Gait training of poststroke patients assisted by the Walkaround (body postural support)

Abstract

Improvement in gait abilities is one of the important goals of stroke rehabilitation. The Walkaround is a new postural assistance device for gait training, which allows an early start for gait training. This device provides body postural support (BPS) and trunk orientation by means of a lumbar belt that is connected to a powered rolling walker. We conducted a randomized, single-blinded, 4-week clinical trial of 22 subacute stroke patients with a follow-up period of 6 months. Patients were divided into two identically sized groups: the treatment group (BPS), which was assisted by the Walkaround, and the control (CON) group, which was assisted by conventional means (cane, therapist) during gait training. The objective of the study was to assess whether the Walkaround is more effective than conventional assistance during gait training. The outcome measures were as follows: Barthel index, Fugl-Meyer score for the lower extremities, Berg balance test, and gait speed. Changes in the outcome measures were significant for the Berg balance score after 6 months in both groups and in gait speed among the BPS group at the end of therapy and after 6 months (P<0.05) compared with the same outcome measures at the beginning of the trial. Significant differences were found in gait speed and Berg balance test scores after 4 weeks and in gait speed after 6 months (P<0.05) between the BPS and the CON groups. The results suggest that added postural support by the Walkaround led to limited yet significant changes in gait speed and balance control.

Systematic Review of Appropriate Robotic Intervention for Gait Function in Subacute Stroke Patients

“…The mean test results with standard deviations and the effect size calculations are reported in Table 3 . Only the effect sizes in 5 studies [ 3 , 4 , 16 , 17 , 19 ] were calculated after excluding those that showed only posttraining differences without pretest and posttest means and standard deviations [ 15 ] and those that included medians and ranges only [ 18 ].…”

“…The period of RAGT ranged from 2 to 5 weeks, with varied intervention durations ranging from 400 to 960 minutes. Five studies [ 4 , 15 – 17 , 19 ] (71.43%) reported intervention effects after the follow-up period. Conventional rehabilitation therapy conducted in control groups included general gait training, muscle strength exercise, Bobath approach therapy, gait training on parallel bars, and stair-ascent activity.…”

“…All experimental groups in the studies received interventions associated with RAGT. Three (42.85%) of the studies used Lokomat as an intervention method [ 3 , 17 , 19 ], and 4 other studies used the G-EO system [ 15 ], walk-around gaiter [ 4 ], gait trainer (GT) [ 16 ], and gait-assistance robot (GAR) [ 18 ] (14.28% each).…”

“…Gait impairment is one of the most important problems after stroke and is associated with activities of daily living and mobility issues [ 4 ]. Therefore, recovery of gait function is an important goal of rehabilitation for independent living [ 5 ].…”

Adaptation of a smart walker for stroke individuals: a study on sEMG and accelerometer signals

“…Better stability and homogeneous distribution of body weight on the lower limbs provides a gait closer to the natural one, with better symmetry between the lower limbs, including increasing the support phase of the paretic limb. In fact, a study (Dragin et al, 2014) of 4-week clinical trial (22 subacute stroke patients) using a body postural support connected to a powered rolling walker concluded that a smart walker changes the gait speed and balance control significantly when compared to a control group.…”