Over-ground and robotic-assisted locomotor training in adults with chronic stroke: a blinded randomized clinical trial

2012 ◽  
Vol 8 (2) ◽  
pp. 161-168 ◽  
Author(s):  
Carolyn P. Kelley ◽  
Jason Childress ◽  
Corwin Boake ◽  
Elizabeth A. Noser
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Chronic Stroke ◽  
Locomotor Training ◽  
Robotic Assisted

scholarly journals Allowing Intralimb Kinematic Variability During Locomotor Training Poststroke Improves Kinematic Consistency: A Subgroup Analysis From a Randomized Clinical Trial

2009 ◽  
Vol 89 (8) ◽  
pp. 829-839 ◽  
Author(s):  
Michael D. Lewek ◽  
Theresa H. Cruz ◽  
Jennifer L. Moore ◽  
Heidi R. Roth ◽  
Yasin Y. Dhaher ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Small Sample Size ◽  
Gait Pattern ◽  
Small Sample ◽  
Lower Limbs ◽  
Walking Ability ◽  
Locomotor Training ◽  
Robotic Assisted ◽  
Robotic Devices

BackgroundLocomotor training (LT) to improve walking ability in people poststroke can be accomplished with therapist assistance as needed to promote continuous stepping. Various robotic devices also have been developed that can guide the lower limbs through a kinematically consistent gait pattern. It is unclear whether LT with either therapist or robotic assistance could improve kinematic coordination patterns during walking.ObjectiveThe purpose of this study was to determine whether LT with physical assistance as needed was superior to guided, symmetrical, robotic-assisted LT for improving kinematic coordination during walking poststroke.DesignThis study was a randomized clinical trial.MethodsNineteen people with chronic stroke (>6 months’ duration) participating in a larger randomized control trial comparing therapist- versus robotic-assisted LT were recruited. Prior to and following 4 weeks of LT, gait analysis was performed at each participant's self-selected speed during overground walking. Kinematic coordination was defined as the consistency of intralimb hip and knee angular trajectories over repeated gait cycles and was compared before and after treatment for each group.ResultsLocomotor training with therapist assistance resulted in significant improvements in the consistency of intralimb movements of the impaired limb. Providing consistent kinematic assistance during robotic-assisted LT did not result in improvements in intralimb consistency. Only minimal changes in discrete kinematics were observed in either group.LimitationsThe limitations included a relatively small sample size and a lack of quantification regarding the extent of movement consistency during training sessions for both groups.ConclusionsCoordination of intralimb kinematics appears to improve in response to LT with therapist assistance as needed. Fixed assistance, as provided by this form of robotic guidance during LT, however, did not alter intralimb coordination.

Multicenter Randomized Clinical Trial Evaluating the Effectiveness of the Lokomat in Subacute Stroke

2008 ◽  
Vol 23 (1) ◽  
pp. 5-13 ◽  
Author(s):  
Joseph Hidler ◽  
Diane Nichols ◽  
Marlena Pelliccio ◽  
Kathy Brady ◽  
Donielle D. Campbell ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Outcome Measures ◽  
Walking Speed ◽  
Gait Training ◽  
Secondary Outcome ◽  
Walking Ability ◽  
Robotic Assisted ◽  
Subacute Stroke

Objective. To compare the efficacy of robotic-assisted gait training with the Lokomat to conventional gait training in individuals with subacute stroke. Methods. A total of 63 participants <6 months poststroke with an initial walking speed between 0.1 to 0.6 m/s completed the multicenter, randomized clinical trial. All participants received twenty-four 1-hour sessions of either Lokomat or conventional gait training. Outcome measures were evaluated prior to training, after 12 and 24 sessions, and at a 3-month follow-up exam. Self-selected overground walking speed and distance walked in 6 minutes were the primary outcome measures, whereas secondary outcome measures included balance, mobility and function, cadence and symmetry, level of disability, and quality of life measures. Results. Participants who received conventional gait training experienced significantly greater gains in walking speed ( P = .002) and distance ( P = .03) than those trained on the Lokomat. These differences were maintained at the 3-month follow-up evaluation. Secondary measures were not different between the 2 groups, although a 2-fold greater improvement in cadence was observed in the conventional versus Lokomat group. Conclusions. For subacute stroke participants with moderate to severe gait impairments, the diversity of conventional gait training interventions appears to be more effective than robotic-assisted gait training for facilitating returns in walking ability.

scholarly journals Effects of Neuromuscular Electrical Stimulation on Plantarflexors Spasticity, Gait Performance, and Self-Reported Health Outcomes in People With Chronic Stroke: A Study Protocol for a Double-Blinded Randomized Clinical Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Sattam M. Almutairi ◽  
Mohamed E. Khalil ◽  
Nadiah Almutairi ◽  
Aqeel M. Alenazi
Keyword(s):  
Physical Activity ◽  
Clinical Trial ◽  
Electrical Stimulation ◽  
Health Outcomes ◽  
Randomized Clinical Trial ◽  
Neuromuscular Electrical Stimulation ◽  
Chronic Stroke ◽  
Walk Test ◽  
Reported Health ◽  
Double Blinded

Introduction: Rehabilitation approaches have been used for people with stroke to decrease spasticity and improve functions, but little is known about the effect of neuromuscular electrical stimulation (NMES) in this population. Therefore, the primary purpose of this study was to establish a protocol for a double-blinded randomized clinical trial to examine using NMES on plantarflexors spasticity, dorsiflexor muscle strength, physical functions, and self-reported health outcomes in people with chronic stroke in Saudi Arabia.Material and Methods: This randomized clinical trial with two arms and double-blinded registered in ClinicalTrials (NCT04673045) will enroll 44 participants with chronic stroke and randomized them into either the experimental group (EG), including electrical stimulation (ES) with conventional therapy or the control sham group (NMESsham) including placebo electrical stimulation with conventional therapy. The frequency will be set at 80 Hz for 30 min. The intervention will be three times a week for 4 weeks for both groups. Data collection for pre- and post-intervention outcomes will include measurements for the primary outcomes including paretic limb (plantarflexor spasticity, ankle range of motion, and dorsiflexor muscles strength), and gait speed using 10-m walk test (10-MWT). The secondary outcomes including mobility function using Timed Up and Go (TUG), walking endurance using 6 Minutes Walk Test (6-MWT), activity of daily living using the Arabic version of Barthel Index (BI), and self-reported health measures such as quality of life using the Medical Outcomes Survey (Short Form 36, SF-36), physical activity using Rapid Assessment of Physical Activity (RAPA), depression symptoms using Patient Health Questionnaire-9 (PHQ-9), fatigue level using Fatigue Severity Scale (FSS), and risk of fall using Fall Efficacy Scale International (FES-I). An independent t-test will be utilized to examine the effect of the intervention on the outcome measures.Results: The recruitment has started and is ongoing.Conclusions: Using 4 weeks of NMES will provide information about its effect in improving plantarflexor spasticity, dorsiflexor muscles strength, gait speed, mobility functions, and other self-reported health outcomes in people with chronic stroke when compared to NMESsham.

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