Repetitive locomotor training and physiotherapy improve walking and basic                 activities of daily living after stroke: a single-blind, randomized multicentre                 trial (DEutsche GAngtrainerStudie, DEGAS)

Pohl, Marcus; Werner, Carsten; Holzgraefe, M.; Kroczek, G; Wingendorf, Insa; Hoölig, G; Koch, Rainer; Hesse, Stefan

doi:10.1177/0269215506071281

Cited by 302 publications

(212 citation statements)

References 25 publications

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“…The number of strides performed by our patients during the 20 min GT session was similar to that previously reported by Pohl et al (mean 425 strides during the first 2 weeks of therapy and 538 during the following 2 weeks) [3]. This number is higher than that reported in a previous study on the number of strides performed during over-ground walking by patients manually supported by physiotherapists (about 100 strides) [28].…”

Section: Discussionsupporting

confidence: 88%

“…The effectiveness of these devices has been investigated in patients with subacute [3][4][5] and chronic [6][7] stroke, but their overall efficacy has been questioned [8][9]. The absence of a general agreement may be due to differences among patients enrolled in these studies, as well as the lack of a unified approach to integrating these devices into rehabilitation programs [10].…”

Section: Introductionmentioning

confidence: 99%

“…BWS permits a greater number of steps within a training session than conventional therapy, in which body weight is manually supported by one or two physiotherapists and/or a walker [3,13]. The physiotherapist initially selects the BWS value in a static posture (BWS s ).…”

Section: Introductionmentioning

confidence: 99%

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Driving electromechanically assisted Gait Trainer for people with stroke

Iosa¹,

Morone²,

Bragoni³

et al. 2011

JRRD

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Abstract-Electromechanically assisted gait training is a promising task-oriented approach for gait restoration, especially for people with subacute stroke. However, few guidelines are available for selecting the parameter values of the electromechanical Gait Trainer (GT) (Reha-Stim; Berlin, Germany) and none is tailored to a patient's motor capacity. We assessed 342 GT sessions performed by 20 people with stroke who were stratified by Functional Ambulatory Category. In the first GT session of all patients, the body-weight support (BWS) required was higher than that reported in the literature. In further sessions, we noted a slow reduction of BWS and a fast increment of walking speed for the most-affected patients. Inverse trends were observed for the less-affected patients. In all the patients, the heart rate increment was about 20 beats per minute, even for sessions in which the number of strides performed was up to 500. In addition, the effective BWS measured during GT sessions was different from that initially selected by the physiotherapist. This difference depended mainly on the position of the GT platforms during selection. Finally, harness acceleration in the anteroposterior direction proved to be higher in patients with stroke than in nondisabled subjects. Our findings are an initial step toward scientifically selecting parameters in electromechanically assisted gait training.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

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Driving electromechanically assisted Gait Trainer for people with stroke

Iosa¹,

Morone²,

Bragoni³

et al. 2011

JRRD

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“…RCTs involving patients <6 months post stroke have demonstrated mean increases in comfortable walking speed that were inversely related to the baseline speed (i.e., the lower the initial speed, the greater the percentage of improvement). 38,39,41,42 Average improvements ranged from 26% (0.18 m/sec change, from 0.70 m/sec at baseline to 0.88 m/sec after training) 38 to 238% (0.31 m/sec change, from 0.13 to 0.44 m/sec). 42 In all the trials, the average improvement in gait speed exceeded the minimal clinically important difference (MCID) of 0.16 m/sec for patients in the subacute stage of recovery after stroke.…”

Section: The Evidencementioning

confidence: 99%

Cardiovascular Fitness Training for a Patient in the Early Stages of Recovery Post Stroke

MacKay-Lyons

Thornton²,

Macdonald³

2011

Physiotherapy Canada

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“…Conventional therapy, including treadmill training with partial body-weight support (BWS) [3][4], is limited by the effort to assist the patients' gait, e.g., when placing the paretic limb. Gait machines intended to relieve therapeutic effort to assist the patients' gait in combination with physiotherapy (PT) affected superior gait ability in most stroke trials [5][6][7][8] and a meta-analysis [9]. The machines, offering practice up to 1,000 steps per session, either used an exoskeleton [10][11] or an end-effector approach [12][13].…”

Section: Introductionmentioning

confidence: 99%

Robot-assisted practice of gait and stair climbing in nonambulatory stroke patients

Hesse

Tomelleri²,

Bardeleben³

et al. 2012

JRRD

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Abstract-A novel gait robot enabled nonambulatory patients the repetitive practice of gait and stair climbing. Thirty nonambulatory patients with subacute stroke were allocated to two groups. During 60 min sessions every workday for 4 weeks, the experimental group received 30 min of robot training and 30 min of physiotherapy and the control group received 60 min of physiotherapy. The primary variable was gait and stair climbing ability (Functional Ambulation Categories [FAC] score 0-5); secondary variables were gait velocity, Rivermead Mobility Index (RMI), and leg strength and tone blindly assessed at onset, intervention end, and follow-up. Both groups were comparable at onset and functionally improved over time. The improvements were significantly larger in the experimental group with respect to the FAC, RMI, velocity, and leg strength during the intervention. The FAC gains (mean +/-standard deviation) were 2.4 +/-1.2 (experimental group) and 1.2 +/-1.5 (control group), p = 0.01. At the end of the intervention, seven experimental group patients and one control group patient had reached an FAC score of 5, indicating an ability to climb up and down one flight of stairs. At follow-up, this superior gait ability persisted. In conclusion, the therapy on the novel gait robot resulted in a superior gait and stair climbing ability in nonambulatory patients with subacute stroke; a higher training intensity was the most likely explanation. A large randomized controlled trial should follow.Clinical Trial Registration: ClinicalTrials.gov; NCT001290611, "Robot-assisted Gait and Stair Practise"; http://www.clinicaltrials.gov.

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Repetitive locomotor training and physiotherapy improve walking and basic activities of daily living after stroke: a single-blind, randomized multicentre trial (DEutsche GAngtrainerStudie, DEGAS)

Abstract: Intensive locomotor training plus physiotherapy resulted in a significantly better gait ability and daily living competence in subacute stroke patients compared with physiotherapy alone.

Cited by 302 publications

References 25 publications

Driving electromechanically assisted Gait Trainer for people with stroke

Driving electromechanically assisted Gait Trainer for people with stroke

Cardiovascular Fitness Training for a Patient in the Early Stages of Recovery Post Stroke

Robot-assisted practice of gait and stair climbing in nonambulatory stroke patients

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