Improving abnormal gait patterns by using a gait exercise assist robot (GEAR) in chronic stroke subjects: A randomized, controlled, pilot trial

Ogino, Tomoyuki; Kanata, Yoshihiro; Uegaki, Ryota; Yamaguchi, Tatuya; Morisaki, Katuhisa; Nakano, Shuhei; Uchiyama, Yuki; Domen, Kazuhisa

doi:10.1016/j.gaitpost.2020.07.017

Cited by 7 publications

(21 citation statements)

References 24 publications

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“…The mean age was 57.8 ± 7.0 years. The subjects were community residents or recruited from the outpatient department in three studies [ 42 , 43 , 45 ], were hospitalised in four studies [ 36 , 37 , 41 , 44 ], and belonged to other categories or were unknown in four studies [ 35 , 38 – 40 ].…”

Section: Resultsmentioning

confidence: 99%

“…Three reports specified a walking speed of 0.3 m/s [ 39 ] and 0.8 m/s or more [ 35 , 38 ]. Furthermore, four studies used the Berg Balance Scale (BBS) [ 36 , 45 ], Timed Up and Go Test [ 36 ], Functional Independence Measure [ 36 ], Modified Ashworth Scale [ 42 , 43 ], etc. at the functional level.…”

Section: Resultsmentioning

confidence: 99%

“…The duration of intervention and the duration of a session differed in each study. In the included studies, the duration of intervention ranged from 3 weeks [ 45 ] to 5 months [ 36 ], and the number of training sessions varied from nine [ 45 ] to 12 sessions [ 35 , 38 – 40 ], 18 sessions [ 44 ], and 20 sessions [ 36 , 41 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…Group differences between fast and slow training groups were not stated Danzl et al (2013) [ 40 ] RCT 8 subjects with chronic stroke IG: active tDCS with RGO CG: sham tDCS with RGO N/A IG: active tDCS with identical locomotor training with a robotic gait orthosis (RGO) CG: sham tDCS with identical locomotor training with a robotic gait orthosis (RGO) 12 sessions 3 times per week Device: Lokomat BWS: 40–50% at the beginning of session and then reduced to 20% at the end of protocol training WS: Initially at comfortable speed, followed by progressive, rapid decrease to a speed slow enough to allow subject to initiate movement, thereby increasing engagement with the task and appropriate attentional demands Outcome measures: 10MWT, BBS, FAC, SIS-16 Result: the active tDCS group showed greater improvement than the sham group in all measures except BBS Bae et al (2014) [ 41 ] RCT 20 subjects with chronic stroke IG: RAGT with FES ( n = 10 ) CG: RAGT only ( n = 10 ) Able to walk for 10 m with or without an assistive device IG: robot-assisted gait training and functional electrical stimulation on the ankle dorsiflexor of the affected side CG: robot-assisted gait training only 15 sessions 3 times per week 30 min per session with regular 30-min PT session in both groups Device: Lokomat BWS: reduced from 40 to 0% according to the patient’s gait pattern WS: from 1.2 km/h up to the maximum speed at which patients could adapt Outcome measures: MMAS, TUG, BBS, gait parameters, WS, cadence, step length, stride length, double support, pelvic, hip, knee, ankle joint angle Result: In IG, Step length and maximal knee extension were significantly greater than those before training and Maximal Knee flexion showed a significant difference between the in IG. The MMAS, BBS, and TUG scores improved significantly after training compared with before training in both groups Ogino et al (2020) [ 42 ] RCT 19 patients with chronic stroke IG: GEAR group ( n = 8 ) CG: treadmill group ( n = 11 ) All subjects were required to walk on the ground or a treadmill without physical assistance using assistive devices IG: GEAR training CG: using only the treadmill function of GEAR 20 sessions 5 times per week 60 min per session Visual and audio feedback was used when needed Device: GEAR system (Welw...…”

Section: Methodsmentioning

confidence: 99%

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Effect of exoskeleton-assisted Body Weight-Supported Treadmill Training on gait function for patients with chronic stroke: a scoping review

Yamamoto

Sasaki

Kuwahara

et al. 2022

J NeuroEngineering Rehabil

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Background Therapeutic exercise for gait function using an exoskeleton-assisted Body Weight Supported Treadmill Training (BWSTT) has been identified as a potential intervention that allows for task-based repetitive training with appropriate kinematics while adjusting the amount of body weight support (BWS). Nonetheless, its effect on gait in patients with stroke in the chronic phase are yet to be clarified. The primary aim of this scoping review was to present the status of effectiveness of exoskeleton-assisted BWSTT in patients with chronic stroke. The secondary aims were to summarise intervention protocols, types and functions of BWSTT exoskeletal robotic devices currently used clinically. Method and results Articles were accessed and collected from PubMed, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science databases, which were completed in October 2020. Articles were included if the subjects were adults with stroke in the chronic phase (onset ≥ 6 months) and if they utilised a robotic exoskeleton with treadmill and body weight support and investigated the efficacy of gait exercise. A total of 721 studies were identified, of which 11 randomised controlled trials were selected. All included studies were published from 2008 to 2020. Overall, 309 subjects were enrolled; of these, 241 (156 males, 85 females) participated. Walking outcome measures were used more often to evaluate the functional aspects of gait than to evaluate gait independence. In 10 of 11 studies, showed the effectiveness of exoskeleton robot-assisted BWSTT in terms of outcomes contributing to improved gait function. Two studies reported that exoskeleton-assisted BWSTT with combination therapy was significantly more effective in improving than exoskeleton-assisted BWSTT alone. However, no significant difference was identified between the groups; compared with therapist-assisted BWSTT groups, exoskeleton-assisted BWSTT groups did not exhibit significant change. Conclusion This review suggests that exoskeleton-assisted BWSTT for patients with chronic stroke may be effective in improving walking function. However, the potential may be “to assist” and not because of using the robot. Further studies are required to verify its efficacy and strengthen evidence on intervention protocols.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Effect of exoskeleton-assisted Body Weight-Supported Treadmill Training on gait function for patients with chronic stroke: a scoping review

Yamamoto

Sasaki

Kuwahara

et al. 2022

J NeuroEngineering Rehabil

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“…GEAR has been shown to have positive effects in stroke patients. Previous studies have reported that gait training using GEAR may be more effective than other training systems in patients with subacute and chronic stroke, and may facilitate early improvement in gait independence [5][6][7][8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

Gait improvement in stroke patients by Gait Exercise Assist Robot training is related to trunk verticality

et al. 2022

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Various types of Gait Exercise Assist Robot (GEAR) have been developed recently, some of which have enabled early improvement in patients with stroke. However, none has yet resulted in independent walking in these patients. Hence, we conducted an exploratory study of the effect of GEAR on achieving independent walking in stroke patients. [Participants and Methods] The participants were 16 patients with severe stroke. We evaluated patients' ability to walk independently after GEAR training. The outcome measure was Stroke Impairment Assessment Set (SIAS) motor score (Hip Flexion, Knee Extension, Foot Pat, Abdominal and Verticality). Differences in five SIAS motor scores were compared between the independent and non-independent walking groups.[Results] There was statistically significant difference between the groups in terms of Verticality among the 5 SIAS items used in the present research . Verticality of SIAS score of 1 was the cut-off value for distinguishing walking independence.[Conclusion] Verticality of SIAS may be a marker of potential walking independence that can be used in rehabilitation plans using walking-assist robots in patients with stroke.

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Maximizing stroke recovery with advanced technologies: A comprehensive assessment of robot-assisted, EMG-Controlled robotics, virtual reality, and mirror therapy interventions

Amin,

Waris,

Iqbal

et al. 2024

Results in Engineering

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Improving abnormal gait patterns by using a gait exercise assist robot (GEAR) in chronic stroke subjects: A randomized, controlled, pilot trial

Cited by 7 publications

References 24 publications

Effect of exoskeleton-assisted Body Weight-Supported Treadmill Training on gait function for patients with chronic stroke: a scoping review

Effect of exoskeleton-assisted Body Weight-Supported Treadmill Training on gait function for patients with chronic stroke: a scoping review

Gait improvement in stroke patients by Gait Exercise Assist Robot training is related to trunk verticality

Maximizing stroke recovery with advanced technologies: A comprehensive assessment of robot-assisted, EMG-Controlled robotics, virtual reality, and mirror therapy interventions

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