scholarly journals Stage 2: Who Are the Best Candidates for Robotic Gait Training Rehabilitation in Hemiparetic Stroke?

2021 ◽  
Vol 10 (23) ◽  
pp. 5715
Author(s):  
Wonjun Oh ◽  
Chanhee Park ◽  
Seungjun Oh ◽  
Sung (Joshua) H. You
Keyword(s):  
Training Session ◽  
Gait Training ◽  
Berg Balance Scale ◽  
Analysis Of Covariance ◽  
Walking Distance ◽  
Functional Score ◽  
Distance Analysis ◽  
Subacute Stroke ◽  
Hemiparetic Stroke ◽  
Main Effects

We aimed to compare the effects of robotic-assisted gait training (RAGT) in patients with FAC < 2 (low initial functional ambulation category [LFAC]) and FAC ≥ 2 (high initial functional ambulation category [HFAC]) on sensorimotor and spasticity, balance and trunk stability, the number of steps and walking distance in subacute hemiparetic stroke. Fifty-seven patients with subacute hemiparetic stroke (mean age, 63.86 ± 12.72 years; 23 women) were assigned to two groups. All patients received a 30-min Walkbot-assisted gait training session, 3 times/week, for 6 weeks. Clinical outcomes included scores obtained on the Fugl–Meyer Assessment (FMA) scale, Modified Ashworth Scale (MAS), Berg Balance Scale (BBS), trunk impairment scale (TIS), and the number of walking steps and walking distance. Analysis of covariance and analysis of variance were conducted at p < 0.05. Significant main effects of time in both groups on number of walking steps and distance (p < 0.05) were observed, but not in MAS (p> 0.05). Significant changes in FMA, BBS, and TIS scores between groups (p < 0.05) were observed. Significant main effects of time on BBS and TIS were demonstrated (p < 0.05). Our study shows that RAGT can maximize improvement in the functional score of FMA, BBS, TIS, steps, and distance during neurorehabilitation of subacute stroke patients regardless of their FAC level.

Comparing Neuroplasticity Changes between High and Low Frequency of Gait Training based on Electroencephalogram Signal Analysis among Subacute Stroke Individuals (Preprint)

2021 ◽  
Author(s):  
Fatimah Ahmedy ◽  
Natiara Mohamad Hashim ◽  
Herwansyah Lago ◽  
Leonard Protasius Plijoly ◽  
Ismail Ahmedy ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Low Frequency ◽  
Gait Training ◽  
Berg Balance Scale ◽  
Controlled Study ◽  
Control Group ◽  
Eeg Signals ◽  
Post Intervention ◽  
National Medical ◽  
Subacute Stroke

BACKGROUND Walking recovery post-stroke can be slow and incomplete. Determining effective stroke rehabilitation frequency requires assessment of neuroplasticity changes. Neurobiological signals from electroencephalogram (EEG) can measure neuroplasticity through incremental changes of these signals after rehabilitation. However, changes seen with different frequency of rehabilitation require further investigation. It is hypothesised that the association between the incremental changes from EEG signals and the improved functional outcome measure scores are greater in higher rehabilitation frequency, implying enhanced neuroplasticity changes. OBJECTIVE The purpose of this study is to identify the changes in the neurobiological signals from EEG, to associate these with functional outcome measures scores, and to compare their associations in different therapy frequency for gait rehabilitation among subacute stroke individuals. METHODS A randomised, single-blinded controlled study among subacute stroke patients with two groups: interventional group (IG) and control group (CG). Each participant in IG and CG will receive three times a week (high frequency) and once a week (low frequency) therapy sessions respectively, for a total of 12 consecutive weeks. Each session will last for an hour with strengthening, balance and gait training. Main variables to be assessed are the 6-Minute Walk Test (6MWT), Motor Assessment Scale (MAS), Berg Balance Scale (BBS), Modified Barthel Index (MBI), and brainwave pattern from EEG signals recordings in the form of delta to alpha ratio (DAR) and delta-plus-theta to alpha-plus-beta ratio (DTABR). These will be measured at pre-intervention (R0) and post-intervention (R1). RESULTS Key analyses are to determine the changes in 6MWT, MAS, BBS, MBI, DAR, and DTABR at R0 and R1 for CG and IG. The changes in the DAR and DTABR will be analysed for association with the changes in the 6MWT, MAS, BBS and MBI to measure neuroplasticity changes for both CG and IG. CONCLUSIONS These associations are expected to be positive in both groups, but the IG group would demonstrate higher correlation compared to the CG group, reflecting enhanced neuroplasticity changes and objective evalution on dose-response relationship. CLINICALTRIAL This study has received the ethics approval from National Medical Research Register of Malaysia, which is the formal and statutory body that governed all medical-related studies in Malaysia, with ID no. NMRR-19-3840-51591 (IIR).

A wearable robotic knee orthosis for gait training: a case-series of hemiparetic stroke survivors

2011 ◽  
Vol 36 (1) ◽  
pp. 113-120 ◽  
Author(s):  
Christopher Kevin Wong ◽  
Lauri Bishop ◽  
Joel Stein
Keyword(s):  
Case Series ◽  
Gait Training ◽  
Training Programme ◽  
Berg Balance Scale ◽  
Post Treatment ◽  
Functional Mobility ◽  
Stroke Survivors ◽  
Functional Training ◽  
Hemiparetic Stroke ◽  
Knee Orthosis

Background and Aim: Until recently, robotic devices for stroke rehabilitation had multi-joint designs that were often tethered to a treadmill for gait training. A new single-joint wearable robotic knee orthosis (RKO) has been designed that provides patient-initiated powered-assistance in untethered functional mobility. This case-series documents application of the wearable RKO in untethered functional training with stroke survivors.Technique: Three ambulatory adult stroke survivors used a wearable RKO during 18 one-hour sessions within a six-week physical therapy programme. Subjects were assessed with a variety of balance, gait and functional tests including the Berg Balance Scale (BBS); six-minute walk test (6MWT); and Emory Functional Ambulation Profile (EFAP) at pre-treatment, post-treatment, one-month and three-month follow-up.Discussion: All subjects improved balance, gait and functional performances with mean individual improvements of 12.6% for BBS, 12.0% for 6MWT and 16.7% for EFAP post-treatment. No adverse events occurred. These three stroke survivors may have benefited from the task-specific functional training programme augmented by RKO use.Clinical relevancePhysical therapists may find a wearable robotic knee orthosis useful for providing patient-initiated assisted movement for ambulatory chronic stroke survivors during functional task-specific balance and mobility training.

The effects of dynamic core-postural chain stabilization on respiratory function, fatigue and activities of daily living in subacute stroke patients: A randomized control trial

2020 ◽  
Vol 47 (4) ◽  
pp. 471-477
Author(s):  
Hyun Sik. Yoon ◽  
Young Joo. Cha ◽  
Joshua (Sung) Hyun You
Keyword(s):  
Activities Of Daily Living ◽  
Respiratory Function ◽  
Daily Living ◽  
Forced Expiratory Volume ◽  
Core Stability ◽  
Analysis Of Covariance ◽  
Stroke Patients ◽  
Subacute Stroke ◽  
Fatigue Severity ◽  
Hemiparetic Stroke

BACKGROUND: Neurodevelopmental treatment (NDT) and dynamic core-postural chain stabilization (DCS)- based exercise is effective for improving core stability and postural control in stroke patients. However, no study has reported respiratory function, increased fatigue and ADL function in subacute stroke patients by training using NDT and DCS exercises. OBJECTIVE: To compare the effects of DCS and NDT exercises on respiratory function, fatigue and activities of daily living in individuals with hemiparetic stroke. METHODS: Thirty-one participants with hemiparetic stroke (17 male, 14 female; mean age 60.4±14.58 years; post-stroke duration, 7.2±2.2 weeks) participated in this study. The participants were randomly allocated into DCS (n = 16) and NDT (n = 15). Respiratory function was determined using forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP). The fatigue severity scale (FSS) and functional independent measure (FIM) were used to evaluate fatigue severity and activities of daily living (ADL). Analysis of covariance (ANCOVA) was used to evaluate post-test differences in the DCS and NDT exercise groups. RESULTS: ANCOVA revealed the superior effects of DCS in respiratory function, as well as clinical FSS and FIM tests, compared with those of NDT (p < 0.05). CONCLUSIONS: The results suggest that DCS training was more effective than NDT training at improving respiratory function, fatigue severity and ADL via balanced co-activation of the diaphragm and increased diaphragm movement in individuals with hemiparetic stroke.

scholarly journals Effects of Self RehAbilitation Video Exercises (SAVE) on Functional Restorations in Patients with Subacute Stroke

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 565
Author(s):  
Seung-Hwan Jung ◽  
Eunhee Park ◽  
Ju-Hyun Kim ◽  
Bi-Ang Park ◽  
Ja-Won Yu ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Short Form ◽  
Intervention Group ◽  
Exercise Program ◽  
Berg Balance Scale ◽  
Control Group ◽  
Early Recovery ◽  
Subacute Stroke ◽  
Sf 36 ◽  
State Examination

Background: Additional exercise therapy has been shown to positively affect acute stroke rehabilitation, which requires an effective method to deliver increased exercise. In this study, we designed a 4-week caregiver-supervised self-exercise program with videos, named “Self rehAbilitation Video Exercises (SAVE)”, to improve the functional outcomes and facilitate early recovery by increasing the continuity of rehabilitation therapy after acute stroke. Methods: This study is a non-randomized trial. Eighty-eight patients were included in an intervention group (SAVE group), who received conventional rehabilitation therapies and an additional self-rehabilitation session by watching bedside exercise videos and continued their own exercises in their rooms for 60 min every day for 4 weeks. Ninety-six patients were included in a control group, who received only conventional rehabilitation therapies. After 4 weeks of hospitalization, both groups assessed several outcome measurements, including the Berg Balance Scale (BBS), Modified Barthel Index (MBI), physical component summary (PCS) and the mental component summary of the Short-Form Survey 36 (SF-36), Mini-Mental State Examination, and Beck Depression Inventory. Results: Differences in BBS, MBI, and PCS components in SF-36 were more statistically significant in the SAVE group than that in the control group (p < 0.05). Patients in the SAVE group showed more significant improvement in BBS, MBI, and PCS components in SF-36 as compared to that in the control group. Conclusions: This evidence-based SAVE intervention can optimize patient recovery after a subacute stroke while keeping the available resources in mind.

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

PM&R ◽  
2009 ◽  
Vol 1 ◽  
pp. S99-S99 ◽  
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

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

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.

scholarly journals EFFICACY OF ROLLING BOARD PERTURBATION TRAINING ON BALANCE AMONG HEMIPARETIC STROKE PATIENTS - A COMPARATIVE STUDY

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Dr. Senthil kumar ◽  
Dr. Franklin Shaju M.K m k ◽  
Dr. Vijaya Senthil Kumar kumar ◽  
Dr. A. velmurugan
Keyword(s):  
Public Health Problem ◽  
Berg Balance Scale ◽  
Major Public Health Problem ◽  
Stroke Patients ◽  
Perturbation Training ◽  
Before And After ◽  
Group A ◽  
Hemiparetic Stroke ◽  
Conventional Physiotherapy ◽  
Group B

Background of the study: Stroke is a major public health problem that ranks in the top four causes of death in most of the countries and is responsible for a large proportion of the burden of neurologic disorders. Patients with stroke have poor balance because they cannot control dynamically the size of the base of support or the location of the line of gravity. Perturbation training undergoes the maximal sway possible without losing his balance. Objective of the study: The objective of the study is to find the effects of rolling board perturbation training on balance among hemiparetic stroke patients. Methodology: Thirty clinically diagnosed hemiparetic stroke patients were selected based on the inclusion and exclusion criteria. They were randomly allocated into two groups (Group A and Group B) consists of 15 subjects each. Group A received conventional physiotherapy alone and group B received rolling board perturbation training along with conventional physiotherapy. Intervention lasted for 4 weeks, three days in a week and one hour per day. Balance was measured before and after 4 weeks of intervention by berg balance scale. Conclusion: Both conventional physiotherapy alone and rolling board perturbation training along with conventional physiotherapy significantly improved balance among hemiparetic stroke patients. When comparing both rolling board perturbation training along with conventional physiotherapy is more effective than conventional physiotherapy alone in improving balance among hemiparetic stroke patients.

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