions on stroke patients. Method: Healbot T, which is a robotic gait training system and capable of providing pelvic movements in the transverse plane as well as flexion/extension of the hip and knee joints and adduction/abduction of the hip joints, is introduced and used to evaluate the effect of the pelvic movement on gait training of stroke patients.Experiment: 23 stroke patients with hemiparesis participated in this study and were assigned into two groups. Pelvis-on group was provided with pelvic motions whereas no pelvic movement was allowed for pelvis-off group during 10 sessions of gait trainings in Healbot T. EMG signals and interaction forces as well as the joint angles of the robot were measured. Gait parameters such as stride length, gait period, cadence, and walking speed were measured after gait training. Result: 37.5 % lower interaction forces of pelvis were observed in the pelvis-on group than the pelvis-off group. Furthermore, the interaction forces at the thighs and calves of both groups showed significant decrease. The EMG signals of gluteus medius of the pelvis-on group increased by 77.2 %. Furthermore, statistically significant increases in various muscles were measured in the pelvis-on group during the stance phase. Conclusion: Gait training using a robotic gait training system with pelvic movements was conducted to study the effects of lateral and rotational pelvic movements in gait training of stroke patients. The pelvic movements made gait training less interfered by the exoskeleton while stimulating the voluntary muscle activation during the stance phase. Clinical trial registration: KCT0003762, 2018-1254, Registered 28 October 2018, https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=14310

THE DEVELOPMENT OF AN EMG CONTROLLER-BASED ROBOTIC GAIT TRAINING SYSTEM AND ITS CLINICAL FEASIBILITY FOR SUBACUTE STROKE PATIENTS IN IMPROVING LOCOMOTIVE FUNCTION

2019 ◽  
Vol 19 (02) ◽  
pp. 1940018
Author(s):  
ANDY CHIEN ◽  
FU-HAN HSIEH ◽  
CHING HUANG ◽  
FEI-CHUN CHANG ◽  
NAI-HSIN MENG ◽  
...  
Keyword(s):  
Muscle Activation ◽  
Gait Cycle ◽  
Gait Training ◽  
Gait Pattern ◽  
Rehabilitation Program ◽  
Training System ◽  
Stroke Patients ◽  
Robotic Training ◽  
Subacute Stroke ◽  
Robotic Gait

One-third of stroke survivors fail to regain independent ambulation and strokes have been identified as a significant source of long-term disability and a tremendous health burden. Robot-assisted gait rehabilitation is gaining traction and advocators for its inclusion as part of the routine post-stroke rehabilitation program are on the increase. However, despite the recent technological advances in the development and design of better robotics, the research evidence on the best model of robotic training remains sparse and unclear. It is therefore the aim of the current study to comparatively investigate the clinical feasibility and efficacy of a recently developed HIWIN Robotic Gait Training System (MRG-P100) combined with the use of a lab-developed MBS-E100 EMG system as a controller on facilitating the development of an appropriate gait pattern for motor impaired subacute stroke patients. The results indicated that due to the heterogeneity of stroke-induced changes in muscle characteristics, an “auto-fit” algorithm was required to allow constant monitoring and updating of the appropriate threshold based on EMG signals captured during previous gait cycle in order to determine the desired muscle activation threshold for the current gait cycle. Eighteen participants were tested using the new auto-fit algorithm and results demonstrated a significantly more fluent and physiologically appropriate gait pattern.

scholarly journals Velocity Determinants in Spastic Patients after Stroke—A Gait Analysis Study

2020 ◽  
Vol 12 (3) ◽  
pp. 48-54
Author(s):  
Miguel Reis e Silva ◽  
Jorge Jacinto
Keyword(s):  
Gait Analysis ◽  
Knee Flexion ◽  
Stride Length ◽  
Stance Phase ◽  
Gait Training ◽  
Swing Phase ◽  
The Body ◽  
Gait Velocity ◽  
Stroke Patients ◽  
Exclusion Criteria

Introduction: Gait velocity in spastic patients after stroke is both a life quality and mortality predictor. However, the precise biomechanical events that impair a faster velocity in this population are not defined. This study goal is to find out which are the gait parameters associated with a higher velocity in stroke patients with spastic paresis. Methods: The registries of a Gait analysis laboratory were retrospectively analyzed. The inclusion criteria were: trials of adult stroke patients with unilateral deficits. The exclusion criteria were: trials when patients used an external walking device, an orthosis, or support by a third person. Of the 116 initial patients, after the application of the exclusion criteria, 34 patients were included in the cohort, all with spatiotemporal, static and dynamic kinematic and dynamometric studies. Results: There was a correlation of velocity with cadence, stride length of the paretic (P) limb, stride length, and time of the P and non-paretic (NP) limb, double support time, all the parameters related to hip extension during stance phase, knee flexion during swing phase, and parameters related to ankle plantarflexion during stance phase. Conclusions: The main gait analysis outcomes that have a correlation with speed are related to the formula velocity = step length × cadence or are related to stance phase events that allow the anterior projection of the body. The only swing phase outcome that has a correlation with speed is knee flexion. More studies are needed from gait analysis laboratories in order to point out the most relevant goals to achieve with gait training in spastic stroke patients.

scholarly journals Clinical Efficacy of a New Robot-assisted Gait Training System for Acute Stroke Patients

2021 ◽  
Author(s):  
Andy Chien ◽  
Fei-Chun Chang ◽  
Nai-Hsin Meng ◽  
Pei-Yu Yang ◽  
Ching Huang ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Acute Stroke ◽  
Quality Index ◽  
Pittsburgh Sleep Quality Index ◽  
Gait Training ◽  
Training System ◽  
Control Group ◽  
Stroke Patients ◽  
Robot Assisted ◽  
Significant Difference

Abstract Purpose Robot-assisted gait rehabilitation has been proposed as a plausible supplementary rehabilitation strategy in stroke rehabilitation in the last decade. However, its exact benefit over traditional rehabilitation remain sparse and unclear. It is therefore the purpose of the current study to comparatively investigate the clinical benefits of the additional robot-assisted training in acute stroke patients compared to standard hospital rehabilitation alone. Methods Ninety acute stroke patients (< 3 month) were recruited. All participants received the standard hospital neurorehabilitation comprises 45–60 min sessions daily for 3 weeks. Sixty patients also received an additional 30 min of robot-assisted gait training with the HIWIN MRG-P100 gait training system after each of the standard neurorehabilitation session. Outcome measures included: 1. Berg Balance Scale (BBS); 2. Brunnstrom Stage; 3. Pittsburgh Sleep Quality Index and 4. Taiwanese Depression Questionnaire (TDQ) which were assessed pre-treatment and then after every five training sessions. Results Both groups demonstrated significant improvement pre- and post-treatment for the BBS (robotic group p = 0.023; control group p = 0.033) but no significant difference (p > 0.1) between the groups were found. However, the robotic training group had more participants demonstrating larger BBS points of improvement as well as greater Brunnstrom stage of improvement, when compared to the control group. No significant within and between group statistical differences (p > 0.3) were found for Pittsburgh Sleep Quality Index and Taiwanese Depression Questionnaire. Conclusion The addition of robotic gait training on top of standard hospital neurorehabilitation for acute stroke patients appear to produce a slightly greater improvement in clinical functional outcomes, which is not transferred to psychological status.

OP43 Robotic Or Conventional Gait Training Rehabilitation? A Health Technology Assessment Study

2018 ◽  
Vol 34 (S1) ◽  
pp. 16-17
Author(s):  
Martina Andellini ◽  
Francesco Faggiano ◽  
Roxana di Mauro ◽  
Pietro Derrico ◽  
Matteo Ritrovato
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Conventional Therapy ◽  
Health Technology ◽  
Gait Training ◽  
Core Model ◽  
Gait Rehabilitation ◽  
Alternative Technologies ◽  
Movement Trajectories ◽  
Robotic Gait

Introduction:The purpose of this study is to gather evidence on safety and overall effectiveness of three alternative technologies for gait rehabilitation in diplegic children with Cerebral Palsy: robotic, conventional and joint conventional and robotic gait training.Methods:A new methodology, decision-oriented health technology assessment (DoHTA), was applied to assess the technology on clinical, technical, organizational, economic, social and ethical, legal and safety domains. This method, conceived as a hospital-based HTA tool for supporting the introduction of innovative technologies, has been implemented merging the EUnetHTA Core Model® with the Multi-Criteria Decision Analysis. In particular, the general items of the EUnetHTA Core Model® are re-formulated as performance indicators and re-placed along a decision tree structure that, from the one hand, respects the original top-down design of the EUnetHTA model (growing level of detail from domains to issues) and, from the other hand, allows obtaining a quantitative evaluation of each identified performance indicator.Results:The multiple indicators, which have been identified for the seven domains, play important and different roles in the alternative technologies evaluation. DoHTA results showed that robotic system offers the possibility to control more accurately the exerted forces and movement trajectories than the traditional therapy. It gives the possibility to measure the task performances parameters and to receive the patient feedback simultaneously. To carry out robotic gait rehabilitation fewer therapists are required compared with the conventional therapy, resulting in lower therapists’ physical workload.Conclusions:Despite the great perspectives that robotics offer to motor rehabilitation, it seems that robotic gait training could not provide greater benefits in terms of motor and functional recovery compared to the conventional therapy. Preliminary results, supported by most recent literature evidence, lead to the hypothesis that joint use of robotic and conventional therapy can produce better clinical outcomes than the separate use of the two rehabilitation techniques.

scholarly journals AN FES-ASSISTED GAIT TRAINING SYSTEM FOR HEMIPLEGIC STROKE PATIENTS BASED ON INERTIAL SENSORS

2006 ◽  
Vol 39 (18) ◽  
pp. 315-320 ◽  
Author(s):  
N.-O. Negård ◽  
T Schauer ◽  
R. Kauert ◽  
J. Raisch
Keyword(s):  
Inertial Sensors ◽  
Gait Training ◽  
Training System ◽  
Stroke Patients

JOINT FUNCTION CONTROL METHOD FOR ROBOTIC GAIT TRAINING OF STROKE PATIENTS

2020 ◽  
Vol 35 (3) ◽  
Author(s):  
Abbas Ehsani-Seresht ◽  
Majid M. Moghaddam ◽  
Mohammad R. Hadian
Keyword(s):  
Control Method ◽  
Gait Training ◽  
Stroke Patients ◽  
Joint Function ◽  
Robotic Gait

What does best evidence tell us about robotic gait rehabilitation in stroke patients: A systematic review and meta-analysis

2018 ◽  
Vol 48 ◽  
pp. 11-17 ◽  
Author(s):  
Maria Federica Bruni ◽  
Corrado Melegari ◽  
Maria Cristina De Cola ◽  
Alessia Bramanti ◽  
Placido Bramanti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Gait Rehabilitation ◽  
Stroke Patients ◽  
Robotic Gait

scholarly journals Adjustment of instantaneous reference walking speed during synchronized robot-based gait rehabilitation

2017 ◽  
Vol 3 (1) ◽  
pp. 49-52
Author(s):  
Santiago Focke Martinez ◽  
Olena Kuzmicheva ◽  
Axel Graeser
Keyword(s):  
Healthy Subject ◽  
Gait Cycle ◽  
Walking Speed ◽  
Mobile Platform ◽  
Gait Rehabilitation ◽  
Practical Test ◽  
Synchronization Algorithm ◽  
Rehabilitation System ◽  
Robotic Gait

Abstract:This paper presents a method to adjust the instantaneous reference speed of the mobile platform or treadmill of robotic gait rehabilitation systems during compliant, synchronized therapy. This method is particularly useful when the robot-patient synchronization algorithms generate compensations that fluctuate significantly throughout the gait cycle, making it unsuitable to apply these compensations directly to the reference speed values. The method was tested with a synchronization algorithm that generates continues temporal-compensations based on a phase controller. The tests comprised simulation of different scenarios and a practical test with a healthy subject using an over-ground gait rehabilitation system.

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