Objective: Stroke is a common, leading cause of balance and locomotor disorders that may lead to chronic physical disabilities. Almost two-thirds of stroke survivors have initial mobility deficits, and more than 30% of survivors cannot walk independently for 6 months after the onset of stroke. Thus, restoration of the gait function constitutes a major portion of stroke rehabilitation. The present clinical investigation was to ascertain whether the effects of robot-assisted locomotor training on balance, gait and motor recovery were superior or similar to the conventional locomotor training in patients with hemiparetic stroke .The purpose of this study was to confirm the effect of robot-assisted gait training on the balance and gait ability of stroke patients who were dependent ambulators.
Method: We enrolled 40 stroke-induced hemiplegic patients who can walk dependently . Of them, seventeen participants were right hemiplegic patients, and the other twenty three were left hemiplegic ones. Patients were grouped into four group. Group 1(11 patients) (figure 1) were received robot-assisted gait training with virtual reality, Group 1(12 patients) were which received the same treatments without virtual reality. Group 3 (12 patients) were received which received robot-assisted gait training with functional electrical stimulation (ankle dorsiflexion). Group 1, 2 and 3 were trained on gait assistive robots for 30 minutes followed followed by conventional physical therapy 30 minutes, 3 times a week for 4weeks Group 4 (5 patients ) received conventional physical therapy. for 1 hours per day 3 times a week for 4week.
The Berg Balance Scale, gait parameter(cadence, stride, foot rotation), attention, satisfaction, static posturography were assessed before and after the 4-week program.
Result: Cadence shows significantly improved in Group 1 and 2 with statistically significance (Paired t-test). Also stride also improved in Group 1 with statistically significance. And berg balance scale, satisfaction and attention were increased in Group 1, 2 and 3 compared group4 with statistically significance(repeated ANOVA test).
Conclusion: Robot assistive gait training shows obvious therapeutic effects that is safely applicable to hemiplegic stroke patients who are dependent ambulators
It is not only was efficacious in improving balance and gait performance but it was also verified to be conductive to improving the satisfaction and attention compared with conventional gait training. Especially robot assistive gait training with virtual reality (group1) was meaningfully improved in gait function (cadence and stride). And robot-assisted gait training with virtual reality was safe, and could be used clinically for the hemiplegic gait training. |
