We have been developing the robotic wear curara as both a welfare device and rehabilitation robot that assists the elderly and disabled. curara is aimed at user friendliness. We have, thus, chosen a non-exoskeleton structure made of a plastic so that the robot is as light in weight as possible and to minimize the restraining stress against natural human movement. We verified the assistance effect of curara on 15 hemiplegic patients with stroke by comparing gait parameters (i.e., velocity, step length, cadence, and symmetry of joint angles) among three conditions. The conditions were "without assistance" (i.e., a control mode that cancels frictional resistances in actuators), Condition A (where joint angles are enlarged but there is no change in gait cycle), and Condition B (where there is no change in joint angles but the gait cycle is shortened). curara improved the walking velocity by 19% and 27% under Conditions A and B, respectively. Improvements in step length and cadence were, respectively, 11% and 7% under Condition A and 14% and 11% under Condition B. Moreover, the two assistance conditions reduced the difference in joint angles between unaffected and paralyzed legs. We consider that curara will facilitate the rehabilitation of stroke patients.

Background We have developed a wearable rehabilitation robot, “curara®,” and examined its immediate effect in patients with spinocerebellar degeneration and stroke, but its rehabilitative effect has not been clarified. The purpose of this study was to examine the effect of this device on gait training in stroke patients. Methods Forty stroke patients were enrolled in this study. The participants were divided randomly into two groups (groups A and B). The participants assigned to group A received RAGT with curara® type 4, whereas those in group B received conventional therapist-assisted gait training. The clinical trial period was 15 days. The participants performed 10 sessions of gait training (5 times per week) each lasting 30 ± 5 min per day. The 10-m walking time (10mWT), and 6-minute walking distance (6MWD) were evaluated as the main outcomes. Timed up and go and Berg Balance Scale (BBS) were also examined. Gait parameters (stride duration and length, standard deviation of stride duration and length, cadence, ratio of the stance/swing phases, minimum/maximum knee joint angle, and minimum/maximum hip joint angle) were measured using a RehaGait®. The items other than BBS were measured on days 0, 7, and 14, whereas BBS was measured on days 0 and 14. The improvement rate was calculated as the difference of values between days 14 and 0 divided by the value on day 0. The improvement rates of the 10mWT and 6MWD were set as the main outcomes. Results The data of 35 participants were analyzed. There was no significant difference in the main outcomes between both groups at the end of gait training. As for intragroup changes, gait speed, stride length, stride duration, and cadence were improved significantly between days 0 and 14 in each group. When examining the interaction effect between the day of measurement and group, stride duration (p = 0.006) and cadence (p = 0.012) were more significantly improved in group A than in group B. Conclusions This novel wearable powered robot may have the potential to improve gait speed of individuals in stroke rehabilitation. Trial registration Japan Registry of Clinical Trials (jRCTs032180163). Registered on February 22, 2019; https://jrct.niph.go.jp/en-latest-detail/jRCTs032180163. UMIN Clinical Trials Registry (UMIN000034237) Registered on September 22, 2018; https://center6.umin.ac.jp/cgi-open-bin/icdr/ctr_view.cgi?recptno=R000038939.

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Background Ataxic gait is one of the most common and disabling symptoms in people with degenerative cerebellar ataxia. Intensive and well-coordinated inpatient rehabilitation improves ataxic gait. In addition to therapist-assisted gait training, robot-assisted gait training has been used for several neurological disorders; however, only a small number of trials have been conducted for degenerative cerebellar ataxia. We aimed to validate the rehabilitative effects of a wearable “curara®” robot developed in a single-arm study of people with degenerative cerebellar ataxia. Methods Twenty participants with spinocerebellar ataxia or multiple system atrophy with predominant cerebellar ataxia were enrolled. The clinical trial duration was 15 days. We used a curara® type 4 wearable robot for gait training. We measured the following items at days 0, 7, and 14: Scale for the Assessment and Rating of Ataxia, 10-m walking time (10 mWT), 6-min walking distance (6 mWD), and timed up and go test. Gait parameters (i.e., stride duration and length, standard deviation of stride duration and length, cadence, ratio of the stance and swing phases, minimum and maximum knee joint angles, and minimum and maximum hip joint angles) were obtained using a RehaGait®. On days 1–6 and 8–13, the participants were instructed to conduct gait training for 30 ± 5 min with curara®. We calculated the improvement rate as the difference of values between days 14 and 0 divided by the value on day 0. Differences in the gait parameters were analyzed using a generalized linear mixed model with Bonferroni’s correction. Results Data from 18 participants were analyzed. The mean improvement rate of the 10 mWT and 6 mWD was 19.0% and 29.0%, respectively. All gait parameters, except the standard deviation of stride duration and length, improved on day 14. Conclusions Two-week RAGT with curara® has rehabilitative effects on gait function comparable to those of therapist-assisted training. Although the long-term effects after a month of RAGT with curara® are unclear, curara® is an effective tool for gait training of people with degenerative ataxia. Trial registration jRCT, jRCTs032180164. Registered: 27 February 2019; retrospectively registered. https://jrct.niph.go.jp/en-latest-detail/jRCTs032180164.

Background: Recently, robot-assisted gait training (RAGT) has been applied widely to individuals with stroke to regain and improve walking ability. We have developed a non-exoskeleton rehabilitation robot, “curara®,” and examined its immediate effect in patients with spinocerebellar degeneration and stroke, but its rehabilitative effect has not been clarified. The purpose of this study was to examine the effect of curara® on gait training in stroke patients.Methods: Forty stroke patients were enrolled in this study. The participants were divided randomly into two groups (groups A and B). The subjects in group A were assigned RAGT with curara® type 4, whereas those in group B received conventional therapist-assisted gait training. The clinical trial period was 15 days. The 10-m walking time (10mWT), 6-min walking distance (6mWD), timed up and go test, and gait parameters (stride duration and length, standard deviation of stride duration and length, cadence, ratio of the stance/swing phases, minimum/maximum knee joint angle, and minimum/maximum hip joint angle) were measured using a RehaGait® analyzer. The Berg Balance Scale was evaluated on days 0 and 14. Gait training was performed for 30 ± 5 min per day through days 2–6 and days 8–13 (total, 12 days) in both groups. The improvement rate was calculated as the difference of values between days 14 and 0 divided by the value on day 0. The improvement rates of the 10mWT and 6mWD were set as the main outcomes.Results: The data of 35 participants were analyzed. There was no significant difference in the main outcomes between both groups. As for intragroup changes, gait speed, stride length, stride duration, and cadence were improved significantly between days 0 and 14 in each group. There was no significant difference between the measured joint angle and the left-right angle ratio of symmetry within or between the groups. When assessing the interaction effect between the day of measurement and group, stride duration and cadence were more significantly improved in group A than in group B.Conclusions: The wearable curara® robot has the potential to improve gait function during stroke rehabilitation.Trial registration: Japan Registry of Clinical Trials (jRCTs032180163). Registered on February 22, 2019; https://jrct.niph.go.jp/en-latest-detail/jRCTs032180163UMIN Clinical Trials Registry (UMIN000034237). Registered on September 22, 2018; https://center6.umin.ac.jp/cgi-open-bin/icdr/ctr_view.cgi?recptno=R000038939