Robot-assisted gait training for balance and lower extremity function in patients with infratentorial stroke: a single-blinded randomized controlled trial

Kim, Ha Yeon; Shin, Joon-Ho; Yang, Sung Phil; Shin, Min A; Lee, Stephanie Hyeyoung

doi:10.1186/s12984-019-0553-5

Cited by 50 publications

(61 citation statements)

References 51 publications

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“…According to previous studies evaluating the effect of RAGT as an add-on to conventional physiotherapy, patients with (subacute or chronic) stroke exhibited improved ambulation function, lower-extremity motor function, balance, and gait performance both immediately postintervention and at follow-up, and these improvements were superior to those conventional physiotherapy [14,16,17,19,21,22,24,25,33]. By contrast, some studies have shown that training effects in locomotion function, activities of daily living, and gait were not superior to those of conventional stroke training in patients with subacute stroke [15,18,20,23].…”

Section: Discussionmentioning

confidence: 96%

Hybrid Robot-Assisted Gait Training for Motor Function in Subacute Stroke: A Single-Blind Randomized Controlled Trial

Lin

Huang

Kuan

et al. 2021

Preprint

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Background:Robot-assisted gait training (RAGT) is a practical treatment adjunctive to conventional rehabilitation to provide high-intensity repetitive training for patients with stroke. The robot models designed are usually either the end-effector type or the exoskeleton type. We developed a novel hybrid RAGT system that combines the advantages of both types.Objective:This randomized controlled trial (RCT) evaluated whether the novel RAGT system was beneficial and assessed long-term effects (at the 3-month follow-up) for nonambulatory patients with subacute stroke.Methods:This trial recruited 40 patients with subacute stroke who were equally randomized to receive conventional rehabilitation or 15 add-on RAGT sessions. We assessed lower-extremity motor function, balance, and gait performance by using the following tools: active range of motion (AROM), manual muscle test (MMT), the Fugl-Meyer Assessment (FMA) lower-extremity subscale (FMA-LE) and total (FMA-total), Postural Assessment Scale for Stroke (PASS), Berg Balance Scale (BBS), Tinetti Performance Oriented Mobility Assessment (POMA) balance and gait subscores, and the 3- and 6-m walking speed and Timed Up and Go (TUG) tests. These measurements were performed before and after the intervention and at the 3-month follow-up.Results:Both groups demonstrated significant within-group changes in the AROM, MMT, FMA-LE, FMA-total, PASS, BBS, POMA, TUG, and 3- and 6-m walking speeds before and after intervention and at the 3-month follow-up (p < 0.05). Only FMA-LE (p = 0.014) and total (p = 0.002) scores differed significantly between groups (RAGT vs. control).Conclusion:Although the novel hybrid RAGT was beneficial, no powerful evidence to supported its effectiveness relative to the control group in substantial leg dysfunction after stroke.Trial Registration: The study was registered with an International Standard Randomized Controlled Trial Number, ISRCTN, ISRCTN15088682. Registered 16 September 2016, Retrospectively registered https://www.isrctn.com/ISRCTN15088682

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Section: Discussionmentioning

confidence: 96%

Hybrid Robot-Assisted Gait Training for Motor Function in Subacute Stroke: A Single-Blind Randomized Controlled Trial

Lin

Huang

Kuan

et al. 2021

Preprint

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“…The results gave information that combined training could improve the activities of life (ADLs) and quality of life (QoL) of patients, compared with the other two groups. In an experiment that was carried out to explore the effect of RAGT on balance and lower limb function of survivors of off infratentorial stroke [23], it was clear that RAGT could improve standing balance function and lower limb motor function for patients with infratentorial stroke more effectively, compared with routine rehabilitation training in the same period of time.…”

Section: Discussmentioning

confidence: 99%

Impacts of a lower limb exoskeleton robot on anxious stroke patients

Zhang

Yao

Zhao³

et al. 2020

E3S Web Conf.

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To explore the intervention effect of exoskeleton robot training on anxiety of stroke patients. Methods 24 stroke patients with hemiplegia were randomly divided into experimental group and control group, with 12 cases in each group. Moreover, the robot group took the walking training with UGO 210, a lower limb exoskeleton walking rehabilitation, once per day, 30 minutes per time, a total of 20 times of treatment. Before the trial and at the end of the trial cycle, patients’ emotions were assessed using the Self-rating Anxiety scale (SAS), and the efficacy of the two groups was compared. Results: The scores of anxiety scale decreased in both groups (P <0.05), and there was no difference between the two groups (P <0.05). Conclusion: The use of exoskeleton robot can improve the anxiety of stroke patients, but there is no difference compared with the conventional walking training.

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“…In recent years, studies recommending the use of exoskeletons in gait training for stroke patients are emerging (Tefertiller et al, 2011;Mehrholz and Pohl, 2012;Pennycott et al, 2012). Parallelly, clinical trials also show the therapeutic benefits of exoskeletons in balance and locomotion (Yeung et al, 2018;Kim et al, 2019;Ii et al, 2020;Moucheboeuf et al, 2020). For example, The ReWalk (ReWalk Robotics, Israel) provides targeted assistance of both paretic ankle plantarflexion and dorsiflexion in overground walking for patients with stroke (Awad et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a Novel Exoskeletal Robot for Locomotor Rehabilitation in Stroke Patients: A Multi-center, Non-inferiority, Randomized Controlled Trial

Fan

et al. 2021

Front. Aging Neurosci.

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Objective: To investigate the efficacy and safety of a novel lower-limb exoskeletal robot, BEAR-H1 (Shenzhen Milebot Robot Technology), in the locomotor function of subacute stroke patients.Methods: The present study was approved by the ethical committee of the First Affiliated Hospital of Nanjing Medical University (No. 2019-MD-43), and registration was recorded on the Chinese Clinical Trial Registry with a unique identifier: ChiCTR2100044475. A total of 130 patients within 6 months of stroke were randomly divided into two groups: the robot group and the control group. The control group received routine training for walking, while in the robot group, BEAR-H1 lower-limb exoskeletal robot was used for locomotor training. Both groups received two sessions daily, 5 days a week for 4 weeks consecutively. Each session lasted 30 min. Before treatment, after treatment for 2 weeks, and 4 weeks, the patients were assessed based on the 6-minute walking test (6MWT), functional ambulation scale (FAC), Fugl-Meyer assessment lower-limb subscale (FMA-LE), and Vicon gait analysis.Results: After a 4-week intervention, the results of 6MWT, FMA-LE, FAC, cadence, and gait cycle in the two groups significantly improved (P < 0.05), but there was no significant difference between the two groups (P > 0.05). The ratio of stance phase to that of swing phase, swing phase symmetry ratio (SPSR), and step length symmetry ratio (SLSR) was not significantly improved after 4 weeks of training in both the groups. Further analyses revealed that the robot group exhibited potential benefits, as the point estimates of 6MWT and Δ6MWT (post-pre) at 4 weeks were higher than those in the control group. Additionally, within-group comparison showed that patients in the robot group had a significant improvement in 6MWT earlier than their counterparts in the control group.Conclusions: The rehabilitation robot in this study could improve the locomotor function of stroke patients; however, its effect was no better than conventional locomotor training.

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Robot-assisted gait training for balance and lower extremity function in patients with infratentorial stroke: a single-blinded randomized controlled trial

Cited by 50 publications

References 51 publications

Hybrid Robot-Assisted Gait Training for Motor Function in Subacute Stroke: A Single-Blind Randomized Controlled Trial

Hybrid Robot-Assisted Gait Training for Motor Function in Subacute Stroke: A Single-Blind Randomized Controlled Trial

Impacts of a lower limb exoskeleton robot on anxious stroke patients

Efficacy of a Novel Exoskeletal Robot for Locomotor Rehabilitation in Stroke Patients: A Multi-center, Non-inferiority, Randomized Controlled Trial

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