Category: Stroke; Technology (e.g. robotics, assistive technology, mHealth)
To examine functional outcomes of people with stroke in response to robotic exoskeleton gait training (RGT).
Design : Retrospective matched case-control
Setting : Inpatient Rehabilitation Facility
Participants (or Animals, Specimens, Cadavers) :
Medical records were reviewed between 2015-2018 and 44 stroke patients were identified who had completed RGT. 52 case control patients were then identified by matching on criteria including gait FIM score < 4, age 18-100 years, meets exoskeleton manufactured eligibility criteria, stroke diagnosis, and participating in usual care (UC) only (e.g., body-weight support treadmill, overground gait training).
Interventions : Robotic exoskeleton gait training and usual care interventions.
Main Outcome Measure(s) :
The Stroke Rehabilitation Assessment of Movement Measure (STREAM), assesses upper and lower limb motor function as well as basic mobility and FIM-motor were collected at initial RGT evaluation and discharge. Patient demographics were collected including age, stroke severity (NIH Stroke Scale), time since stroke, length of stay.
Results : Significant differences were observed for both RGT and UC groups on STREAM (p54.7±13.2 years), more severely involved (NIHSS=28.2±34), admitted later to rehabilitation after stroke (17.5 days) with longer length of stay (40.2±14.7 days) than their UC counterpart (n=52, 64.0±14.8 years, NIHSS=9.7±7.3, 9 days, and 31.9±15.1 days, respectively) while demonstrating similar change scores on STREAM (RGT=14.2±14.8, UC=13.8±11.9, p=0.918) and FIM-motor (RGT=18.5±9, UC=20.9±9.8, p=0.318)
Conclusions : Data suggests that RGT for people with stroke during inpatient rehabilitation results in similar clinical outcomes as UC. RGT may provide therapists with a new intervention option for patients who have had more severe stroke.
Molly Trammell– Physical Therapy Supervisor, Baylor Scott and White Institute for Rehabilitation Dallas Texas, Frisco, Texas
Chad Swank– Research Scientist, Baylor Scott & White Institute for Rehabilitation, Dallas, Texas
Kara Patterson– Clinical Specialist, Baylor Scott and White Institute for Rehabilitation, Dallas, Texas
Monica Bennett– Statistician, Baylor Scott and White Health, Dallas, Texas
Christa Ochoa– Research Analyst I, Baylor Scott and White Health, Dallas, Texas
Librada Callender– Epidemiologist, Baylor Scott & White Institute for Rehabilitation, Dallas, Texas
Charles Ellis– Therapy Coordinator, Baylor Scott and White Institute for rehabilitation, Dallas, Texas