Effect of Stride Management Assist Gait Training for Poststroke Hemiplegia: A Single Center, Open-Label, Randomized Controlled Trial

Abstract

Background: Poststroke gait disorders negatively impact activities of daily living. Rehabilitation for stroke patients is aimed at improving their walking ability, balance, and quality of life. Robot-assisted gait training (RAGT) is associated with an increased number of task-specific exercises, which may benefit poststroke motor learning. We investigated the effects of RAGT using Stride Management Assist (SMA, which increases walk ratio by inducing hip-joint flexion and extension) in subacute stroke patients with hemiplegia. Methods: We conducted a single center, open-label randomized controlled trial in hemiplegia patients who experienced a first ever stroke and were admitted to the convalescent rehabilitation ward. A total of 41 were divided into the control (20 patients) and experimental group (21 patients). A 10-day, conventional gait training program was carried out for the control group; and RAGT with SMA was used for the experimental group. The maximum walking speed and other gait parameters were compared preintervention and postintervention. The intergroup differences in the improvement ratio were compared using an intention-to-treat analysis. Results: Ten-day intervention was completed by 36 patients. There was no difference between the 2 groups regarding gait parameters at intervention initiation. The improvement ratio of the maximum walking speed was significantly higher for the experimental group. Significant improvements were observed postintervention for maximum walking speed, paralysis-side step length, symmetry, and cadence in the experimental group. No adverse events attributable to the SMA were observed. Conclusions: Ten days of RAGT with the SMA was effective for improving gait disorders of subacute stroke patients.

Gait improvements by assisting hip movements with the robot in children with cerebral palsy: a pilot randomized controlled trial

“…The RAGT induced the expansion of hip joint angles on the affected side. These results are consistent with the results of previous studies that have reported the increase of the limb symmetry after the intervention with the HWA [9]. These previous studies recruited individuals with the first stroke, who mostly have only one leg paralyzed.…”

“…Despite the significant changes in gait kinematics and kinetics, there was no significant change in gait speed. This result is inconsistent with some previous studies which have reported a significant change in maximum walking speed of stroke individuals after 10-day intervention [9]. This inconsistency may be due to the slow treadmill speed settings because the HWA could not produce the assistive torques to the gait with a high pitch.…”

“…A previous study reported that the HWA was effective for reducing energy expenditure in healthy young adults [7]. Additionally, the HWA was able to increase the symmetry of hip movements [8] and paretic step length [9] in stroke individuals. Furthermore, chronic stroke individuals were able to improve walking endurance and increase steps in daily life activity in comparison to functional gait training [10].…”

“…Honda Walking Assist (HWA) [7][8][9][10] is a mobile exoskeleton type of robot that assists hip flexion and extension of both limbs during gait, developed by Honda R&D Co., Ltd. The HWA assists only a single joint and does not limit the degree of freedom on other joints, which would be effective for sufficient locomotor learning.…”

Gait training using the Honda Walking Assist Device® for individuals with transfemoral amputation: A report of two cases

“…Although the HWA has previously been used as a means of gait training for individuals with stroke [12,13], there is no study, to the best of our knowledge, that has used the HWA to improve the gait of amputees, i.e., the safety and feasibility of the HWA are unknown in TF amputees who have problems with stump shortness, socket-thigh cuff interference, and high susceptibility to skin problems. In this study, we investigated the safety, feasibility, and efficacy of gait training using the HWA in two amputees.…”