A Review of Robot-Assisted Gait Training in Stroke Patients

Kim, Ha Yeon; You, Joshua H.

doi:10.12786/bn.2017.10.e9

Cited by 10 publications

(13 citation statements)

References 31 publications

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“…So far, results suggest that robotic therapy may be beneficial to treat acute and chronic post-stroke patients (Van der Loos et al, 2016). Nonetheless, there is no agreement on the optimal robot-assisted approaches to promote neurorecovery through plasticity mechanisms following neural injury (Kim and You, 2017;Belas dos Santos et al, 2018;Gassert, 2018;Barroso et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Haptic Adaptive Feedback to Promote Motor Learning With a Robotic Ankle Exoskeleton Integrated With a Video Game

Asín-Prieto

Martínez-Expósito

Barroso

et al. 2020

Front. Bioeng. Biotechnol.

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Background: Robotic devices have been used to rehabilitate walking function after stroke. Although results suggest that post-stroke patients benefit from this non-conventional therapy, there is no agreement on the optimal robot-assisted approaches to promote neurorecovery. Here we present a new robotic therapy protocol using a grounded exoskeleton perturbing the ankle joint based on tacit learning control. Method: Ten healthy individuals and a post-stroke patient participated in the study and were enrolled in a pilot intervention protocol that involved performance of ankle movements following different trajectories via video game visual feedback. The system autonomously modulated task difficulty according to the performance to increase the challenge. We hypothesized that motor learning throughout training sessions would lead to increased corticospinal excitability of dorsi-plantarflexor muscles. Transcranial Magnetic Stimulation was used to assess the effects on corticospinal excitability. Results: Improvements have been observed on task performance and motor outcomes in both healthy individuals and post-stroke patient case study. Tibialis Anterior corticospinal excitability increased significantly after the training; however no significant changes were observed on Soleus corticospinal excitability. Clinical scales showed functional improvements in the stroke patient. Discussion and Significance: Our findings both in neurophysiological and performance assessment suggest improved motor learning. Some limitations of the study include treatment duration and intensity, as well as the non-significant changes in corticospinal excitability obtained for Soleus. Nonetheless, results suggest that this robotic training framework is a potentially interesting approach that can be explored for gait rehabilitation in post-stroke patients.

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Section: Introductionmentioning

confidence: 99%

Haptic Adaptive Feedback to Promote Motor Learning With a Robotic Ankle Exoskeleton Integrated With a Video Game

Asín-Prieto

Martínez-Expósito

Barroso

et al. 2020

Front. Bioeng. Biotechnol.

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“…Robot-assisted gait intervention offers the advantage of high-intensity and task-specific training that can be delivered, decreasing the physiotherapist physical burden (Morone et al, 2017; Sung et al, 2017). Over the last 20 years, the robot-assisted application in neurorehabilitation has inspired clinicians and researchers in further investigating the training effects on the multifaceted aspects involved in functional recovery after neurological disorders (Morone et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, it appears to be most beneficial a mixture of different treatment for an individual patient (Pollock et al, 2014). Considering that, rehabilitation involving repetitive, high intensity, task-specific exercises is the pathway for restoring motor function after stroke (Mehrholz et al, 2013; Lo et al, 2017) robotic assistive devices for gait training have been progressively being used in neurorehabilitation to Sung et al (2017). In the current literature, three primary evidence have been reported.…”

Section: Introductionmentioning

confidence: 99%

“…Firstly, a recent literature review highlights that robot-assisted gait training is advantageous as add-on therapy in stroke rehabilitation, as it adds special therapeutic effects that could not be afforded by conventional therapy alone (Morone et al, 2017; Sung et al, 2017). Specifically, robot-assisted gait training was beneficial for improving motor recovery, gait function, and postural control in post-stroke patients (Morone et al, 2017; Sung et al, 2017). Stroke patients who received physiotherapy treatment in combination with robotic devices were more likely to reach better outcomes compared to patients who received conventional training alone (Bruni et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Robot-Assisted Stair Climbing Training on Postural Control and Sensory Integration Processes in Chronic Post-stroke Patients: A Randomized Controlled Clinical Trial

et al. 2019

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BackgroundPostural control disturbances are one of the important causes of disability in stroke patients affecting balance and mobility. The impairment of sensory input integration from visual, somatosensory and vestibular systems contributes to postural control disorders in post-stroke patients. Robot-assisted gait training may be considered a valuable tool in improving gait and postural control abnormalities.ObjectiveThe primary aim of the study was to compare the effects of robot-assisted stair climbing training against sensory integration balance training on static and dynamic balance in chronic stroke patients. The secondary aims were to compare the training effects on sensory integration processes and mobility.MethodsThis single-blind, randomized, controlled trial involved 32 chronic stroke outpatients with postural instability. The experimental group (EG, n = 16) received robot-assisted stair climbing training. The control group (n = 16) received sensory integration balance training. Training protocols lasted for 5 weeks (50 min/session, two sessions/week). Before, after, and at 1-month follow-up, a blinded rater evaluated patients using a comprehensive test battery. Primary outcome: Berg Balance Scale (BBS). Secondary outcomes:10-meter walking test, 6-min walking test, Dynamic gait index (DGI), stair climbing test (SCT) up and down, the Time Up and Go, and length of sway and sway area of the Center of Pressure (CoP) assessed using the stabilometric assessment.ResultsThere was a non-significant main effect of group on primary and secondary outcomes. A significant Time × Group interaction was measured on 6-min walking test (p = 0.013) and on posturographic outcomes (p = 0.005). Post hoc within-group analysis showed only in the EG a significant reduction of sway area and the CoP length on compliant surface in the eyes-closed and dome conditions.ConclusionPostural control disorders in patients with chronic stroke may be ameliorated by robot-assisted stair climbing training and sensory integration balance training. The robot-assisted stair climbing training contributed to improving sensorimotor integration processes on compliant surfaces. Clinical trial registration (NCT03566901).

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“…In addition, the efficacy of PWSTT depends on the therapist's level of expertise, and there are limited repetitions of the walking cycle [3]. Robotic-assisted gait training (RAGT), based on intensive repetitions of tasks, is widely used for improving stance and gait in paralyzed patients [13][14][15]. RAGT improves gait through biomechanical feedback and high-intensity repetitive walking in a real-like environment [14,15].…”

Section: Introductionmentioning

confidence: 99%

Impact of WALKBOT on the Gait and Balance Recovery of Patients with Acute Neurologic Disorders

Yun¹

2021

ujph

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This study investigated the effects of WALKBOT robotic-assisted gait training (RAGT) on lower extremity strength, functional ability, balance, and gait in patients with acute neurologic disorders. Twenty-six patients with acute hemiplegia, paraplegia, or quadriplegia resulting from cerebrovascular accident (n = 14) or spinal cord injury (n = 12) received RAGT 10-15 times over 2 weeks (up to 5 times or 20 min per day), combined with neurodevelopmental treatment. The main outcomes were pre-and post-intervention Motricity Index (MI), Berg Balance Scale (BBS), and Functional Ambulation Category (FAC). The secondary outcomes were comparison of combined pre-and post-intervention scores for all patients (spinal cord injury and cerebrovascular accident) on 14 items in the BBS. There were significant improvements in MI, BBS, and FAC scores after WALKBOT RAGT (p < .001). After WALKBOT RAGT, the BBS scores on items 1-11 increased for all patients with acute neurologic disorders (p < .05); no significant differences were observed for items 12-14 (p > .05). WALKBOT RAGT improves balance and gait in patients with acute neurologic disorders.

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A Review of Robot-Assisted Gait Training in Stroke Patients

Cited by 10 publications

References 31 publications

Haptic Adaptive Feedback to Promote Motor Learning With a Robotic Ankle Exoskeleton Integrated With a Video Game

Haptic Adaptive Feedback to Promote Motor Learning With a Robotic Ankle Exoskeleton Integrated With a Video Game

Robot-Assisted Stair Climbing Training on Postural Control and Sensory Integration Processes in Chronic Post-stroke Patients: A Randomized Controlled Clinical Trial

Impact of WALKBOT on the Gait and Balance Recovery of Patients with Acute Neurologic Disorders

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