Effects of gait training with the Hybrid Assistive Limb on gait ability in stroke patients: A systematic review of randomized controlled trials

Taki, Shingo; Iwamoto, Yoshiki; Imura, Takeshi; Mitsutake, Tsubasa; Tanaka, Ryo

doi:10.1016/j.jocn.2022.04.001

Cited by 3 publications

(4 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, to the previously described scenarios, the WPE-assisted gait is characterized by greater hip flexion during the swing phase and no-knee flexion during the loading response phase. weight suspension) [17,[31][32][33]. In our study, gait kinematics in real-life outdoor scenarios (regular terrain, irregular terrains, and slopes) were analyzed by comparing ecological gait and WPE-assisted gait in five healthy volunteers.…”

Section: Resultsmentioning

confidence: 99%

“…In this context, Wearable Powered Exoskeletons (WPEs) could be valuable complementary rehabilitation devices, as they emulate overground human neuromotor control of locomotion, allowing early, intensive, and specific gait training even in individuals unable to maintain the upright position [9]. The efficacy of WPE-assisted gait training to improve motor and functional outcomes in stroke patients is well established in the literature [10][11][12][13][14][15][16][17][18], although the neurophysiological effects have not yet been adequately studied [19][20][21][22]. The relevance of WPEs for stroke patients is not only related to their effect on gait rehabilitation, but also to the possibility of using them as an assistive technology for walking in the community or at home settings [23].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Kinematic Analysis of Exoskeleton-Assisted Community Ambulation: An Observational Study in Outdoor Real-Life Scenarios

Goffredo

Romano

Infarinato

et al. 2022

Sensors

View full text Add to dashboard Cite

(1) Background: In neurorehabilitation, Wearable Powered Exoskeletons (WPEs) enable intensive gait training even in individuals who are unable to maintain an upright position. The importance of WPEs is not only related to their impact on walking recovery, but also to the possibility of using them as assistive technology; however, WPE-assisted community ambulation has rarely been studied in terms of walking performance in real-life scenarios. (2) Methods: This study proposes the integration of an Inertial Measurement Unit (IMU) system to analyze gait kinematics during real-life outdoor scenarios (regular, irregular terrains, and slopes) by comparing the ecological gait (no-WPE condition) and WPE-assisted gait in five able-bodied volunteers. The temporal parameters of gait and joint angles were calculated from data collected by a network of seven IMUs. (3) Results: The results showed that the WPE-assisted gait had less knee flexion in the stance phase and greater hip flexion in the swing phase. The different scenarios did not change the human–exoskeleton interaction: only the low-speed WPE-assisted gait was characterized by a longer double support phase. (4) Conclusions: The proposed IMU-based gait assessment protocol enabled quantification of the human–exoskeleton interaction in terms of gait kinematics and paved the way for the study of WPE-assisted community ambulation in stroke patients.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Kinematic Analysis of Exoskeleton-Assisted Community Ambulation: An Observational Study in Outdoor Real-Life Scenarios

Goffredo

Romano

Infarinato

et al. 2022

Sensors

View full text Add to dashboard Cite

show abstract

“…Improvement of walking ability is one of the crucial rehabilitation goals for patients with hemiplegic stroke, and several studies have used improvement of walking ability as an outcome [1][2][3]. Robotic-assisted overground gait training and increasing the training time for treadmill-walking practice by wearable robot improved walking ability compared with a control [4,5].…”

Section: Introductionmentioning

confidence: 99%

Gait training with a safety suspension device accelerates the achievement of supervision level walking in subacute stroke: a randomized controlled trial

Kawakami,

Miyasaka,

Hioki

et al. 2024

International Journal of Rehabilitation Research

View full text Add to dashboard Cite

Practicing walking in a safety suspension device allows patients to move freely and without excessive reliance on a therapist, which requires correcting errors and may facilitate motor learning. This opens the possibility that patients with subacute stroke may improve their walking ability more rapidly. Therefore, we tested the hypothesis that overground gait training in a safety suspension device will result in achieving faster supervision-level walking than gait training without the suspension device. Twenty-seven patients with stroke admitted to the rehabilitation ward with functional ambulation categories (FAC) score of 2 at admission were randomly allocated to safety suspension-device group (SS group) or conventional assisted-gait training group (control group). In addition to regular physical therapy, each group underwent additional gait training for 60 min a day, 5 days a week for 4 weeks. We counted the days until reaching a FAC score of 3 and assessed the probability using Cox regression models. The median days required to reach a FAC score of 3 were 7 days for the SS group and 17.5 days for the control group, which was significantly different between the groups (P < 0.05). The SS group had a higher probability of reaching a FAC score of 3 after adjusting for age and admission motor impairment (hazard ratio = 3.61, 95% confidence interval = 1.40–9.33, P < 0.01). The gait training with a safety suspension device accelerates reaching the supervision-level walking during inpatient rehabilitation. We speculate that a safety suspension device facilitated learning by allowing errors to be experienced and correct in a safe environment.

show abstract

“…A systematic review of current guidelines on robotic-assisted gait rehabilitation after stroke states that future guidelines should focus on identifying the characteristics of patients who may better benefit from a specific robotic device (Morone et al, 2017 ). In addition, a systematic review of effects of gait training with HAL reported no strong evidence supporting the effectiveness of HAL in improving the walking ability owing to differing patient characteristics (Taki et al, 2022 ). Therefore, identifying the characteristics of patients who have difficulty gaining benefits from gait training with HAL is crucial, as it provides criteria for clinical decision-making, including the arrangement of individual rehabilitation programs, early discharge planning and guideline development.…”

Section: Introductionmentioning

confidence: 99%

Identifying the characteristics of patients with stroke who have difficulty benefiting from gait training with the hybrid assistive limb: a retrospective cohort study

Taki,

Imura,

Mitsutake

et al. 2024

Front. Neurorobot.

Self Cite

View full text Add to dashboard Cite

Robot-assisted gait training is effective for walking independence in stroke rehabilitation, the hybrid assistive limb (HAL) is an example. However, gait training with HAL may not be effective for everyone, and it is not clear who is not expected to benefit. Therefore, we aimed to identify the characteristics of stroke patients who have difficulty gaining benefits from gait training with HAL. We conducted a single-institutional retrospective cohort study. The participants were 82 stroke patients who had received gait training with HAL during hospitalization. The dependent variable was the functional ambulation category (FAC) that a measure of gait independence in stroke patients, and five independent [age, National Institutes of Health Stroke Scale, Brunnstrom recovery stage (BRS), days from stroke onset, and functional independence measure total score (cognitive items)] variables were selected from previous studies and analyzed by logistic regression analysis. We evaluated the validity of logistic regression analysis by using several indicators, such as the area under the curve (AUC), and a confusion matrix. Age, days from stroke onset to HAL initiation, and BRS were identified as factors that significantly influenced walking independence through gait training with HAL. The AUC was 0.86. Furthermore, after building a confusion matrix, the calculated binary accuracy, sensitivity (recall), and specificity were 0.80, 0.80, and 0.81, respectively, indicated high accuracy. Our findings confirmed that older age, greater degree of paralysis, and delayed initiation of HAL-assisted training after stroke onset were associated with increased likelihood of walking dependence upon hospital discharge.

show abstract

Effects of gait training with the Hybrid Assistive Limb on gait ability in stroke patients: A systematic review of randomized controlled trials

Cited by 3 publications

References 33 publications

Kinematic Analysis of Exoskeleton-Assisted Community Ambulation: An Observational Study in Outdoor Real-Life Scenarios

Kinematic Analysis of Exoskeleton-Assisted Community Ambulation: An Observational Study in Outdoor Real-Life Scenarios

Gait training with a safety suspension device accelerates the achievement of supervision level walking in subacute stroke: a randomized controlled trial

Identifying the characteristics of patients with stroke who have difficulty benefiting from gait training with the hybrid assistive limb: a retrospective cohort study

Contact Info

Product

Resources

About