Effects of gait rehabilitation with a footpad-type locomotion interface in patients with chronic post-stroke hemiparesis: a pilot study

Tanaka, Naoki; Saitou, Hideyuki; Takao, Toshifumi; Iizuka, Noboru; Okuno, Junko; Yano, Hiroaki; Tamaoka, Akira; Yanagi, Hisako

doi:10.1177/0269215511432356

Cited by 33 publications

(14 citation statements)

References 29 publications

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“…Some past reports have demonstrated electromechanical devices for gait rehabilitation, such as the Lokomat, 11 , 12) Gait Trainer, 13) and Gait Master. 14) These devices were developed to help patients in the swing phase, and control patient movements using a personal computer to assist them in moving their legs in a physiological gait pattern on a moving treadmill. Patients cannot influence the motion by themselves because these systems use a fixed gait pattern.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Acute Phase Hybrid Assistive Limb Rehabilitation in Stroke Patients Classified by Paralysis Severity

Fukuda

Samura

Hamada

et al. 2015

Neurol. Med. Chir.(Tokyo)

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The purpose of the present study was to investigate the effectiveness of acute phase hybrid assistive limb (HAL) rehabilitation training for patients after stroke by measuring the difference in the severity of paralysis. Fifty-three acute stroke patients were enrolled in this prospective cohort study. HAL training was administered about twice per week, and the mean number of sessions was 3.9 ± 2.7. The walking training was performed on a treadmill with individually adjustable body weight support and speed and there was a 10-m walk test (10MWT) before and after each session. Assessment at baseline and at endpoint consisted of the Glasgow Coma Scale (GCS), Revised Hasegawa’s Dementia Scale (HDS-R), Brunnstrom stage (Brs), Functional Independence Measure (FIM), Barthel index (BI), and 10MWT. We measured these assessments at the first walking training session and at the end of the final training session without the HAL. To evaluate the feasibility of training with the HAL, the outcome measures of BI, FIM, and speed and number of steps of 10MWT were compared before and after training using a paired Wilcoxon’s signed-rank test in different Brs. Except for Brs IV, the Brs III or higher subgroups displayed significant amelioration in BI, and the Brs III subgroup displayed significant amelioration in FIM. The Brs V and VI subgroups displayed significant amelioration in 10-m walking speed and steps. In acute phase rehabilitation after stroke, it is thought that the HAL is more effective for patients with less lower-limb paralysis, such as Brs III or higher.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Acute Phase Hybrid Assistive Limb Rehabilitation in Stroke Patients Classified by Paralysis Severity

Fukuda

Samura

Hamada

et al. 2015

Neurol. Med. Chir.(Tokyo)

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“…Gait Master 4 is another operational machine based on the movement of two footplates moved by a connecting rod-crank system. The footplates allow the movement of the human effector back and forth (to simulate the walk) or up and down (up/down the stairs) [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Assessing Effectiveness and Costs in Robot-Mediated Lower Limbs Rehabilitation: A Meta-Analysis and State of the Art

Carpino

Pezzola

Urbano

et al. 2018

Journal of Healthcare Engineering

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Robots were introduced in rehabilitation in the 90s to meet different needs, that is, reducing the physical effort of therapists. This work consists of a meta-analysis of robot-mediated lower limbs rehabilitation for stroke-affected patients; it aims at evaluating the effectiveness of the robotic approach through the use of wearable robots or operational machines with respect to the conventional approach (i.e., manual rehabilitation therapy). The primary assessed outcome is the patient's ability to recover walking independence, whereas the secondary outcome is the average walking speed. The therapy acceptability and the treatment costs are also assessed. The assessment shows that the robot-mediated therapy is more effective than the conventional one in reaching the primary outcome. As for the secondary outcome, there is no significant difference between the robotic (wearable robots or operational machines) and the conventional approach. Rehabilitation using wearable robots has a greater acceptability than the conventional one. This does not apply to operational machines. The cost of robotic treatment with wearable robots ranges from double to triple the cost of the conventional approach. On the contrary, rehabilitation using operational machines costs the same as the conventional treatment. Robotic rehabilitation based on operational machines is the most cost-effective approach.

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“…For the selective reporting domain, a proxy judgement was made that if a trial reported that a study protocol had been approved and the trial report described primary and secondary outcomes with results, then the trial could be considered at low risk of selective reporting bias. We classified RCTs as being at overall low risk of bias if they were rated as “low” for each of three key domains: (1) allocation concealment [ 31 ], (2) blinding of outcome assessment, and (3) completeness of outcome data. RCTs judged as being at high risk of bias for any of these domains were judged at overall high risk.…”

Section: Methodsmentioning

confidence: 99%

The Effectiveness of Lower-Limb Wearable Technology for Improving Activity and Participation in Adult Stroke Survivors: A Systematic Review

2016

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BackgroundWith advances in technology, the adoption of wearable devices has become a viable adjunct in poststroke rehabilitation. Regaining ambulation is a top priority for an increasing number of stroke survivors. However, despite an increase in research exploring these devices for lower limb rehabilitation, little is known of the effectiveness.ObjectiveThis review aims to assess the effectiveness of lower limb wearable technology for improving activity and participation in adult stroke survivors.MethodsRandomized controlled trials (RCTs) of lower limb wearable technology for poststroke rehabilitation were included. Primary outcome measures were validated measures of activity and participation as defined by the International Classification of Functioning, Disability and Health. Databases searched were MEDLINE, Web of Science (Core collection), CINAHL, and the Cochrane Library. The Cochrane Risk of Bias Tool was used to assess the methodological quality of the RCTs.ResultsIn the review, we included 11 RCTs with collectively 550 participants at baseline and 474 participants at final follow-up including control groups and participants post stroke. Participants' stroke type and severity varied. Only one study found significant between-group differences for systems functioning and activity. Across the included RCTs, the lowest number of participants was 12 and the highest was 151 with a mean of 49 participants. The lowest number of participants to drop out of an RCT was zero in two of the studies and 19 in one study. Significant between-group differences were found across three of the 11 included trials. Out of the activity and participation measures alone, P values ranged from P=.87 to P ≤.001.ConclusionsThis review has highlighted a number of reasons for insignificant findings in this area including low sample sizes, appropriateness of the RCT methodology for complex interventions, a lack of appropriate analysis of outcome data, and participant stroke severity.

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Effects of gait rehabilitation with a footpad-type locomotion interface in patients with chronic post-stroke hemiparesis: a pilot study

Cited by 33 publications

References 29 publications

Effectiveness of Acute Phase Hybrid Assistive Limb Rehabilitation in Stroke Patients Classified by Paralysis Severity

Effectiveness of Acute Phase Hybrid Assistive Limb Rehabilitation in Stroke Patients Classified by Paralysis Severity

Assessing Effectiveness and Costs in Robot-Mediated Lower Limbs Rehabilitation: A Meta-Analysis and State of the Art

The Effectiveness of Lower-Limb Wearable Technology for Improving Activity and Participation in Adult Stroke Survivors: A Systematic Review

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