Robot-assisted walking training for individuals with Parkinson's disease: a pilot randomized controlled trial

Patrizio Sale, Maria Francesca De Pandis, Domenica Le Pera, Ivan Sova, Veronica Cimolin, Andrea Ancillao, Giorgio Albertini, Manuela Galli, Fabrizio Stocchi, Marco Franceschini, Patrizio Sale, Maria Francesca De Pandis, Domenica Le Pera, Ivan Sova, Veronica Cimolin, Andrea Ancillao, Giorgio Albertini, Manuela Galli, Fabrizio Stocchi, Marco Franceschini

Abstract

Background: Over the last years, the introduction of robotic technologies into Parkinson's disease rehabilitation settings has progressed from concept to reality. However, the benefit of robotic training remains elusive. This pilot randomized controlled observer trial is aimed at investigating the feasibility, the effectiveness and the efficacy of new end-effector robot training in people with mild Parkinson's disease.

Methods: Design. Pilot randomized controlled trial.

Results: Robot training was feasible, acceptable, safe, and the participants completed 100% of the prescribed training sessions. A statistically significant improvement in gait index was found in favour of the EG (T0 versus T1). In particular, the statistical analysis of primary outcome (gait speed) using the Friedman test showed statistically significant improvements for the EG (p = 0,0195). The statistical analysis performed by Friedman test of Step length left (p = 0,0195) and right (p = 0,0195) and Stride length left (p = 0,0078) and right (p = 0,0195) showed a significant statistical gain. No statistically significant improvements on the CG were found.

Conclusions: Robot training is a feasible and safe form of rehabilitative exercise for cognitively intact people with mild PD. This original approach can contribute to increase a short time lower limb motor recovery in idiopathic PD patients. The focus on the gait recovery is a further characteristic that makes this research relevant to clinical practice. On the whole, the simplicity of treatment, the lack of side effects, and the positive results from patients support the recommendation to extend the use of this treatment. Further investigation regarding the long-time effectiveness of robot training is warranted.

Trial registration: ClinicalTrials.gov NCT01668407.

Figures

Figure 1
Figure 1
CONSORT 2010 flow diagram.

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