Category: Stroke; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
Objective : To compare the effects of exoskeleton type of robot-assisted gait training (ESRAGT) and end-effect type of robot-assisted gait training (EERAGT) in patients with stroke.
Design : Randomized controlled trial.
Setting : Rehabilitation research institute.
Participants (or Animals, Specimens, Cadavers) : Twenty-one stroke participants (18 men, 3 women; mean age ± standard deviation, 46.2 ± 10.7 years) with functional ambulation category (FAC) 3 level and ankle dorsiflexor and plantar flexor 2 or 3 score of Medical Research Council (MRC) scale were randomized into 2 robot training groups, ESRAGT group (n = 10) or EERAGT group (n = 11).
Interventions : The ESRAGT group received ESRAGT for 5 times a week for 4 weeks, provided by using LokomatⓇ robotic orthosis (Hocoma AG, Volketswil, Switzerland). The EERAGT group received EERAGT for 5 times a week for 4 weeks, provided by G-EO system device (Reha Technology AG, Olten, Switzerland).
Main Outcome Measure(s) :
The outcome measures were FAC, 10 meter walking test (10MWT), Fugl-Meyer assessment - lower extremity (FMA), Berg balance scale (BBS) and ankle joint angle. All participants were evaluated twice, before and after the 4-week intervention.
The FAC, FMA, BBS and ankle joint angle were improved after training in both the ESRAGT and EERAGT groups. However, only FMA demonstrated a significantly greater improvement in the EERAGT group than in the ESRAGT group. The 10MWT between pre- and post-test significantly increased in the ESRAGT group, but there was no significant difference between the ESRAGT and EERAGT groups
Conclusions : Our results showed that two types of ESRAGT and EERAGT improved gait independent level, lower extremities motor function, and balance in patient with stroke. Especially, in lower extremities motor function, EERAGT showed more effective than ESRAGT.
Hayeon Kim– Researcher, National Rehabilitation Center, Ministry of Health and Welfare, Republic of Korea, Seoul, Seoul-t'ukpyolsi
Dohoon Koo– Researcher, National Rehabilitation Research Institute, Seoul, Seoul-t'ukpyolsi
Sungphil Yang– Physical therapist, National Rehabilitation Center, Ministry of Health and Welfare, Republic of Korea, Seoul, Seoul-t'ukpyolsi
Joon-Ho Shin– Chief of Brain Injury Rehabilitation Department, National Rehabilitation Center, Ministry of Health and Welfare, Republic of Korea, Seoul, Seoul-t'ukpyolsi