Plantar Pressure Distribution During Robotic-Assisted Gait in Post-stroke Hemiplegic Patients

Yang, Jae Mo; Ahn, Na El; Kim, Dae Hyun; Kim, Deog Young

doi:10.5535/arm.2014.38.2.145

Cited by 15 publications

(11 citation statements)

References 25 publications

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“…Secondly, we must take into account the small sample size of our healthy volunteers and their young age (mean: 25 ± 4 years), which also had no gait pathologies. Thus, RA guidance of gait movement might have different effects in elderly subjects or patients who are not able to walk without restrictions [96]. Therefore, the findings from our study are difficult to apply to other age or patient groups, as neurological patients often suffer from movement disorders and therefore use different control strategies during RAW.…”

Section: Discussionmentioning

confidence: 97%

Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people

Berger

Horst

Steinberg

et al. 2019

J NeuroEngineering Rehabil

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BackgroundGait disorders are major symptoms of neurological diseases affecting the quality of life. Interventions that restore walking and allow patients to maintain safe and independent mobility are essential. Robot-assisted gait training (RAGT) proved to be a promising treatment for restoring and improving the ability to walk. Due to heterogenuous study designs and fragmentary knowlegde about the neural correlates associated with RAGT and the relation to motor recovery, guidelines for an individually optimized therapy can hardly be derived. To optimize robotic rehabilitation, it is crucial to understand how robotic assistance affect locomotor control and its underlying brain activity. Thus, this study aimed to investigate the effects of robotic assistance (RA) during treadmill walking (TW) on cortical activity and the relationship between RA-related changes of cortical activity and biomechanical gait characteristics.MethodsTwelve healthy, right-handed volunteers (9 females; M = 25 ± 4 years) performed unassisted walking (UAW) and robot-assisted walking (RAW) trials on a treadmill, at 2.8 km/h, in a randomized, within-subject design. Ground reaction forces (GRFs) provided information regarding the individual gait patterns, while brain activity was examined by measuring cerebral hemodynamic changes in brain regions associated with the cortical locomotor network, including the sensorimotor cortex (SMC), premotor cortex (PMC) and supplementary motor area (SMA), using functional near-infrared spectroscopy (fNIRS).ResultsA statistically significant increase in brain activity was observed in the SMC compared with the PMC and SMA (p < 0.05), and a classical double bump in the vertical GRF was observed during both UAW and RAW throughout the stance phase. However, intraindividual gait variability increased significantly with RA and was correlated with increased brain activity in the SMC (p = 0.05; r = 0.57).ConclusionsOn the one hand, robotic guidance could generate sensory feedback that promotes active participation, leading to increased gait variability and somatosensory brain activity. On the other hand, changes in brain activity and biomechanical gait characteristics may also be due to the sensory feedback of the robot, which disrupts the cortical network of automated walking in healthy individuals. More comprehensive neurophysiological studies both in laboratory and in clinical settings are necessary to investigate the entire brain network associated with RAW.

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Section: Discussionmentioning

confidence: 97%

Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people

Berger

Horst

Steinberg

et al. 2019

J NeuroEngineering Rehabil

View full text Add to dashboard Cite

show abstract

“…Furthermore, ankle immobilization by ankle straps has been reported to limit gait improvement [7]. Therefore, RAG training does not increase walking speed more than overground gait training and other forms of physiotherapy, but their effects on walking distance are not clear [17].…”

Section: Discussionmentioning

confidence: 99%

“…To analyze the effects of the RAG on gait improvement, differences in foot pressure distribution during walking between RAG training and BWSTT were studied [16]. It was also found that BWSTT and RAG training do not increase walking speed more than overground gait training and other forms of physiotherapy, but their effects on walking distance are not clear [17]. Therefore, almost no research has been conducted to determine the differences in gait between the RAG condition, which moves by active assist under the help of a robot, and the active independent over-ground gait (IOGG) condition.…”

Section: Introductionmentioning

confidence: 99%

Different Effects of Robot-Assisted Gait and Independent Over-Ground Gait on Foot Plantar Pressure in Incomplete Spinal Cord Injury: A Preliminary Study

Bae

Chang

Fong

2021

IJERPH

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Background: There is insufficient evidence to establish the optimal treatment protocol for robot-assisted gait training. Objective: This study aimed to analyze the effects of robot-assisted gait and independent over-ground gait on foot pressure and to determine an effective training protocol for improvement of gait pattern in patients with incomplete spinal cord injury due to industrial accidents. Methods: Four patients with incomplete spinal cord injury due to an industrial accident who had gait disturbance underwent measurement of peak foot pressure and stance phase duration using a foot pressure analysis system with robot-assisted gait and independent over-ground gait. Results: The robot-assisted gait condition has lower peak foot pressure and shorter stance phase duration than the independent over-ground gait. Conclusions: In this study, robot-assisted gait was found to limit gait pattern improvement in patients with gait disturbance caused by incomplete spinal cord injury due to industrial accidents. Therefore, future research will be conducted to determine the optimal protocol for robot-assisted gait training for gait pattern improvement.

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“…Therefore, we think the experimental group’s gait improved in comparison to the control group because the training used an ankle strategy to distribute weight evenly between the left and right side and to displace the COP laterally, and antero/posteriorly increased the COP displacement lengths that had been shortened. Yang et al 18 ) reported that patients with hemiplegia due to stroke showed improvement in their gait index after gait training using robots. In that study, the patients’ COP displacement increased a finding that is similar to the results obtained in the present study.…”

Section: Discussionmentioning

confidence: 99%

The effects of symmetric center of pressure displacement training with feedback on the gait of stroke patients

Kim

2015

J Phys Ther Sci

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[Purpose] This study investigated the effects of COP displacement training using visual feedback had on the gait of patients with hemiplegia due to stroke. [Subjects and Methods] This study was conducted with 20 patients with hemiplegia due to stroke. The training consisted of five training sets repeated 10 times and the activity was conducted for 15 minutes each session, three times per week for six weeks immediately after completion of central nervous system developmental treatment. [Results] A comparison of the results of before and after the experiment found that the COP displacement training group showed significant improvements in step length, stride length, gait velocity, and the functional reach test, while the control group showed significant improvement only in the functional reach test. In the intergroup comparison, the COP displacement training group showed significant improvements in paretic side step length, paretic side stride length, gait velocity, and the functional reach test compared to the control group. [Conclusion] In conclusion, according to the results of this study, visual feedback training for COP displacement is more effective at enhancing the gait and balance of hemiplegic patients due to stroke than only performing feedback training for even weight distribution.

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Plantar Pressure Distribution During Robotic-Assisted Gait in Post-stroke Hemiplegic Patients

Cited by 15 publications

References 25 publications

Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people

Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people

Different Effects of Robot-Assisted Gait and Independent Over-Ground Gait on Foot Plantar Pressure in Incomplete Spinal Cord Injury: A Preliminary Study

The effects of symmetric center of pressure displacement training with feedback on the gait of stroke patients

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