Adjustable Parameters and the Effectiveness of Adjunct Robot-Assisted Gait Training in Individuals with Chronic Stroke

Int J Environ Res Public Health. 2022 Jul 4;19(13):8186. doi: 10.3390/ijerph19138186.

Authors

Shih-Ching Chen^{1

2}, Jiunn-Horng Kang^{1

2}, Chih-Wei Peng^{3

4}, Chih-Chao Hsu^{2

5}, Yen-Nung Lin^{6

7}, Chien-Hung Lai^{1

2

8}

Affiliations

¹ Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
² Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei 110, Taiwan.
³ School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan.
⁴ School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei 110, Taiwan.
⁵ Institute of Biomedical Engineering, National Taiwan University, Taipei 10617, Taiwan.
⁶ Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei 110, Taiwan.
⁷ Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan.
⁸ Taipei Neuroscience Institute, Taipei Medical University, Taipei 110, Taiwan.

Abstract

The aims of this study were (1) to compare the effect of robot-assisted gait orthosis (RAGO) plus conventional physiotherapy with the effect of conventional therapy alone on functional outcomes, including balance, walking ability, muscle strength, daily activity, and cognition, in chronic stroke patients, and (2) to determine the association of adjustable parameters of RAGO on functional outcomes. Adjustable parameters of RAGO included guidance force, treadmill speed, and body-weight support. This retrospective cohort study enrolled 32 patients with chronic stroke. Of these, 16 patients received RAGO plus conventional physiotherapy (RAGO group), and 16 patients received conventional physiotherapy alone (control group). Balance was assessed using the Berg Balance Scale, walking ability using the Functional Ambulation Category, muscle strength using the Motricity Index, daily activity using the Barthel Index, and cognition using the Mini-Mental State Examination. The scores were assessed before and after training. The Mini-Mental State Examination and the Berg Balance Scale increased significantly in both groups, whereas improvements in the Motricity Index and the Barthel Index were only observed in the RAGO group after intervention. During RAGO training, reducing guidance force and body-weight support assistance was associated with improvements in the Barthel Index, whereas higher treadmill walking speed was associated with improvements in the Berg Balance Scale. Our study found that RAGO combination therapy resulted in improvements in more functional outcomes than did conventional training alone. The adjustable parameters of the RAGO training were partly associated with training outcomes.

Keywords: Barthel Index; body-weight support; guidance force; motricity index; robot-assisted gait orthosis; stroke.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Exercise Therapy / methods
Gait / physiology
Humans
Retrospective Studies
Robotics* / methods
Stroke Rehabilitation* / methods
Stroke* / complications
Treatment Outcome
Walking

Grants and funding

This work was supported by the Ministry of Science and Technology (grant number MOST-108-2221-E-038-008 and MOST 110-2221-E-038-011), and Taipei Medical University Hospital (grant number 111-TMUH-MOST-04 and 110IIT02) in Taiwan.