Clinical effects of robot-assisted gait training and treadmill training for Parkinson's disease. A randomized controlled trial

Capecci, Marianna; Pournajaf, Sanaz; Galafate, Daniele; Sale, Patrizio; Pera, Domenica Le; Goffredo, Michela; Pandis, Maria Francesca De; Andrenelli, Elisa; Pennacchioni, M.; Ceravolo, Maria Gabriella; Franceschini, Marco

doi:10.1016/j.rehab.2019.06.016

Cited by 58 publications

(72 citation statements)

References 36 publications

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“…In a recent systematic review and meta-analysis robotassisted gait training (RAGT) showed better outcomes than conventional interventions on some motor aspects in PD [23], and greater advantages than treadmill training for individuals with freezing of gait-related disability were observed in another study [24]. Upper limb motor performances in patients with PD were also improved after motor training aided by high technological devices [25].…”

Section: Introductionmentioning

confidence: 99%

Rehabilitation of older people with Parkinson’s disease: an innovative protocol for RCT study to evaluate the potential of robotic-based technologies

et al. 2020

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Background: Parkinson's disease is one of the most frequent causes of disability among the older adults. It is a chronic-progressive neuro-degenerative disease, characterized by several motor disorders. Balance disorders are a symptom that involves the body axis and do not respond to dopaminergic therapy used in Parkinson's disease. Therefore, physiotherapy becomes an important intervention for the management of motor disorders. Originally, these rehabilitative approaches were based on empirical experiences, but several scientific evidences suggests that neuronal plasticity is exercise-dependent. In this context, robotic rehabilitation plays an important role because it allows to perform task-oriented exercises and to increase the number of repetitions and their intensity. This protocol study aims to evaluate the effectiveness of robotic-based intervention of the older adults with Parkinson's disease, designed to improve the gait and to reduce the risk of falling. Methods: This study is a single-blinded randomized controlled trial. The primary outcomes are: risk of falling, gait performance and fear of falling measured through Performance-Oriented Mobility Assessment (POMA), instrumental gait analysis and Short Falls Efficacy Scale-International (FES-I), respectively. One hundred ninety-five patients with PD will be recruited and randomly divided into three groups, to receive a traditional rehabilitation program or a robotic rehabilitation using Tymo system or Walker View in addition to the traditional therapy. Assessments will be performed at baseline, at the end of treatment and 6 months, 1 year and 2 years from the end of the treatment. A 10-treatment session will be conducted, divided into 2 training sessions per week, for 5 weeks. The control group will perform traditional therapy sessions lasting 50 min. The technological intervention group will carry out 30 min of traditional therapy and 20 min of treatment with a robotic system. Discussion: The final goals of the present study are to propose a new approach in the PD rehabilitation, focused on the use of robotic device, and to check the results not only at the end of the treatment but also in the long term.

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Section: Introductionmentioning

confidence: 99%

Rehabilitation of older people with Parkinson’s disease: an innovative protocol for RCT study to evaluate the potential of robotic-based technologies

et al. 2020

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“…There are several reports of robot-assisted gait training (RAGT) for PD. Cappecci et al reported that RAGT significantly improved endurance, gait capacity, motor symptoms, quality of life, and freezing gait (18). In addition, Alwardat et al's meta-analysis reported that RAGT showed better outcomes than conventional interventions in some motor aspects of PD (19).…”

Section: Discussionmentioning

confidence: 99%

Biofeedback Core Exercise Using Hybrid Assistive Limb for Physical Frailty Patients With or Without Parkinson's Disease

et al. 2020

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Introduction: Elderly people often exhibit "frailty," and motor dysfunction occurs. Several studies have reported about the relationship between motor dysfunction and frailty in Parkinson's disease (PD). This study aimed to test whether the core exercise using the hybrid assistive limb lumbar type for care support (HAL-CB02) may improve the motor functions in frailty patients with or without PD and to explore the optimal patient selection from the frailty cohort. Materials and Methods: We recruited 16 frailty patients (PD = 8; non-PD = 8). The participants performed core exercise and squats using HAL-CB02 for five sessions a week. Outcome measures were 10-m walking test, step length, timed up-and-go test, 30-s chair stand test, and visual analog scale. Evaluation was conducted at baseline, post-exercise, and 1-and 3-month follow-ups. Results: Both PD and non-PD patients showed significant improvement in all evaluation items post-exercise. Moreover, no significant difference was found in the improvement value between the two groups. Conclusions: Our results suggest that biofeedback exercise with HAL-CB02 is a safe and promising treatment for frailty patients. Motor dysfunction in PD patients may be partly due to physical frailty, and biofeedback exercise with HAL-CB02 is proposed as a treatment option.

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“…In addition, the use of gait training through robotic therapy is an additional treatment opportunity for individuals with axial disorders, increasing the challenge of training by imposing specific kinematic parameters, and providing intensive and somatosensory cues. 18 Along with this, a good balance is essential for individuals with spinal cord injury (SCI) to regain their mobility and independence. 19 The GS is considered as a robot that has the end-effector feature that is through modular platforms attached to the feet of individuals, it modulates the gait in relation to speed and stride length.…”

Section: Discussionmentioning

confidence: 99%

Combined effects of physiotherapy and robotic therapy on gait balance and speed in patients with incomplete spinal cord injury

et al. 2019

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Restoring the ability to walk, especially independently, is one of the goals in the rehabilitation of patients with incomplete spinal cord injury (ISCI). The G-EO System (GS) robotic gait training acts as a reinforcer of the repetitive and specific practice of the gait phases. Objective: Investigate the combined effects of physiotherapy and robotic therapy on gait functionality in relation to balance and gait speed in patients with ISCI. Methods: Retrospective cohort study with 14 patients in the chronic phase of the disease, using the GS as a robotic intervention for gait and stairs, consisting of a 20-session protocol associated with conventional physical therapy. We used the 10-meter Walk Test (10WT) and the Berg Balance Scale (BBS). P values <0.05 were considered statistically significant using the Wilcoxon test at the beginning of conventional physical therapy and before and after intervention. Results: At the 10WT, the mean initial velocity ranged from 2.60 m/s ± 1.72 at the beginning of conventional physical therapy to 1.57 m/s ± 0.80 at the end of the 20 GS sessions with p = 0.0424. For BBS at the beginning of conventional physical therapy, the average was 31.85 points ± 12.50, and 42.35 ± 14.25 at the end of the 20 GS sessions, with p = 0.0096. Conclusions: Robotic gait therapy associated with conventional physiotherapy has been shown to be effective in promoting balance and gait speed improvement in individuals in the chronic phase after involvement of incomplete spinal cord injury.

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Clinical effects of robot-assisted gait training and treadmill training for Parkinson's disease. A randomized controlled trial

Cited by 58 publications

References 36 publications

Rehabilitation of older people with Parkinson’s disease: an innovative protocol for RCT study to evaluate the potential of robotic-based technologies

Rehabilitation of older people with Parkinson’s disease: an innovative protocol for RCT study to evaluate the potential of robotic-based technologies

Biofeedback Core Exercise Using Hybrid Assistive Limb for Physical Frailty Patients With or Without Parkinson's Disease

Combined effects of physiotherapy and robotic therapy on gait balance and speed in patients with incomplete spinal cord injury

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