Use of Robotics in Gait Rehabilitation Following Stroke: A Review

Warutkar, Vaishnavi; Dadgal, Ragini; Mangulkar, Utkarsha R

doi:10.7759/cureus.31075

Cited by 15 publications

(7 citation statements)

References 37 publications

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“…Robot-assisted gait training (RAGT) positively affects lower extremity muscle strength, gait speed, walking performance, and gait pattern in patients with central nervous system damage such as SCI or stroke [9][10][11][12][13]. The therapeutic area of robot therapy is expanding to improve the function of musculoskeletal patients who have undergone arthroplasty or burn skin grafting [14][15][16].…”

Section: Ofmentioning

confidence: 99%

Clinical Utility of Robot-Assisted Gait Training in Patients with Spinal Cord Injury Caused by Electrical Burns: A Case Report

Lee,

Seo,

Cho

et al. 2023

JCM

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Robot-assisted gait training (RAGT) has been proven effective in improving gait function in not only patients with central nervous system damage, but also in patients who have undergone musculoskeletal surgery. Nevertheless, evidence supporting the efficacy of such training in burn patients remains insufficient. This report aimed to evaluate the effect of RAGT in burn patients with spinal cord injuries (SCI) caused by electrical trauma. We reported a case of two patients. The total duration of each session was about 1 h 30 min. This included 10 min to put on the exoskeleton, 30 min of robot-assisted training using SUBAR®, 10 min to remove the exoskeleton, 10 min to observe whether complications such as skin abrasion, ulcer, or pain occur in the scar area after RAGT, and 30 min of conventional physiotherapy, at a rate of 5 days a week for 12 weeks. All measurements were assessed before training (0 week) and after training (12 weeks). The American Spinal Cord Injury Association (ASIA) lower extremity motor score (LEMS), passive range of motions (ROMs) of different joints (hip, knee, and ankle), ambulatory motor index (AMI), functional ambulation categories (FAC), and 6 min walking (6 MWT) distances were evaluated to measure the degree of gait function through training. In both patients, manual muscle test measurement and joint ROM in the lower extremities improved after 12 weeks training. The first patient scored 0 in the FAC before training. After 12 weeks of training, he could walk independently indoors, improving to an FAC score of 4. He also reached 92.16 m in the 6 MWT. LEMS improved from 22 before training to 30 after training, and AMI score improved from 12 before training to 16 after training. In the second patient, an independent walking function was not acquired. LEMS improved from 10 before training to 26 after training. AMI scores were the same at 10 points before and after training. The results suggested the possibility of achieving clinical effects in terms of improving lower extremity muscle strength, joint ROMs, and gait performance in patients with SCI caused by electrical trauma.

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Section: Ofmentioning

confidence: 99%

Clinical Utility of Robot-Assisted Gait Training in Patients with Spinal Cord Injury Caused by Electrical Burns: A Case Report

Lee,

Seo,

Cho

et al. 2023

JCM

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“…Thus, they enable the stimulation of non-walking people with a “real” sensomotor stimulus associated with gait activity [ 19 ]. In addition, using robotic systems, it is possible to measure individual kinematic parameters during walking, which allows a more objective assessment of the patient’s progress in therapy [ 20 ]. This is particularly important from the perspective of the reliability of the tools available to assess gait in stroke patients.…”

Section: Introductionmentioning

confidence: 99%

Enhanced Rehabilitation Outcomes of Robotic-Assisted Gait Training with EksoNR Lower Extremity Exoskeleton in 19 Stroke Patients

Wiśniowska-Szurlej,

Wołoszyn,

Brożonowicz

et al. 2023

Med Sci Monit

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Background Stroke is a leading cause of long-term disability, often resulting in impaired mobility and gait abnormalities, necessitating effective rehabilitation approaches. Robotic-assisted gait training (RAGT) offers precise control and intensive, task-specific training. The EksoNR exoskeleton shows potential in facilitating gait recovery. This study assesses the efficacy and tolerability of RAGT using EksoNR in the rehabilitation of 19 stroke patients. Material/Methods A prospective nonrandomized, observational study design was employed with a single group convenience sample. The study included 19 individuals post-stroke, who underwent a 4-week rehabilitation program. Baseline and post-rehabilitation assessments were conducted using selected International Classification of Functioning, Disability and Health (ICF) codes, gait exoskeleton parameters (number of steps, walking time, time of verticalization) obtained during the exoskeleton sessions, and the Timed Up and Go Test (TUG). Results The study revealed statistically significant improvements in all analyzed ICF categories, except for D530 Toileting, indicating enhanced functioning. The most notable improvements in activity and participation were observed in the categories of D410 Changing basic body position (−0.84±0.60) and D450 Walking (−0.84±0.60). Additionally, gait analysis demonstrated significant enhancements in the number of steps (difference of 506.79±252.49), walking time (13.02±7.91), and time of verticalization (11.82±9.21) (p>0.001). The TUG test also showed a statistically significant improvement in mobility (p=0.005). Conclusions This study supports previous findings, demonstrating that RAGT using the EksoNR lower extremity exoskeleton improves gait and functional status in stroke patients, while being well tolerated. The results highlight the potential of this approach for improved rehabilitation outcomes.

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“…Stroke survivors may experience muscle weakness, abnormal muscle tone and movement patterns, asymmetric body balance, and difficulty in walking and balance. Moreover, there may be deficits in the ability to transfer weight, resulting in disability, extremity dysfunction, and difficulty in attaining dynamic postures such as walking and exercising (2, 3).…”

Section: Introductionmentioning

confidence: 99%

Effect of real-time feedback-based core stabilization training using a sling on balance and gait in patients with stroke: Randomized Controlled Trial

Yoo,

An,

Lee

2023

Preprint

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BackgroundBalance impairments commonly occur in patients after stroke. Research is warranted to improve the efficiency of rehabilitation by combining core stabilization training, such as trunk exercises, and real-time feedback. This study aimed to evaluate the effect of real-time feedback-based core stabilization training (RFCST) using a sling on the dynamic balance and gait of patients with stroke.MethodsThirty-eight patients with stroke were randomly assigned to either RFCST using a sling group (n=19) or a control group (n=19). Each group was trained for 30 min daily, 3 times a week for 4 weeks. The Trunk Impairment Scale (TIS), Functional Reach Test (FRT), Postural Assessment Scale for Stroke (PASS), Timed Up and Go (TUG) test, and gait parameters were assessed using the GAITRite system before and after the intervention.ResultsThe results showed a significant interaction between Group*Time effect F(1, 36)= 36.068,p<0.001, η²p= 0.5 in TIS; F(1, 36)= 63.890,p<0.001, η²p= 0.640 in FRT; F(1, 36)= 89.283,p<0.001, η²p= 0.713 in PASS, F(1, 36)= 150.893,p<0.001, η²p= 0.807 in TUG; F(1, 36)= 27.275,p<0.001, η²p= 0.431 in gait velocity; F(1, 36)= 54.401,p<0.001, η²p= 0.447 in cadence; F(1, 36)= 5.601,p=0.023, η²p= 0.135 in step length; F(1, 36)= 22.559,p<0.001, η²p= 0.385 in stride length; F(1, 36)= 15.516,p<0.001, η²p= 0.301 in swing phase rate; and F(1, 36)= 28.451,p<0.001, η²p= 0.441 in stance phase rate.ConclusionBased on these results, it can be concluded that RFCST using a sling can improve dynamic balance and gait parameters in patients with stroke.

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Use of Robotics in Gait Rehabilitation Following Stroke: A Review

Cited by 15 publications

References 37 publications

Clinical Utility of Robot-Assisted Gait Training in Patients with Spinal Cord Injury Caused by Electrical Burns: A Case Report

Clinical Utility of Robot-Assisted Gait Training in Patients with Spinal Cord Injury Caused by Electrical Burns: A Case Report

Enhanced Rehabilitation Outcomes of Robotic-Assisted Gait Training with EksoNR Lower Extremity Exoskeleton in 19 Stroke Patients

Effect of real-time feedback-based core stabilization training using a sling on balance and gait in patients with stroke: Randomized Controlled Trial

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