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

Abstract

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.

Robotic versus Conventional Overground Gait Training in Subacute Stroke Survivors: A Multicenter Controlled Clinical Trial

“…Furthermore, it remains to be addressed whether the use of robotic devices in addition to conventional physical therapy compared to conventional physical therapy alone could be beneficial for post-stroke patients [ 43 ]. On the other hand, Taveggia et al showed a significantly higher increase (above the minimal detectable change) in functional independence and gait speed (10 MWT) at the end of the treatment and at follow-up in patients receiving robot-assisted gait training compared with the overground gait training [ 27 ]. Other studies reported a smaller mean improvement (0.09 m/s) in gait speed compared with our data (0.30 m/s) [ 44 ].…”

“…A recent study showed that people with stroke who receive robot-assisted gait training in combination with standard physical therapy achieve positive effects in terms of independent walking, as compared with those receiving only conventional gait rehabilitation training [ 19 ]. However, several studies have reported inconclusive results regarding the efficacy and potential indications of using robotics alone in both acute and chronic stroke [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. Additionally, a variety of devices and treatment duration and frequency contribute to the wide variability in outcomes across studies [ 21 ].…”

“…The current study was designed with the aim of assessing the clinical effects of robot-assisted gait training compared with conventional training in subacute stroke patients. Considering that gait speed is a key indicator of post-stroke gait performance and has considerable importance on disability burden reduction [ 25 ], we hypothesized that gait speed would improve most in subjects who received an effective number of robot-assisted gait training sessions (a total of 20 sessions) [ 26 , 27 ] versus those treated with overground gait training. As a secondary analysis of data from patients receiving robot-assisted gait training, we compared the effects of the two types of stationary robotic devices.…”

Emerging Limb Rehabilitation Therapy After Post-stroke Motor Recovery

“… Lamberti et al (2021) conducted a clinical study consisting of 236 stroke patients (145 males, 91 females) admitted to a rehabilitation program with robot-assisted gait training. After accomplishing a rehabilitation program, the results have shown that the patients exhibited significant improvements in Functional Independence Measure and Functional Ambulatory Category, with a substantial recovery in women, indicating that using robotics for female stroke patients may favor a selective selection functional effect of recovery.…”

Use of Robotics in Gait Rehabilitation Following Stroke: A Review

“…Robotics' advent in recent times has produced intriguing recovery results for stroke victims, providing an option to conventional physiotherapy [ 10 , 11 ]. Rehabilitation robots are mechanical interactive gadgets that enable limb movement for both sensorimotor and, maybe, cognitive recovery [ 12 , 13 ].…”