Objective: Robot assisted gait training is implemented as part of therapy for the recovery of gait patterns in recent clinical fields, and the scope of implications are continuously increasing. However clear therapy protocols of robot assisted gait training are insufficent. The purpose of this study was to investigate the effects of robot-assisted gait training applied with guidance force on balance and gait performance in persons with hemiparetic stroke. Design: Two group pre-test post-test design. Methods: Nineteen persons were diagnosed with hemiparesis following stroke participated in this study. The participants were randomly assigned to the unilateral guidance group or bilateral guidance group to conduct robot-assisted gait training. All participants underwent robot-assisted gait training for twelve sessions (30 min/d, 3 d/wk for 4 weeks). They were assessed with gait parameters (gait velocity, cadence, step length, stance phase, and swing phase) using Optogait. This study also measured the dynamic gait index (DGI), the Berg balance scale (BBS) score, and timed up and go (TUG). Results: After training, BBS scores were was significantly increased in the bilateral training group than in the unilateral guidance group (p<0.05). Spatiotemporal parameters were significantly changed in the bilateral training group (gait speed, swing phase ratio, and stance phase ratio) compared to the unilateral training group (p<0.05). Conclusions:The results of this study suggest that robot-assisted gait training show feasibility in facilitating improvements in balance and gait performance for subacute hemiparetic stroke patients.
The purpose of this study was to investigate the effects of fall experience and task complexity on gait performance in community-dwelling persons with chronic hemiparetic stroke. Design: Cross-sectional study. Methods: Thirty-three persons who had a history of stroke participated in this study. The participants included 18 persons (aged mean 54.0, mean score of 24.6 points on the Montreal Cognitive Assessment, MoCA) with fall experience (faller group) and 15 persons (aged mean 53.7, mean score of 24.7 points on the MoCA) without fall experience (non-faller group) in the previous six months. This study measured balance and gait performance at two different conditions (with/without 70% of water filled in a 200 cc cup). The participants were clinically assessed using the 10-meter walk test (10MWT), 6-minute walk test (6MWT), Berg Balance scale (BBS), Dynamic Gait Index (DGI), and Timed Up-and-Go (TUG) test. Results: After analyzation, persons in the faller group performed significantly better on the 10MWT, 6MWT, BBS, DGI, and the TUG test in the no-cup-carrying condition than those in the cup-carrying condition (p<0.05). The persons in the non-faller group also performed significantly better in all outcome measures with the no-cup-carrying condition than those in the cup-carrying condition (p<0.05). However, there was no interaction between fall experience and task complexity in the two groups. Conclusions: Our results showed that balance and gait performance depended on fall experience and task complexity but fall experience did not interact with task complexity. Clinicians should consider fall prevention and task complexity during therapeutic approaches in persons with hemiparetic stroke.
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