Recovery of walking ability using a robotic device in subacute stroke patients: a randomized controlled study

Abstract

These results indicate that substituting Lokomat therapy for some of conventional therapy is as effective in recovering walking ability in non-ambulatory stroke patients as conventional therapy alone. Implications for Rehabilitation Recovery of walking after stroke is important. Robot-assisted therapy is currently receiving much attention in research and rehabilitation practice as devices such as the Lokomat seem to be promising assistive devices. Technical developments, sub-optimal study designs in literature and new therapy insights warrant new effectiveness studies. RESULTS of a financially and practically feasible study indicate that substituting Lokomat therapy for some of conventional therapy is as effective in recovering walking ability in non-ambulatory stroke patients as compared to conventional overground therapy alone.

A randomized controlled study incorporating an electromechanical gait machine, the Hybrid Assistive Limb, in gait training of patients with severe limitations in walking in the subacute phase after stroke

“…However, no clear conclusion regarding a long-lasting effect of the use of electromechanical devices is provided, which is in line with the results of the present study. A closer comparison of studies included in the review [48][49][50][51][52][53][54], and additional studies [55,56] that are comparable to our study design and setting, exhibit both concordant and conflicting results.…”

Gait training in subacute non-ambulatory stroke patients using a full weight-bearing gait-assistance robot: A prospective, randomized, open, blinded-endpoint trial

“…Furthermore, Husemann et al reported no significant differences in functional score improvements between Lokomat-assisted and conventional gait training when they were combined with physiotherapy, but the Lokomat group of subacute stroke patients exhibited greater improvements in gait abnormality and body tissue composition [15]. In contrast, Van Nunen et al reported that subacute non-ambulatory stroke patients who receive 2 h and 1.5 h per week of Lokomat therapy and conventional physical therapy, respectively, experience no significant gain in walking speed or related tests during long-term follow-up [41]. Hidler et al reported that subacute ambulatory stroke patients who receive conventional gait training experience significantly greater gains in walking speed and distance than those who are trained on the Lokomat [34].…”

“…In addition to this conventional method, treadmill training with and without partial body weight support [12][13][14] and robot-assisted gait training have been reported as repetitive practices [15][16][17]34,41]. Robot-assisted gait training has been reported to be more beneficial than overground gait training in some of the studies of gait training in acute and subacute stroke patients with severe gait disturbances [15][16][17] but has also been reported to be less beneficial in other studies [34,41]. Controversies related to this issue still require clarification.…”

Effects of bodyweight support and guidance force on muscle activation during Locomat walking in people with stroke: a cross-sectional study

“…There is also evidence that Locomat training significantly improved the duration of single stance phase, step length ratio on the paretic leg when walking on the ground [29,30]. However, there are also studies showing that the Locomat was not superior to conventional therapy in people with stroke [9,30,31]. Despite the heterogeneous features of participants, the difference in training parameters of Locomat may also contribute to the controversial results.…”