A Comparative Study of Conventional Physiotherapy Versus Robotic Training Combined with Physiotherapy in Patients with Stroke

Dündar, Ümit; Toktaş, Hasan; Solak, Okan; Ulaşlı, Alper Murat; Eroğlu, Selma

doi:10.1310/tsr2106-453

Cited by 64 publications

(46 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other alternative strategies for spasticity management are nonpharmacologic options such as: (1) orthopedic management (reconstructive surgery of upper extremity, soft tissue operations or bony procedures for treatment of hip deformities, and surgical correction or orthotic treatment of foot abnormalities and spine abnormalities 84–87 ); (2) selective dorsal rhizothomy (surgical resection of selected dorsal roots for reduce afferent input to the spinal reflex arc and dampen the muscle elongation 88–90 ); (3) stretching, fitting of splints/braces or serial casting, ultrasound and thermotherapy, neuromuscular electrical stimulation, muscle strengthening, or use of robotics to perform stretching and movement training 91,92 ; and others pharmacologic treatment options such as the following: (1) local injections of phenol (≥3%) or alcohol (≥50%) that induces chemical neurolysis and performed on motor nerves, which reduces the symptoms of spasticity 93 ; (2) antiepileptic drugs, such as gabapentin or pregabalin, has been used as adjunct therapies particularly when central neuropathic pain is present 94,95 ; (3) immunomodulators (interferon beta and glatiramer acetate), Sativex (agonist at cannabinoid receptors) and cannabis that have been used in some countries for treatment of spasticity only in multiple sclerosis 96–100 ; and (4) Zolpidem, a nonbenzodiazepine approved for the treatment of insomnia, for treatment of neurological complications (including spasticity after of hypoxic ischemic in brain injury). 101 Others alternative used in spasticity management is the administration of natural agents as the oil of Alpinia zerumbet , which has been used in patients with clinical diagnosis of stroke who presented spasticity.…”

Section: Clinical Relevance and Conclusionmentioning

confidence: 99%

Baclofen in the Therapeutic of Sequele of Traumatic Brain Injury: Spasticity

et al. 2016

View full text Add to dashboard Cite

Traumatic brain injury (TBI) is an alteration in brain function, caused by an external force, which may be a hit on the skull, rapid acceleration or deceleration, penetration of an object, or shock waves from an explosion. Traumatic brain injury is a major cause of morbidity and mortality worldwide, with a high prevalence rate in pediatric patients, in which treatment options are still limited, not available at present neuroprotective drugs. Although the therapeutic management of these patients is varied and dependent on the severity of the injury, general techniques of drug types are handled, as well as physical and surgical. Baclofen is a muscle relaxant used to treat spasticity and improve mobility in patients with spinal cord injuries, relieving pain and muscle stiffness. Pharmacological support with baclofen is contradictory, because disruption of its oral administration may cause increased muscle tone syndrome and muscle spasm, prolonged seizures, hyperthermia, dysesthesia, hallucinations, or even multisystem organ failure. Combined treatments must consider the pathophysiology of broader alterations than only excitation/inhibition context, allowing the patient's reintegration with the greatest functionality.

show abstract

Section: Clinical Relevance and Conclusionmentioning

confidence: 99%

Baclofen in the Therapeutic of Sequele of Traumatic Brain Injury: Spasticity

et al. 2016

View full text Add to dashboard Cite

show abstract

“…There is sufficient evidence showing that the Locomat training provided better improvement in terms of independent walking ability, walking speed, balance and disability than conventional physiotherapy to people with stroke [23][24][25][26][27][28]. There is also evidence that Locomat training significantly improved the duration of single stance phase, step length ratio on the paretic leg when walking on the ground [29,30].…”

Section: Introductionmentioning

confidence: 99%

Effects of bodyweight support and guidance force on muscle activation during Locomat walking in people with stroke: a cross-sectional study

Lin

Ran

et al. 2020

J NeuroEngineering Rehabil

View full text Add to dashboard Cite

Background: Locomat is a robotic exoskeleton providing guidance force and bodyweight support to facilitate intensive walking training for people with stroke. Although the Locomat has been reported to be effective in improving walking performance, the effects of training parameters on the neuromuscular control remain unclear. This study aimed to compare the muscle activities between Locomat walking and treadmill walking at a normal speed, as well as to investigate the effects of varying bodyweight support and guidance force on muscle activation patterns during Locomat walking in people with stroke. Methods: A cross-sectional study design was employed. Participants first performed an unrestrained walking on a treadmill and then walked in the Locomat with different levels of bodyweight support (30% or 50%) and guidance force (40% or 70%) at the same speed (1.2 m/s). Surface electromyography (sEMG) of seven muscles of the affected leg was recorded. The sEMG envelope was time-normalised and averaged over gait cycles. Mean sEMG amplitude was then calculated by normalising the sEMG amplitude with respect to the peak amplitude during treadmill walking for statistical analysis. A series of Non-parametric test and post hoc analysis were performed with a significance level of 0.05. Results: Fourteen participants with stroke were recruited at the Yangzhi Affiliated Rehabilitation Hospital of Tongji University (female n = 1; mean age 46.1 ± 11.1 years). Only the mean sEMG amplitude of vastus medialis oblique during Locomat walking (50% bodyweight support and 70% guidance force) was significantly lower than that during treadmill walking. Reducing both bodyweight and guidance increased muscle activity of gluteus medius and tibialis anterior. Activity of vastus medialis oblique muscle increased as bodyweight support reduced, while that of rectus femoris increased as guidance force decreased. Conclusions: The effects of Locomat on reducing muscle activity in people with stroke were minimized when walking at a normal speed. Reducing bodyweight support and guidance force increased the activity of specific muscles during Locomat walking. Effects of bodyweight support, guidance force and speed should be taken into account when developing individualized Locomat training protocols for clients with stroke.

show abstract

“…that also serve as assessment devices. Patients with severe stroke may require the assistance of a passive or active rehabilitation robot providing upper limb (Krebs et al, 2004;Oblak et al, 2010) or lower limb support (Chen et al, 2002;Dundar et al, 2014;Meuleman et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Multi-Exergames to Set Targets and Supplement the Intensified Conventional Balance Training in Patients With Stroke: A Randomized Pilot Trial

et al. 2020

View full text Add to dashboard Cite

People who survive a stroke usually suffer movement disorders resulting in involuntary abnormal movements. Intensive and repetitive physiotherapy is often a key to functional restoration of movements. Rehabilitation centers have recently offered balance training supported by exergames in addition to conventional therapy. The primary objective was to investigate different types of balance training (multi-exergaming and conventional) in addition to a conventional 6-week physiotherapy program. Furthermore, we examined the choice of an appropriate exergame to target balance training. We designed a randomized pilot trial. Hospital inpatients with stroke aged 33-65 were recruited and randomized into 2 groups by drawing lots; a control group receiving 1 week of conventional balance training and an exergaming group 1 week of multiple-game exergaming, comprising single leg exercises, weight shifting, balancing and standing up. Center of pressure was monitored for the exergaming group and clinical data were collected (non-blinded assessment) using Four Square Step Test, Timed Up and Go, 10 m Walk Test, Romberg, Sharpened Romberg, Clinical Test for Sensory Interaction in Balance in both groups. Statistical tests were used to find significant (p < 0.05) differences and Cohen's U3 for effect sizes. Recruited participants (20/30) met the inclusion criteria and were randomized; 10 per group. 1 participant of the exergaming group was excluded from center of pressure analysis. Both groups demonstrated substantively and statistically significant improvements of functional balance, in particular the exergaming group (FSST p = 0.009, U3 = 0.9 and 10 MWT p = 0.008, U3 = 0.9). However, significant differences between the groups were found in tests with eyes closed, Sharpened Romberg test (p = 0.05) and standing on the right leg (p = 0.035). The center of pressure area decreased up to 20% for the exergaming group. Both types of additional balance training demonstrated comparable outcomes, however, the multi-exergaming could target specific motor control disorders by the selection of exergames according to Gentile's taxonomy. We may not prioritize exergaming due to the low statistical power of clinical outcomes. However, exergaming Frontiers in Psychology | www.frontiersin.org April 2020 | Volume 11 | Article 572 Cikajlo et al.Multiple Exergaming Platform enables independent balance training, which is feasible without strenuous physiotherapy and may thus be crucial for future home or telerehabilitation services.Clinical Trial Registration: www.clinicaltrials.gov/, identifier NCT03282968.

show abstract

A Comparative Study of Conventional Physiotherapy Versus Robotic Training Combined with Physiotherapy in Patients with Stroke

Abstract: RT combined with CP produced better improvement in FIM, MMSE, BRS lower extremity categories, and all subparts of SF-36 of the patients with subacute and chronic stroke (up to 1 year) than the CP program.

Cited by 64 publications

References 35 publications

Baclofen in the Therapeutic of Sequele of Traumatic Brain Injury: Spasticity

Baclofen in the Therapeutic of Sequele of Traumatic Brain Injury: Spasticity

Effects of bodyweight support and guidance force on muscle activation during Locomat walking in people with stroke: a cross-sectional study

Multi-Exergames to Set Targets and Supplement the Intensified Conventional Balance Training in Patients With Stroke: A Randomized Pilot Trial

Contact Info

Product

Resources

About