Conflicting results of robot-assisted versus usual gait training during postacute rehabilitation of stroke patients

Abstract

Robot gait training has the potential to increase the effectiveness of walking therapy. Clinical outcomes after robotic training are often not superior to conventional therapy. We evaluated the effectiveness of a robot training compared with a usual gait training physiotherapy during a standardized rehabilitation protocol in inpatient participants with poststroke hemiparesis. This was a randomized double-blind clinical trial in a postacute physical and rehabilitation medicine hospital. Twenty-eight patients, 39.3% women (72±6 years), with hemiparesis (<6 months after stroke) receiving a conventional treatment according to the Bobath approach were assigned randomly to an experimental or a control intervention of robot gait training to improve walking (five sessions a week for 5 weeks). Outcome measures included the 6-min walk test, the 10 m walk test, Functional Independence Measure, SF-36 physical functioning and the Tinetti scale. Outcomes were collected at baseline, immediately following the intervention period and 3 months following the end of the intervention. The experimental group showed a significant increase in functional independence and gait speed (10 m walk test) at the end of the treatment and follow-up, higher than the minimal detectable change. The control group showed a significant increase in the gait endurance (6-min walk test) at the follow-up, higher than the minimal detectable change. Both treatments were effective in the improvement of gait performances, although the statistical analysis of functional independence showed a significant improvement in the experimental group, indicating possible advantages during generic activities of daily living compared with overground treatment.

Robotic Assist-As-Needed as an Alternative to Therapist-Assisted Gait Rehabilitation

“…Robot-aided gait training (RAGT) that provides automated training has been developed as a potential gait rehabilitation method for individuals with neurological impairments [17–19], as it is less fatiguing for physical therapists than the therapist-assisted BWSTT. RAGT was initially developed to provide continuous movement guidance so subjects would walk in a prescribed gait pattern.…”

Theoretical aspects of substantiating the efficiency of economic decisions aimed at development of high-rise housing construction

“…In particular, she suggested another stratification and social structure of Russian society, which includes: --the ruling elite (the top of Russian society, whose share in the population is a fraction of a percent, while the resources under their control are comparable to the resources of the rest of society); --the top stratum (sub-elite) -owners and managers of large enterprises, banks, companies, generals of law enforcement agencies, etc . ; bureaucracy worker, high-ranking officers, small and medium entrepreneurs, directors of small state enterprises, private sector managers, highly-qualified and high-demand professionals; --the base stratum (the major part of the society, 2/3 of the employed in the economy and more than half of all Russians): the majority of ordinary professionals in mass occupations (engineers, teachers, doctors), clerks, industrial workers, peasants, farmers, trade and service workers; --the lower stratum (narrow and powerless stratum): the least qualified part of workers and employees, persons without occupation, chronically unemployed, the majority of pensioners and disabled people with minimal means of living; --underclass (quite extensive): its representatives are virtually excluded from society, they live according to their own norms and rules, that are often contrary to morality and law: thieves, bandits, racketeers, prostitutes, beggars, homeless people, vagabonds, street children, alcoholics and drug addicts living in families [7]. Thus, the suggested stratification should be based on the base stratum of society and partly on the middle class in the development of expensive high-rise housing construction.…”

“…Zaslavskaya were not considered [7]. In particular, she suggested another stratification and social structure of Russian society, which includes: --the ruling elite (the top of Russian society, whose share in the population is a fraction of a percent, while the resources under their control are comparable to the resources of the rest of society); --the top stratum (sub-elite) -owners and managers of large enterprises, banks, companies, generals of law enforcement agencies, etc .…”

A selective study of Information technologies to improve operations efficiency in construction

“…VSATs comprise the following two major parts: external unit (antenna and receiver/transmitter) and internal unit (to convert information in a format suitable for telephones, computers etc.). Internet speed for VSATs can reach 18 Mbps [9].…”