Comparison of Aquatic Treadmill and Anti-Gravity Treadmill Gait Training to Improve Balance and Gait Abilities in Stroke Patients

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.

Download Full-text

Robotic Technologies and Rehabilitation: New Tools for Stroke Patients’ Therapy

BioMed Research International ◽

10.1155/2013/153872 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 69

Author(s):

Patrizia Poli ◽

Giovanni Morone ◽

Giulio Rosati ◽

Stefano Masiero

Keyword(s):

Gait Training ◽

Lower Limbs ◽

Robotic Rehabilitation ◽

Stroke Patients ◽

Home Based ◽

Comprehensive Search ◽

Improve Muscle Strength ◽

Training Protocol ◽

Robotic Technologies

Introduction. The role of robotics in poststroke patients’ rehabilitation has been investigated intensively. This paper presents the state-of-the-art and the possible future role of robotics in poststroke rehabilitation, for both upper and lower limbs.Materials and Methods. We performed a comprehensive search of PubMed, Cochrane, and PeDRO databases using as keywords “robot AND stroke AND rehabilitation.”Results and Discussion. In upper limb robotic rehabilitation, training seems to improve arm function in activities of daily living. In addition, electromechanical gait training after stroke seems to be effective. It is still unclear whether robot-assisted arm training may improve muscle strength, and which electromechanical gait-training device may be the most effective for walking training implementation.Conclusions. In the field of robotic technologies for stroke patients’ rehabilitation we identified currently relevant growing points and areas timely for developing research. Among the growing points there is the development of new easily transportable, wearable devices that could improve rehabilitation also after discharge, in an outpatient or home-based setting. For developing research, efforts are being made to establish the ideal type of treatment, the length and amount of training protocol, and the patient’s characteristics to be successfully enrolled to this treatment.

Download Full-text

The Effectiveness of Locomotor Therapy Using Robotic-assisted Gait Training in Subacute Stroke Patients: A Randomized Controlled Trial

PM&R ◽

10.1016/j.pmrj.2009.08.004 ◽

2009 ◽

Vol 1 ◽

pp. S99-S99 ◽

Cited By ~ 2

Author(s):

Zeev Meiner ◽

Iris Fisher ◽

Michal Katz-Leurer ◽

Martin Neeb ◽

Anna Sajin ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Gait Training ◽

Stroke Patients ◽

Robotic Assisted ◽

Randomized Controlled ◽

Subacute Stroke

Download Full-text

The effect of robot-assisted gait training on cortical activation in stroke patients: A functional near-infrared spectroscopy study

Neurorehabilitation ◽

10.3233/nre-210034 ◽

2021 ◽

pp. 1-9

Author(s):

Kyeong Joo Song ◽

Min Ho Chun ◽

Junekyung Lee ◽

Changmin Lee

Keyword(s):

Gait Speed ◽

Functional Outcomes ◽

Near Infrared ◽

Gait Training ◽

Berg Balance Scale ◽

Cortical Activation ◽

Control Group ◽

Stroke Patients ◽

Robot Assisted ◽

Functional Near Infrared Spectroscopy

OBJECTIVE: To investigate the effects of the robot–assisted gait training on cortical activation and functional outcomes in stroke patients. METHODS: The patients were randomly assigned: training with Morning Walk® (Morning Walk group; n = 30); conventional physiotherapy (control group; n = 30). Rehabilitation was performed five times a week for 3 weeks. The primary outcome was the cortical activation in the Morning Walk group. The secondary outcomes included gait speed, 10-Meter Walk Test (10MWT), FAC, Motricity Index–Lower (MI–Lower), Modified Barthel Index (MBI), Rivermead Mobility Index (RMI), and Berg Balance Scale (BBS). RESULTS: Thirty-six subjects were analyzed, 18 in the Morning Walk group and 18 in the control group. The cortical activation was lower in affected hemisphere than unaffected hemisphere at the beginning of robot rehabilitation. After training, the affected hemisphere achieved a higher increase in cortical activation than the unaffected hemisphere. Consequently, the cortical activation in affected hemisphere was significantly higher than that in unaffected hemisphere (P = 0.036). FAC, MBI, BBS, and RMI scores significantly improved in both groups. The Morning Walk group had significantly greater improvements than the control group in 10MWT (P = 0.017), gait speed (P = 0.043), BBS (P = 0.010), and MI–Lower (P = 0.047) scores. CONCLUSION: Robot-assisted gait training not only improved functional outcomes but also increased cortical activation in stroke patients.

Download Full-text

The Effect of Assist-as-Needed Support on Metabolic Cost During Gait Training of Chronic Stroke Patients in LOPESII

Converging Clinical and Engineering Research on Neurorehabilitation III - Biosystems & Biorobotics ◽

10.1007/978-3-030-01845-0_83 ◽

2018 ◽

pp. 415-419

Author(s):

Bertine M. Fleerkotte ◽

Jaap H. Buurke ◽

Edwin H. F. van Asseldonk ◽

Johan S. Rietman

Keyword(s):

Metabolic Cost ◽

Gait Training ◽

Chronic Stroke ◽

Stroke Patients

Download Full-text

LOWER LIMB REHABILITATION ROBOT FOR GAIT TRAINING

Journal of Mechanics in Medicine and Biology ◽

10.1142/s0219519414400041 ◽

2014 ◽

Vol 14 (06) ◽

pp. 1440004 ◽

Cited By ~ 4

Author(s):

SHUAI GUO ◽

JIANCHENG JI ◽

GUANGWEI MA ◽

TAO SONG ◽

JING WANG

Keyword(s):

Lower Limb ◽

Degrees Of Freedom ◽

Balance Training ◽

Gait Training ◽

Rehabilitation Robot ◽

Stroke Patients ◽

Motion Characteristics ◽

Set Up ◽

Limb Rehabilitation ◽

Lower Limb Rehabilitation

After analyzing the rehabilitation needs of stroke patients and the previous studies on lower limb rehabilitation robot, our lower limb rehabilitation robot is designed for stroke patients' gait and balance training. The robot consists of the mobile chassis, the support column and the pelvis mechanism and it is described in detail. As the pelvis mechanism allows most of the patient's motion degrees of freedom (DOFs), the kinematics model of the mechanism is set up, and kinematics simulation is carried out to study the motion characteristics of the mechanism. After analyzing the calculation and simulation results, the pelvis mechanism is proven to measure up to the movement needs of the paralytic's waist and pelvis in walking rehabilitation process.

Download Full-text