Gait Recovery with an Overground Powered Exoskeleton: A Randomized Controlled Trial on Subacute Stroke Subjects.

exoskeleton device neurologic gait disorders rehabilitation robot-assisted gait training stroke

Journal

Brain sciences
ISSN: 2076-3425
Titre abrégé: Brain Sci
Pays: Switzerland
ID NLM: 101598646

Informations de publication

Date de publication:
14 Jan 2021
Historique:
received: 29 12 2020
revised: 09 01 2021
accepted: 11 01 2021
entrez: 20 1 2021
pubmed: 21 1 2021
medline: 21 1 2021
Statut: epublish

Résumé

Overground Robot-Assisted Gait Training (o-RAGT) provides intensive gait rehabilitation. This study investigated the efficacy of o-RAGT in subacute stroke subjects, compared to conventional gait training. A multicenter randomized controlled trial was conducted on 75 subacute stroke subjects (38 in the Experimental Group (EG) and 37 in the Control Group (CG)). Both groups received 15 sessions of gait training (5 sessions/week for 60 min) and daily conventional rehabilitation. The subjects were assessed at the beginning (T1) and end (T2) of the training period with the primary outcome of a 6 Minutes Walking Test (6MWT), the Modified Ashworth Scale of the Affected lower Limb (MAS-AL), the Motricity Index of the Affected lower Limb (MI-AL), the Trunk Control Test (TCT), Functional Ambulation Classification (FAC), a 10 Meters Walking Test (10MWT), the modified Barthel Index (mBI), and the Walking Handicap Scale (WHS). The 6MWT increased in both groups, which was confirmed by both frequentist and Bayesian analyses. Similar outcomes were registered in the MI-AL, 10MWT, mBI, and MAS-AL. The FAC and WHS showed a significant number of subjects improving in functional and community ambulation in both groups at T2. The clinical effects of o-RAGT were similar to conventional gait training in subacute stroke subjects. The results obtained in this study are encouraging and suggest future clinical trials on the topic.

Sections du résumé

BACKGROUND BACKGROUND
Overground Robot-Assisted Gait Training (o-RAGT) provides intensive gait rehabilitation. This study investigated the efficacy of o-RAGT in subacute stroke subjects, compared to conventional gait training.
METHODS METHODS
A multicenter randomized controlled trial was conducted on 75 subacute stroke subjects (38 in the Experimental Group (EG) and 37 in the Control Group (CG)). Both groups received 15 sessions of gait training (5 sessions/week for 60 min) and daily conventional rehabilitation. The subjects were assessed at the beginning (T1) and end (T2) of the training period with the primary outcome of a 6 Minutes Walking Test (6MWT), the Modified Ashworth Scale of the Affected lower Limb (MAS-AL), the Motricity Index of the Affected lower Limb (MI-AL), the Trunk Control Test (TCT), Functional Ambulation Classification (FAC), a 10 Meters Walking Test (10MWT), the modified Barthel Index (mBI), and the Walking Handicap Scale (WHS).
RESULTS RESULTS
The 6MWT increased in both groups, which was confirmed by both frequentist and Bayesian analyses. Similar outcomes were registered in the MI-AL, 10MWT, mBI, and MAS-AL. The FAC and WHS showed a significant number of subjects improving in functional and community ambulation in both groups at T2.
CONCLUSIONS CONCLUSIONS
The clinical effects of o-RAGT were similar to conventional gait training in subacute stroke subjects. The results obtained in this study are encouraging and suggest future clinical trials on the topic.

Identifiants

pubmed: 33466749
pii: brainsci11010104
doi: 10.3390/brainsci11010104
pmc: PMC7830339
pii:
doi:

Types de publication

Journal Article

Langues

eng

Subventions

Organisme : Ministero della Salute
ID : RicercaCorrente

Références

Front Neurol. 2020 Jan 15;10:1344
pubmed: 32010039
J Neuroeng Rehabil. 2018 Apr 25;15(1):35
pubmed: 29695280
Comput Methods Programs Biomed. 2014 Sep;116(2):116-22
pubmed: 24461799
J Clin Neurosci. 2018 Feb;48:11-17
pubmed: 29208476
J Neuroeng Rehabil. 2016 Jun 08;13(1):53
pubmed: 27278136
Phys Ther. 1984 Jan;64(1):35-40
pubmed: 6691052
J Phys Ther Sci. 2015 Jul;27(7):2391-3
pubmed: 26311989
PM R. 2017 Sep;9(9):839-846
pubmed: 28093370
Multivariate Behav Res. 2004 Oct 1;39(4):653-86
pubmed: 26745462
Stroke. 2019 Dec;50(12):3337-3338
pubmed: 31623546
Eur J Phys Rehabil Med. 2019 Aug;55(4):433-441
pubmed: 30543267
Front Neurorobot. 2020 Oct 30;14:581815
pubmed: 33192438
Phys Ther. 1987 Feb;67(2):206-7
pubmed: 3809245
Eur J Phys Rehabil Med. 2017 Oct;53(5):676-684
pubmed: 28118698
Data Brief. 2020 Mar 16;30:105419
pubmed: 32258281
Front Neurol. 2020 Oct 19;11:564067
pubmed: 33193001
J Neurol Neurosurg Psychiatry. 2002 Aug;73(2):188-90
pubmed: 12122181
Phys Ther. 2015 Oct;95(10):1423-32
pubmed: 25929533
Med J Islam Repub Iran. 2012 Feb;26(1):27-30
pubmed: 23483112
Stroke. 1997 Jul;28(7):1382-5
pubmed: 9227687
J Am Geriatr Soc. 2006 May;54(5):743-9
pubmed: 16696738
J Bodyw Mov Ther. 2020 Jan;24(1):194-198
pubmed: 31987544
Front Neurorobot. 2018 Mar 19;12:10
pubmed: 29615890
Neuropsychiatr Dis Treat. 2017 May 15;13:1303-1311
pubmed: 28553117
NeuroRehabilitation. 2019;45(2):201-212
pubmed: 31498139
Ann Phys Rehabil Med. 2020 Nov;63(6):535-542
pubmed: 31676456
Stroke. 2019 Dec;50(12):3545-3552
pubmed: 31623545
PM R. 2018 Sep;10(9 Suppl 2):S174-S188
pubmed: 30269804
Clin Rehabil. 2009 Nov;23(11):1018-33
pubmed: 19786420
Cochrane Database Syst Rev. 2020 Oct 22;10:CD006185
pubmed: 33091160
Ann Phys Rehabil Med. 2019 Sep;62(5):303-312
pubmed: 31377382
PLoS One. 2020 Feb 28;15(2):e0229707
pubmed: 32109255
Eur J Phys Rehabil Med. 2019 Dec;55(6):710-721
pubmed: 30723189
Stroke. 1995 Jun;26(6):982-9
pubmed: 7762050
J Affect Disord. 2018 Aug 1;235:589-596
pubmed: 29704854
IEEE Eng Med Biol Mag. 2010 May-Jun;29(3):57-63
pubmed: 20659858

Auteurs

Franco Molteni (F)

Villa Beretta Rehabilitation Center, Valduce Hospital, Costa Masnaga, 23845 Lecco, Italy.

Eleonora Guanziroli (E)

Villa Beretta Rehabilitation Center, Valduce Hospital, Costa Masnaga, 23845 Lecco, Italy.

Michela Goffredo (M)

Neurorehabilitation Research Laboratory, IRCCS San Raffaele Pisana, 00163 Rome, Italy.

Rocco Salvatore Calabrò (RS)

Neurorobotic Rehabilitation, IRCCS Centro Neurolesi "Bonino-Pulejo", 98124 Messina, Italy.

Sanaz Pournajaf (S)

Neurorehabilitation Research Laboratory, IRCCS San Raffaele Pisana, 00163 Rome, Italy.

Marina Gaffuri (M)

Villa Beretta Rehabilitation Center, Valduce Hospital, Costa Masnaga, 23845 Lecco, Italy.

Giulio Gasperini (G)

Villa Beretta Rehabilitation Center, Valduce Hospital, Costa Masnaga, 23845 Lecco, Italy.

Serena Filoni (S)

Fondazione Centri di Riabilitazione Padre Pio Onlus, 71013 Foggia, Italy.

Silvano Baratta (S)

SCRIN Trevi Dipartimento di Riabilitazione USL Umbria 2, 06039 Perugia, Italy.

Daniele Galafate (D)

Neurorehabilitation Research Laboratory, IRCCS San Raffaele Pisana, 00163 Rome, Italy.

Domenica Le Pera (D)

Neurorehabilitation Research Laboratory, IRCCS San Raffaele Pisana, 00163 Rome, Italy.

Placido Bramanti (P)

Neurorobotic Rehabilitation, IRCCS Centro Neurolesi "Bonino-Pulejo", 98124 Messina, Italy.

Marco Franceschini (M)

Neurorehabilitation Research Laboratory, IRCCS San Raffaele Pisana, 00163 Rome, Italy.
Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, 00166 Rome, Italy.

Classifications MeSH