Slow Versus Fast Robot-Assisted Locomotor Training After Severe Stroke

Rodrigues, Thais Amanda; Goroso, Daniel Gustavo; Westgate, Philip M.; Carrico, Cheryl; Batistella, Linamara Rizzo; Sawaki, Lumy

doi:10.1097/phm.0000000000000810

Cited by 22 publications

(38 citation statements)

References 54 publications

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“…Advanced gait trainers are able to provide training with high speeds over longer periods of time, and high speeds are preferred to increase activity of the leg muscles [26,47]. Conversely, one study also found that slower training speeds may lead to greater benefits than fast training in severely affected patients early after a stroke [48].…”

Section: Locomotor Training (Lt) Principlesmentioning

confidence: 99%

Getting the Best Out of Advanced Rehabilitation Technology for the Lower Limbs: Minding Motor Learning Principles

Spiess

Steenbrink²,

Esquenazi

2018

PM&R

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Advanced technology, including gait‐training devices, is increasingly being integrated into neurorehabilitation. However, to use gait‐training devices to their optimal potential, it is important that they are applied in accordance with motor learning and locomotor training principles. In this article, we outline the most important principles and explain how advanced gait‐training devices are best used to improve therapy outcome.

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Section: Locomotor Training (Lt) Principlesmentioning

confidence: 99%

Getting the Best Out of Advanced Rehabilitation Technology for the Lower Limbs: Minding Motor Learning Principles

Spiess

Steenbrink²,

Esquenazi

2018

PM&R

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“…After removing duplicates and screening titles and abstracts, 1083 full text articles were assessed for eligibility. Twenty-eight studies were included in the systematic review 42–73. Two thousand six-hundred and seventy-seven participants were recruited to these studies—mean participant age was 72.7 years, 49.3% were males and 87% of patients sustained a cerebral infarction.…”

Section: Resultsmentioning

confidence: 99%

“…Ten studies were completed in the acute to early subacute phase poststroke,44–46 48 49 51–55 five studies were completed in the acute to late subacute phase poststroke59 62 66 68 69 and two studies were completed in the chronic phase poststroke 70 72. The most frequently used outcome measures of sensorimotor function were the Fugl-Meyer Assessment, used in 11 studies,45 46 48 51 53 54 59 68–70 72 and the MRC (Medical Research Council) scale for muscle strength, used in five studies. 46 51 52 59 72…”

Section: Resultsmentioning

confidence: 99%

“…Six studies were performed in the acute to early subacute phase,44–46 49 51 54 two studies were performed in the acute to late subacute phase63 66 and one study was performed in the chronic phase 70. The Functional Ambulation Classification was used in eight studies, making it the most frequently used outcome measure of gait ability 45 46 49 51 54 63 66 70. The 10-m walk test was used in five studies, making it the most frequently used outcome measure of gait speed 44 49 54 66 70…”

Section: Resultsmentioning

confidence: 99%

“…The Functional Ambulation Classification was used in eight studies, making it the most frequently used outcome measure of gait ability 45 46 49 51 54 63 66 70. The 10-m walk test was used in five studies, making it the most frequently used outcome measure of gait speed 44 49 54 66 70…”

Section: Resultsmentioning

confidence: 99%

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The effect of rehabilitation interventions on physical function and immobility-related complications in severe stroke: a systematic review

et al. 2020

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ObjectiveTo evaluate the effectiveness of rehabilitation interventions on physical function and immobility-related complications in severe stroke.DesignSystematic review of electronic databases (Medline, Excerpta Medica database, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Physiotherapy Evidence Database, Database of Research in Stroke, Cochrane Central Register of Controlled Trials) searched between January 1987 and November 2018.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement guided the review. Randomised controlled trials comparing the effect of one type of rehabilitation intervention to another intervention, usual care or no intervention on physical function and immobility-related complications for patients with severe stroke were included. Studies that recruited participants with all levels of stroke severity were included only if subgroup analysis based on stroke severity was performed. Two reviewers screened search results, selected studies using predefined selection criteria, extracted data and assessed risk of bias for selected studies using piloted proformas. Marked heterogeneity prevented meta-analysis and a descriptive review was performed. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess evidence strength.Results28 studies (n=2677, mean age 72.7 years, 49.3% males) were included in the review. 24 studies were rated low or very low quality due to high risk of bias and small sample sizes. There was high-quality evidence that very early mobilisation (ie, mobilisation with 24 hours poststroke) and occupational therapy in care homes were no more effective than usual care. There was moderate quality evidence supporting short-term benefits of wrist and finger neuromuscular electrical stimulation in improving wrist extensor and grip strength, additional upper limb training on improving upper limb function and additional lower limb training on improving upper limb function, independence in activities of daily living, gait speed and gait independence.ConclusionsThere is a paucity of high-quality evidence to support the use of rehabilitation interventions to improve physical function and reduce immobility-related complications after severe stroke. Future research investigating more commonly used rehabilitation interventions, particularly to reduce poststroke complications, is required.PROSPERO registration numberCRD42017077737

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Clinical non-superiority of technology-assisted gait training with body weight support in patients with subacute stroke: A meta-analysis

Hsu

Cheng

Lai

et al. 2020

Annals of Physical and Rehabilitation Medicine

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Slow Versus Fast Robot-Assisted Locomotor Training After Severe Stroke

Abstract: In initial stages of robot-assisted locomotor training on a bodyweight-supported treadmill after severe stroke, slow training targeting discrete movement may yield greater benefit than fast training.

Cited by 22 publications

References 54 publications

Getting the Best Out of Advanced Rehabilitation Technology for the Lower Limbs: Minding Motor Learning Principles

Getting the Best Out of Advanced Rehabilitation Technology for the Lower Limbs: Minding Motor Learning Principles

The effect of rehabilitation interventions on physical function and immobility-related complications in severe stroke: a systematic review

Clinical non-superiority of technology-assisted gait training with body weight support in patients with subacute stroke: A meta-analysis

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