A Robot-Assisted Therapy to Increase Muscle Strength in Hemiplegic Gait Rehabilitation

Abstract

This study examines the feasibility of using a robot-assisted therapy methodology based on the Bobath concept to perform exercises applied in conventional therapy for gait rehabilitation in stroke patients. The aim of the therapy is to improve postural control and movement through exercises based on repetitive active-assisted joint mobilization, which is expected to produce strength changes in the lower limbs. As therapy progresses, robotic assistance is gradually reduced and the patient's burden increases with the goal of achieving a certain degree of independence. The relationship between force and range of motion led to the analysis of both parameters of interest. The study included 23 volunteers who performed 24 sessions, 2 sessions per week for 12 weeks, each lasting about 1 h. The results showed a significant increase in hip abduction and knee flexion strength on both sides, although there was a general trend of increased strength in all joints. However, the range of motion at the hip and ankle joints was reduced. The usefulness of this platform for transferring exercises from conventional to robot-assisted therapies was demonstrated, as well as the benefits that can be obtained in muscle strength training. However, it is suggested to complement the applied therapy with exercises for the maintenance and improvement of the range of motion.

Effect of robotic-assisted gait training as adjunct to traditional therapy on motor impairments in children with cerebral palsy

“…A recent study showed a significant increase of muscle strength in hip abductors and knee flexors on both sides in adult hemiplegic after RAGT (20). Our study showed an overall improvement of strength in all the lower limb muscles.…”

Effects of flexor reflex stimulation on gait aspects in stroke patients: randomized clinical trial

“…Finally, the percentage of change that occurred between with and without electrostimulation variables was calculated. For this purpose, the following equation was applied [ 7 ]: …”

“…Hemiparesis stands out as very frequent and widely recognized impairment that had been reported in approximately 65% of patients [ 4 ]. Gait recovery is an important aspect of stroke rehabilitation and a primary goal for most patients [ 5 – 7 ], because gait is of fundamental importance in the activities of daily living [ 8 ]. Thus, for improvement of poststroke gait impairment, numerous rehabilitative training methods have been developed, such as overground walking, cycling, treadmill walking, balance and cardiorespiratory training, repetitive standing exercise, proprioceptive neuromuscular facilitation, repetitive transcranial magnetic stimulation and electrostimulation [ 9 – 18 ].…”

Hand rehabilitation based on the RobHand exoskeleton in stroke patients: A case series study

“…Rehabilitation therapies have made great strides in recent years, where information technology, robotics, and the design of exoskeletons have been key elements in new therapies ( Pelier et al., 2021 ). These allow the practitioner to have more information to evaluate the response to certain exercises and then adapt the therapy mechanism or exoskeleton to the biomechanics, requirements, and demands of the patient ( Gil et al., 2022 ). Additionally, it allows the performance of more prolonged and repetitive exercises compared to those offered in traditional rehabilitation therapy ( Mancisidor et al., 2018 ).…”