The Effectiveness of Body Weight-Supported Gait Training and Floor Walking in Patients With Chronic Stroke

Peurala, Sinikka H.; Tarkka, Ina M.; Pitkänen, Kauko; Sivenius, Juhani

doi:10.1016/j.apmr.2005.02.005

Cited by 180 publications

(130 citation statements)

References 35 publications

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“…Further, observed differences between LT groups were consistent with published results. Separate laboratories have reported mean changes in walking speed of Յ0.07 m/s in ambulatory subjects with neurological injury over 3 to 4 weeks of robotic-assisted LT. 29,30 In contrast, previous data in stroke survivors 6,9 indicate larger changes (Ն0.15 m/s) in SSV after 4 weeks of task-specific LT. The magnitudes of these changes are comparable to those observed in the present study.…”

Section: Discussionmentioning

confidence: 58%

See 1 more Smart Citation

Enhanced Gait-Related Improvements After Therapist- Versus Robotic-Assisted Locomotor Training in Subjects With Chronic Stroke

Hornby

Campbell

Kahn

et al. 2008

Stroke

479

403

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Background and Purpose-Locomotor training (LT) using a treadmill can improve walking ability over conventional rehabilitation in individuals with hemiparesis, although the personnel requirements often necessary to provide LT may limit its application. Robotic devices that provide consistent symmetrical assistance have been developed to facilitate LT, although their effectiveness in improving locomotor ability has not been well established. Methods-Forty-eight ambulatory chronic stroke survivors stratified by severity of locomotor deficits completed a randomized controlled study on the effects of robotic-versus therapist-assisted LT. Both groups received 12 LT sessions for 30 minutes at similar speeds, with guided symmetrical locomotor assistance using a robotic orthosis versus manual facilitation from a single therapist using an assist-as-needed paradigm. Outcome measures included gait speed and symmetry, and clinical measures of activity and participation. Results-Greater improvements in speed and single limb stance time on the impaired leg were observed in subjects who received therapist-assisted LT, with larger speed improvements in those with less severe gait deficits. Perceived rating of the effects of physical limitations on quality of life improved only in subjects with severe gait deficits who received therapist-assisted LT. Conclusions-Therapist-assisted LT facilitates greater improvements in walking ability in ambulatory stroke survivors as compared to a similar dosage of robotic-assisted LT.

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Section: Discussionmentioning

confidence: 58%

“…A power analysis using estimates of gait speed improvements after robotic- 29,30 and therapist-assisted 9 LT indicated that 48 subjects (24 in each group) were required for 92% power using an unpaired comparison. Subjects were enrolled until 48 individuals completed all training sessions (on-protocol analysis).…”

Section: Subjectsmentioning

confidence: 99%

Enhanced Gait-Related Improvements After Therapist- Versus Robotic-Assisted Locomotor Training in Subjects With Chronic Stroke

Hornby

Campbell

Kahn

et al. 2008

Stroke

479

403

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“…2 The long-term disability and institutionalization of stroke sufferers pose a substantial economic burden in many countries. 3 For this reason, it is necessary further effective rehabilitation programs to improve the recovery of functional status and quality of life of individuals who have suffered a stroke.…”

Section: Introductionmentioning

confidence: 99%

Aerobic Program in Persons with Stroke: A Systematic Review

et al. 2014

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Introduction: The aim of this study was to perform a systematic review on the exercise trials post stroke. Material and Methods: Therefore, we conducted a systematic review of randomized controlled clinical trials published in PubMed and PEDro. The inclusion criteria were: Studies -randomized or controlled clinical trials; Participants -Adults of any age with a clinical diagnosis of stroke; Interventions -any aerobic physical training aimed at improving cardiovascular capacity and/or function. Two independent reviewers categorized the selected trials, assessed methodological quality and extracted the relevant data. Various protocols were analyzed and used for both the assessment and physical training of post-stroke subjects. results:According to clinical trials analyze, a wide range of instruments were used to measure functional capacity. Ergospirometry and ergometry were found to be main devices in the assessment of cardiovascular capacity. Cycle ergometer training was the most commonly used training strategy, and conventional physiotherapy (based on stretching, strengthening, balance, coordination and gait training) was the most frequent control therapy. Discussion: Training duration ranged from 4 weeks to 6 months; the mean weekly frequency was 3 sessions per week while training intensity ranged from 40 to 80% of maximal heart rate or VO2 peak. Duration of training sessions ranged from 25 minutes to 1 hour. conclusion: Exercise training is a promising tool for the management of post-stroke patients, both in terms of improved cardiovascular and functional capacity. Further studies are needed to widen the scope of therapeutic management of this population. Treino\exercício na bicicleta ergométrica foi a estratégia de treino mais comumente usada, e fisioterapia convencional (baseada em alongamentos, fortalecimentos, treino de equilíbrio, coordenação e marcha) foi a terapia de controle mais frequente. Discussão: A duração do programa variou de 4 semanas a 6 meses, a frequência semanal média foi de três sessões por semana, enquanto que a intensidade do treinamento variou de 40 a 80% da frequência cardíaca máxima ou VO2 máximo. A duração de sessões de treino variou entre 25 minutos a 1 hora. conclusão: O treino físico é uma ferramenta promissora para o tratamento de pacientes pós-AVC, tanto em termos de melhoria da capacidade funcional e da capacidade cardiovascular. No entanto, mais estudos são necessários para ampliar a área de atuação terapêutica nesta população.

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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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The Effectiveness of Body Weight-Supported Gait Training and Floor Walking in Patients With Chronic Stroke

Cited by 180 publications

References 35 publications

Enhanced Gait-Related Improvements After Therapist- Versus Robotic-Assisted Locomotor Training in Subjects With Chronic Stroke

Enhanced Gait-Related Improvements After Therapist- Versus Robotic-Assisted Locomotor Training in Subjects With Chronic Stroke

Aerobic Program in Persons with Stroke: A Systematic Review

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

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