Effects of Robotic Gait Training with Lower Extremity Restraint on Static Balance, Lower Extremity Function, Gait Ability in Subacute Stroke Patients

2021 ◽  
Vol 10 (3) ◽  
pp. 270-277
Author(s):  
Yun-Su Kang ◽  
Won-Seob Shin
Keyword(s):  
Lower Extremity ◽  
Gait Training ◽  
Static Balance ◽  
Lower Extremity Function ◽  
Stroke Patients ◽  
Extremity Function ◽  
Subacute Stroke ◽  
Robotic Gait

scholarly journals Effectiveness of a Novel Contralaterally Controlled Neuromuscular Electrical Stimulation for Restoring Lower Limb Motor Performance and Activities of Daily Living in Stroke Survivors: A Randomized Controlled Trial

2022 ◽  
Vol 2022 ◽  
pp. 1-9
Author(s):  
Ying Shen ◽  
Lan Chen ◽  
Li Zhang ◽  
Shugang Hu ◽  
Bin Su ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Lower Extremity ◽  
Activities Of Daily Living ◽  
Motor Function ◽  
Daily Living ◽  
Neuromuscular Electrical Stimulation ◽  
Lower Extremity Function ◽  
Stroke Patients ◽  
Extremity Function ◽  
Subacute Stroke

Background. Contralaterally controlled neuromuscular electrical stimulation (CCNMES) is a novel electrical stimulation treatment for stroke; however, reports on the efficacy of CCNMES on lower extremity function after stroke are scarce. Objective. To compare the effects of CCNMES versus NMES on lower extremity function and activities of daily living (ADL) in subacute stroke patients. Methods. Forty-four patients with a history of subacute stroke were randomly assigned to a CCNMES group and a NMES group ( n = 22 per group). Twenty-one patients in each group completed the study per protocol, with one subject lost in follow-up in each group. The CCNMES group received CCNMES to the tibialis anterior (TA) and the peroneus longus and brevis muscles to induce ankle dorsiflexion motion, whereas the NMES group received NMES. The stimulus current was a biphasic waveform with a pulse duration of 200 μs and a frequency of 60 Hz. Patients in both groups underwent five 15 min sessions of electrical stimulation per week for three weeks. Indicators of motor function and ADL were measured pre- and posttreatment, including the Fugl–Meyer assessment of the lower extremity (FMA-LE) and modified Barthel index (MBI). Surface electromyography (sEMG) assessments included average electromyography (aEMG), integrated electromyography (iEMG), and root mean square (RMS) of the paretic TA muscle. Results. Values for the FMA-LE, MBI, aEMG, iEMG, and RMS of the affected TA muscle were significantly increased in both groups after treatment ( p < 0.01 ). Patients in the CCNMES group showed significant improvements in all the measurements compared with the NMES group after treatment. Within-group differences in all post- and pretreatment indicators were significantly greater in the CCNMES group than in the NMES group ( p < 0.05 ). Conclusion. CCNMES improved motor function and ADL ability to a greater extent than the conventional NMES in subacute stroke patients.

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.

Abstract WP161: Early Short Physical Performance Battery (SPPB) Score Can Predict Functional Independence and Death for Acute Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Ken-ichi Kumagae ◽  
Kohta Yamauchi ◽  
Risa Hagiwara ◽  
Yasuhiro Koyanagi ◽  
Shuji Arakawa ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Acute Stroke ◽  
Roc Curve ◽  
Assessment Tool ◽  
Functional Independence ◽  
Curve Analysis ◽  
Lower Extremity Function ◽  
Stroke Patients ◽  
Roc Curve Analysis ◽  
Extremity Function

Background and Purpose: Lower extremity function is a strong predictor for functional outcome and death in a variety of pathological status. National Institute of Health Stroke Scale (NIHSS) is a world-wide standard scoring system for stroke patients; however, it is not sufficient to evaluate lower extremity function. Short Physical Performance Battery (SPPB) is a simple assessment tool for lower extremity function, consists of standing balance, walking speed, and repetitive standing (range: 0-12, 12: high function). SPPB can predict adverse events, such as disability and mortality in elderly population, but its disease specific utility for stroke patients is still unknown. The purpose of this study was to determine whether SPPB score predicts functional independence and death for acute stroke. Methods: Between April 2013 and November 2014, 410 consecutive stroke patients admitted within 7 days after the onset. Patients with premorbid modified Rankin Scale (mRS) of 0-2, and evaluated SPPB at 7 th days after the admission were enrolled in this study. Clinical data were analyzed using univariate and multivariate model to assess functional independence (defined as mRS of 0-2) at 3 months and 1 year mortality adjusting covariates to investigate the association between SPPB and functional independence or death. Receiver operating characteristics (ROC) curve analysis was performed for detecting optimal cut-off value. Results: A total of 243 patients (mean age 73.8 years, male 58.4%) were included in this study. Of them, 132 (54.3%) patients were independent at 3 months follow up, and 14 (5.8%) patients have died. Median SPPB score at 7 th days after the admission was 6 (IQR: 1-11). After adjusting age, sex, BMI, NIHSS score on admission, SPPB score at 7 th days after the admission was significantly associated with 3-month functional independence (odds ratio, 1.48; 95%CI, 1.29-1.69; p<0.001) and 1-year death (hazard ratio, 0.36; 95% CI, 0.17-0.74; p=0.005). ROC curve analysis revealed the cut-off point of SPPB for functional independence was 6 (AUC:0.88, 95%CI, 0.83-0.93, p<0.001, sensitivity: 0.83, specificity:0.84). Conclusions: Early SPPB score is a useful assessment tool in predicting functional independence and death for acute stroke patients.

scholarly journals Effect of Action Observation Therapy on Lower-extremity Function of Chronic Stroke Patients

2015 ◽  
Vol 30 (2) ◽  
pp. 251-256
Author(s):  
Takeshi FUCHIGAMI ◽  
Atsushi MATSUO ◽  
Hiroaki KOSHIMOTO ◽  
Saori KAWAGUCHI ◽  
Masaki KITAURA ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Action Observation ◽  
Chronic Stroke ◽  
Lower Extremity Function ◽  
Stroke Patients ◽  
Extremity Function

scholarly journals A Novel Virtual Reality Training Strategy for Poststroke Patients: A Randomized Clinical Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Naveed Anwar ◽  
Hossein Karimi ◽  
Ashfaq Ahmad ◽  
Nazia Mumtaz ◽  
Ghulam Saqulain ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Virtual Reality ◽  
Physical Therapy ◽  
Lower Extremity ◽  
Randomized Clinical Trial ◽  
Virtual Reality Training ◽  
Lower Extremity Function ◽  
Stroke Patients ◽  
Extremity Function ◽  
Significant Difference

Stroke patients suffer impairments including sensory, motor, visual, and cognitive areas, as well as gait and balance manifestations making activities of daily living difficult. In such conditions, virtual reality training can be a potential rehabilitation tool in comparison to conventional physical therapy to cater to the burden of this disability; hence, this randomized clinical trial compared the effects of virtual reality training and conventional physical therapy on balance and lower extremity function in stroke patients. The sample of 68 poststroke participants from Kanaan Physical Therapy and Spine Clinic, Lahore, Pakistan, were divided into N = 34 cases each using the lottery method with one group given virtual reality training and the other received conventional physical therapy. Each group received 60 minutes intervention, 3 days per week for 6 weeks. The Berg balance scale and the Fugl-Meyer assessment-lower extremity scale were employed for data collection preintervention, immediate postintervention, and 6 weeks postintervention. The statistically significant differences between virtual reality and conventional physical therapy groups for the Berg Balance score ( p < 0.001 ), Fugl-Meyer assessment (FMA)-lower extremity domains of FMA-motor function ( p < 0.001 ), FMA-joint pain, and joint range ( p < 0.001 ); however, there is no significant difference p = 0.202 for time vs. group interaction and significant ( p < 0.001 ) for the time main effect for FMA sensation. Hence, virtual reality training is more effective to restore balance and lower extremity function compared to conventional physical therapy in stroke patients. The results of the study have significant implications for the clinicians with better case management enhancing quality of life of patients along with the dearth of local literature, thus providing base for future research from a developing country’s perspective.

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