Gait training using a stationary, one-leg gait exercise assist robot for chronic stroke hemiplegia: a case report

Effect of Robot Assisted Gait Training on Motor and Walking Function in Patients with Subacute Stroke: A Random Controlled Study

BACKGROUND

Robot-assisted gait training has been confirmed to have beneficial effect on the rehabilitation of stroke patients. An exoskeleton robot, named BEAR-H1, is designed to help stroke patients with walking disabilities.

METHODS

17 subjects in experimental group and 15 subjects in control group completed the study. The experimental group received 30 minutes of BEAR-H1 assisted gait training(BAGT), and the control group received 30 minutes of conventional training, 5 times/week for 4weeks. All subjects were evaluated with 6-minute walk test (6MWT), Fugl-Meyer Assessment for lower extremity (FMA-LE), Functional Ambulatory Classification (FAC), Modified Ashworth Scale (MAS), and gait analysis at baseline and after 4 weeks intervention.

RESULTS

The improvements of 6MWT, FMA-LE, gait speed, cadence, step length and cycle duration in BAGT group were more noticeable than in the control group. However, there was no difference in the assessment of MAS between two groups.

CONCLUSIONS

Our results showed that BAGT is an effective intervention to improve the motor and walking ability during 4 weeks training for subacute stroke patients.

Improving abnormal gait patterns by using a gait exercise assist robot (GEAR) in chronic stroke subjects: A randomized, controlled, pilot trial

BACKGROUND

Although the Gait Exercise Assist Robot (GEAR) has been reported to effectively improve gait of hemiplegic patients, no study has investigated its use in chronic stroke patients. It is possible to facilitate gait reorganization by gait training with less compensation using the GEAR even in chronic stroke patients.

RESEARCH QUESTION

What are the effects of GEAR training on the abnormal gait patterns of chronic stroke subjects?

METHODS

Subjects were randomly assigned to either the GEAR group (n = 8) or the treadmill group (n = 11). Each group underwent 20 sessions (40 min/day, 5 days/week). The changes in the 10 types of abnormal gait patterns were evaluated using a three-dimensional motion analysis system and the Global Rating of Change (GRC) scale before and after the intervention, and at 1-month and 3-month follow-up assessment.

RESULTS

In the GEAR group, hip hiking at a 1-month follow-up assessment was markedly lesser than that before the intervention, and the excessive hip external rotation at 3-month follow-up assessment was notably lesser than that after the intervention, but the change in excessive hip external rotation was in the normal range. In the treadmill group, knee extensor thrust at a 1-month follow-up assessment was strikingly lesser than that before the intervention, but the difference was in the normal range. In the GEAR group, the GRC scale scores were considerably higher after the intervention, at a 1-month, and 3-month follow-up assessment than those before the intervention. But, in the treadmill group, only the GRC scale score at a 1-month follow-up assessment was visibly higher than that before the intervention.

SIGNIFICANCE

Gait training using the GEAR may be more effective than treadmill-training in improving the swing phase in chronic stroke subjects.

Effects of gait exercise assist robot (GEAR) on subjects with chronic stroke: A randomized controlled pilot trial

OBJECTIVE

The aim of this study was to investigate whether gait training using the Gait Exercise Assist Robot (GEAR) is more effective for improving gait ability than treadmill gait training in chronic stroke subjects.

DESIGN

Subjects were randomly assigned to either the GEAR group (n = 8) or treadmill group (n = 11). Both groups received a training program of 20 sessions (5 days/week). The 10-m walk test, Timed Up and Go (TUG) test, 6-min walk test, the Medical Outcome Study 8-item Short Form Health Survey (SF-8), and Global Rating of Change (GRC) scales were administered at baseline (week 0), completion of training (week 4), 1-mo follow-up (week 8), and 3-mo follow-up (week 16).

RESULTS

Gait speed was significantly increased at completion of training and 1-mo follow-up compared with baseline in the GEAR group. Mean changes in TUG and 6-min walk were significantly greater in the GEAR group than in the treadmill group at completion of training compared to baseline. Furthermore, GRC scales were significantly increased at completion of training, 1-mo follow-up, and 3-mo follow-up compared with baseline in the GEAR group.

CONCLUSION

This study suggests that gait training using GEAR was more effective for improving gait ability than treadmill among subjects with chronic stroke.

REGISTRATION OF CLINICAL TRIALS

This study was registered with the University Hospital Medical Information Network (No. UMIN000028042).