Effect of hybrid assistive limb treatment on maximal walking speed and six-minute walking distance during stroke rehabilitation: a pilot study

Abstract

In stroke rehabilitation, gait assessment measures the maximal walking speed and six-minute walking distance, both of which have not been thoroughly investigated as determinants of walking ability. Here, we assessed the methods for evaluating these gait parameters using clinical data on hybrid assistive limb treatment compared with conventional training. [Participants and Methods] In total, 20 stroke patients (hybrid assistive limb group, n=9; conventional group, n=11) participated in this randomized controlled trial. For 12 sessions (three times per week in 4 weeks), the hybrid assistive limb and conventional groups performed gait treatment with hybrid assistive limb and conventional gait training, respectively. Short physical performance battery and walking ability (maximal walking speed and six-minute walking distance) were evaluated pre-and post-intervention. Subsequently, the patients were divided further into two groups: low-and high-balance score groups. [Results] Maximum walking speed and six-minute walking distance were significantly associated, with a positive relationship observed postintervention. The high-balance score group showed a significant improvement in the six-minute walking distance compared to the low-balance score group. However, no significant improvement in maximum walking speed was observed between both groups. [Conclusion] Due to its sensitivity in detecting differences in balance, six-minute walking distance may be a useful assessment parameter for stroke rehabilitation, particularly in the recovery of physiological walking ability.

Effect of robot-assisted gait training on improving cardiopulmonary function in stroke patients: a meta-analysis

“…4 (A) Forest plots of meta-analysis to evaluate the effects of robot-assisted gait training on HR peak ; (B) Forest plots of meta-analysis to evaluate the effects of robot-assisted gait training on RER peak stroke patients require higher aerobic capacity to maintain basic ADL function due to limb dysfunction [38,39]. Of the included studies, fourteen [13,[21][22][23][24][25][26][27][28][29][30][32][33][34] were available for quantitative assessment of the shortterm effect of robot-assisted gait training on 6MWT in stroke patients. There was statistically significant effect between the treatment and control groups, with an overall MD difference of 19.26.…”

“…One study only included male participants [21]. In the control group, one study used treadmill training [22], while routine gait training was reported in another eight studies [23][24][25][26][27][28][29][30], Other studies used routine rehabilitation therapy [13,14,21,[31][32][33][34][35]. Most of the subjects were in the subacute phase (two weeks to six months).…”

“…Overall, fourteen studies [13,[21][22][23][24][25][26][27][28][29][30][32][33][34] evaluated baseline data and post-treatment results of the 6MWT in 582 patients. The heterogeneity between the studies was low (I 2 = 0%, p = 0.70), and the fixed effect model was used.…”

“…2B). The funnel map analysis of 14 articles with the outcome index of 6MWT [13,[21][22][23][24][25][26][27][28][29][30][32][33][34] showed that most of the studies were at the top and that the funnel map was not very symmetrical on both sides, so there may be some risk of bias (Fig. 3).…”

“…The two investigators who assessed the risk of bias (CX and MSJ) agreed on 88% of the domains. The results of 9 studies were rated as low risk of bias [13,21,23,25,26,30,31,34,35], 4 studies were rated as some concerns [27,28,32,33], and the remaining four were rated as high risk of bias [14,22,24,29] (Fig. 5).…”