Beneficial Effects of Robot-Assisted Gait Training on Functional Recovery in Women after Stroke: A Cohort Study

Background and Objectives: Robot-assisted gait training (RAGT) could be a rehabilitation option for patients after experiencing a stroke. This study aims to determine the sex-related response to robot-assisted gait training in a cohort of subacute stroke patients considering mixed results previously reported. Materials and Methods: In this study, 236 participants (145 males, 91 females) were admitted to a rehabilitation facility after experiencing a stroke and performed RAGT within a multidisciplinary rehabilitation program. Functional Independence Measure (FIM) and Functional Ambulatory Category (FAC) were assessed at admission and discharge to determine sex-related outcomes. Results: At the baseline, no significant difference among sexes was observed. At the end of rehabilitation, both males and females exhibited significant improvements in FIM (71% of males and 80% of females reaching the MCID cut-off value) and FAC (∆score: men 1.9 ± 1.0; women 2.1 ± 1.1). A more remarkable improvement was observed in women of the whole population during the study, but statistical significance was not reached. When analysing the FAC variations with respect to the total number of RAGT sessions, a more significant improvement was observed in women than men (p = 0.025). Conclusion: In conclusion, among subacute stroke patients, benefits were observed following RAGT during a multidisciplinary rehabilitation program in both sexes. A greater significant recovery for women with an ischemic stroke or concerning the number of sessions attended was also highlighted. The use of gait robotics for female patients may favour a selective functional recovery after stroke.

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Effectiveness of Robot-Assisted Gait Training on Functional Skills in Children with Cerebral Palsy

Journal of Pediatric Neurology ◽

10.1055/s-0041-1725128 ◽

2021 ◽

Author(s):

Burak Yaşar ◽

Emine Atıcı ◽

Derya Azim Razaei ◽

Tülay Çevik Saldıran

Keyword(s):

Cerebral Palsy ◽

Functional Independence Measure ◽

Gait Training ◽

Functional Independence ◽

Rehabilitation Program ◽

Robot Assisted ◽

Timed Up And Go ◽

Motor Functions ◽

Significant Difference ◽

Children With Cerebral Palsy

AbstractThis study was aimed to investigate the effects of robot-assisted gait training (RAGT) on motor functions, spasticity status, balance, and functionality in children with cerebral palsy (CP). A total of 26 patients who were diagnosed with CP (diplegic, with gross motor function classification system [GMFCS] levels of 2–5) and who regularly participated in a rehabilitation program were recruited in the study after obtaining approval from their parents. The patients were randomly assigned to two groups. Group 1 (n = 13) received conventional physical therapy (65 minutes, 2 days/week × 8) and group 2 (n = 13) received 25 minutes of RAGT (RoboGait) in addition to conventional therapy (CT; 40 minutes, 2 days/week × 8). GMFCS was used to evaluate motor functions and the Modified Ashworth Scale was used to evaluate spasticity. The pediatric Berg balance scale, pediatric functional independence measure, and timed up and go tests were employed to assess balance and functional status. The evaluations were performed at baseline and after 8 weeks of therapy. Both rehabilitation methods led to a statistically significant decrease in spasticity (p < 0.05); however, there was no difference in this improvement of spasticity between the groups (p > 0.05). Both groups exhibited significant improvements in functional independence, balance, and performance at the end of therapy (p < 0.05), and there was no significant difference between the groups (p > 0.05). The results of this study show that addition of RAGT to CT for 8 weeks is not superior to CT alone in children with CP.

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Efficacy of End-Effector Robot-Assisted Gait Training Combined With Robotic Balance Training in Subacute Stroke Patients

Case Medical Research ◽

10.31525/ct1-nct04162197 ◽

2019 ◽

Author(s):

Keyword(s):

Balance Training ◽

Gait Training ◽

Stroke Patients ◽

Robot Assisted ◽

End Effector ◽

Subacute Stroke

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

Journal of Medical and Biological Engineering ◽

10.1007/s40846-020-00590-z ◽

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.

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

Journal of Mechanics in Medicine and Biology ◽

10.1142/s0219519419400189 ◽

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.

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Barriers to sEMG Assessment During Overground Robot-Assisted Gait Training in Subacute Stroke Patients

Frontiers in Neurology ◽

10.3389/fneur.2020.564067 ◽

2020 ◽

Vol 11 ◽

Author(s):

Michela Goffredo ◽

Francesco Infarinato ◽

Sanaz Pournajaf ◽

Paola Romano ◽

Marco Ottaviani ◽

...

Keyword(s):

Gait Training ◽

Stroke Patients ◽

Robot Assisted ◽

Subacute Stroke

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Effects of Robot-Assisted Gait Training on Cardiopulmonary Fitness in Subacute Stroke Patients

Neurorehabilitation and Neural Repair ◽

10.1177/1545968311408916 ◽

2011 ◽

Vol 26 (4) ◽

pp. 318-324 ◽

Cited By ~ 72

Author(s):

Won Hyuk Chang ◽

Min Su Kim ◽

Jung Phil Huh ◽

Peter K. W. Lee ◽

Yun-Hee Kim

Keyword(s):

Gait Training ◽

Stroke Patients ◽

Robot Assisted ◽

Cardiopulmonary Fitness ◽

Subacute Stroke

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Abstract WP200: Robot-assisted Arm Training in Subacute Hemiplegic Stroke Patients

Stroke ◽

10.1161/str.51.suppl_1.wp200 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Hyun Jung Kim ◽

Ye Jin Jo ◽

Jun Yup Kim ◽

Jun-taek Hong ◽

Deog Young Kim

Keyword(s):

Occupational Therapy ◽

Motor Function ◽

Repeated Measures ◽

Functional Independence Measure ◽

Functional Independence ◽

Longitudinal Analyses ◽

Stroke Patients ◽

Robot Assisted ◽

Significant Difference ◽

Function Test

Background and Aims: Robotic rehabilitation therapy has been tried as a novel technology in field of upper extremity rehabilitation of stroke patients. However, the previous trial revealed the additional effect of robotic therapy compared to conservative therapy. We aimed to investigate whether the same intensity robot-assisted arm training(RAT) was more effective on the recovery of motor and improvement of upper limb function than conventional occupational therapy(COT) in subacute first-ever hemiplegic stroke patients (Fig.1). Methods: The clinical assessment included Fugl-Meyer Assessment(FMA), Motricity Index(MI), Functional Independence Measure(FIM), Motor Function Test(MFT), Wolf Motor Function Test(WMFT), Trunk Control Test(TCT), Maximal Voluntary Torques(MVT), Visual Analogue Scale(VAS) for pain, and Active Range of Motion(AROM). The repeated measures ANOVA was used to compare the results of longitudinal analyses between two groups (SPSS Inc., Chicago, IL, USA). Results: The all parameters measured at baseline did not differ between two groups. Both groups showed significant improvements in FMA, MI, FIM, MFT, WMFT, TCT, MVT, and AROM after treatment (P<0.05). However, the results of longitudinal analyses during the 8-week study period did not show significant difference between two groups except VAS in AROM (p=0.011) and AROM of shoulder adduction (p=0.032) (Table 1). Conclusions: This study did not agree that robot-assisted arm training combined with conventional occupational therapy in subacute post-stroke hemiplegic patients may be superior to the same intensity conventional occupational therapy.

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