Journal of Rehabilitation Research & Development (JRRD)

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Volume 49 Number 4, 2012
   Pages 613 — 622

Abstract — Robot-assisted practice of gait and stair climbing in nonambulatory stroke patients

Stefan Hesse, MD;1* Christopher Tomelleri, PhD;2 Anita Bardeleben, MA;1 Cordula Werner, MA;1 Andreas Waldner, MD2
1Department of Neurological Rehabilitation, Medical Park Berlin, Charit??-Universit??tsmedizin Berlin, Berlin, Germany; 2Department of Neurological Rehabilitation, Villa Melitta, Bolzano, Italy

Abstract–A novel gait robot enabled nonambulatory patients the repetitive practice of gait and stair climbing. Thirty nonambulatory patients with subacute stroke were allocated to two groups. During 60 min sessions every workday for 4 weeks, the experimental group received 30 min of robot training and 30 min of physiotherapy and the control group received 60 min of physiotherapy. The primary variable was gait and stair climbing ability (Functional Ambulation Categories [FAC] score 0–5); secondary variables were gait velocity, Rivermead Mobility Index (RMI), and leg strength and tone blindly assessed at onset, intervention end, and follow-up. Both groups were comparable at onset and functionally improved over time. The improvements were significantly larger in the experimental group with respect to the FAC, RMI, velocity, and leg strength during the intervention. The FAC gains (mean +/– standard deviation) were 2.4 +/– 1.2 (experimental group) and 1.2 +/– 1.5 (control group), p = 0.01. At the end of the intervention, seven experimental group patients and one control group patient had reached an FAC score of 5, indicating an ability to climb up and down one flight of stairs. At follow-up, this superior gait ability persisted. In conclusion, the therapy on the novel gait robot resulted in a superior gait and stair climbing ability in nonambulatory patients with subacute stroke; a higher training intensity was the most likely explanation. A large randomized controlled trial should follow.

Clinical Trial Registration: ClinicalTrials.gov; NCT001290611, –Robot-assisted Gait and Stair Practise–;
http://www.clinicaltrials.gov.

Keywords: gait, hemiparesis, locomotor training, mobility, physiotherapy, rehabilitation, robots, spasticity, stair climbing, stroke.


View HTML  ¦  View PDF  ¦  Contents Vol. 49, No. 4
This article and any supplementary material should be cited as follows:
Hesse S, Tomelleri C, Bardeleben A, Werner C, Waldner A. Robot-assisted practice of gait and stair climbing in nonambulatory stroke patients. J Rehabil Res Dev. 2012; 49(4):613–22.
http://dx.doi.org/10.1682/JRRD.2011.08.0142
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Last Reviewed or Updated  Wednesday, May 30, 2012 10:25 AM

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