Efficacy of Robot-Assisted Gait Training Combined with Robotic Balance Training in Subacute Stroke Patients: A Randomized Clinical Trial

Irene Aprile, Carmela Conte, Arianna Cruciani, Cristiano Pecchioli, Letizia Castelli, Sabina Insalaco, Marco Germanotta, Chiara Iacovelli, Irene Aprile, Carmela Conte, Arianna Cruciani, Cristiano Pecchioli, Letizia Castelli, Sabina Insalaco, Marco Germanotta, Chiara Iacovelli

Abstract

Recently, the use of robotic technology in gait and balance rehabilitation of stroke patients has been introduced, with positive results. The purpose of this study was to evaluate the effectiveness of robotic gait and trunk rehabilitation compared to robotic gait training alone on balance, activities, and participation measures in patients with subacute stroke. The study was a randomized, controlled, single blind, parallel group clinical trial. Thirty-six patients with first ischemic or hemorrhagic stroke event were enrolled, and they were randomized in two groups: Gait Group (GG), where they received only robotic treatment for gait rehabilitation through an end-effector system, and Gait/Trunk Group (GTG) where they performed end-effector gait rehabilitation and balance with a robotic platform, 3 times/week for 12 sessions/month. At the end of the study, there was an improvement in balance ability in both groups. Instead, the lower limb muscle strength and muscle tone significantly improved only in the GTG group, where we found a significant reduction in the trunk oscillations and displacement during dynamic exercises more than the GG group. The robotic platform which was added to the gait robotic treatment offers more intense and controlled training of the trunk that positively influences the tone and strength of lower limb muscles.

Keywords: balance; end-effector device; rehabilitation; robot-assisted gait training; stroke.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Rehabilitation training: Gait Group (GG) and Gait/Trunk Group (GTG).
Figure 2
Figure 2
CONSORT Flow Chart.
Figure 3
Figure 3
Dynamic condition results: between-group statistical analysis (comparison of the percentage changes—%∆GaitGroup vs. %∆Gait/TrunkGroup—obtained in the two groups).

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