Naojiro Tanaka1, Shinro Matsushita2, Yasushi Sonoda3, Yoshikatsu Maruta4, Yuta Fujitaka5, Masashi Sato6, Miki Simomori7, Rhyuki Onaka7, Keiji Harada7, Takashi Hirata8, Shoji Kinoshita9, Takatsugu Okamoto10, Hitoshi Okamura11. 1. Department of Rehabilitation Medicine, Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, Japan; Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan. Electronic address: naojirou@live.jp. 2. Department of Rehabilitation Medicine, Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, Japan. Electronic address: bxmbg232@ybb.ne.jp. 3. Department of Rehabilitation Medicine, Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, Japan. Electronic address: sonoda88@voice.ocn.ne.jp. 4. Department of Rehabilitation Medicine, Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, Japan. Electronic address: yoshikatsu_sr425@yahoo.co.jp. 5. Department of Rehabilitation Medicine, Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, Japan. Electronic address: fjtk1122@yahoo.co.jp. 6. Department of Rehabilitation Medicine, Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, Japan. Electronic address: jakee310@hi2.enjoy.ne.jp. 7. Department of Rehabilitation Medicine, Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, Japan. 8. Fundamental Technology Research Center, Honda R&D Co., Ltd., Wako, Japan. Electronic address: Takashi_Hirata@hm.honda.co.jp. 9. Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan. Electronic address: kinoshita@jikei.ac.jp. 10. Department of Rehabilitation Medicine, Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, Japan; Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan. Electronic address: takatsugu@amy.hi-ho.ne.jp. 11. Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan. Electronic address: hokamura@hiroshima-u.ac.jp.
Abstract
BACKGROUND: Poststroke gait disorders negatively impact activities of daily living. Rehabilitation for stroke patients is aimed at improving their walking ability, balance, and quality of life. Robot-assisted gait training (RAGT) is associated with an increased number of task-specific exercises, which may benefit poststroke motor learning. We investigated the effects of RAGT using Stride Management Assist (SMA, which increases walk ratio by inducing hip-joint flexion and extension) in subacute stroke patients with hemiplegia. METHODS: We conducted a single center, open-label randomized controlled trial in hemiplegia patients who experienced a first ever stroke and were admitted to the convalescent rehabilitation ward. A total of 41 were divided into the control (20 patients) and experimental group (21 patients). A 10-day, conventional gait training program was carried out for the control group; and RAGT with SMA was used for the experimental group. The maximum walking speed and other gait parameters were compared preintervention and postintervention. The intergroup differences in the improvement ratio were compared using an intention-to-treat analysis. RESULTS: Ten-day intervention was completed by 36 patients. There was no difference between the 2 groups regarding gait parameters at intervention initiation. The improvement ratio of the maximum walking speed was significantly higher for the experimental group. Significant improvements were observed postintervention for maximum walking speed, paralysis-side step length, symmetry, and cadence in the experimental group. No adverse events attributable to the SMA were observed. CONCLUSIONS: Ten days of RAGT with the SMA was effective for improving gait disorders of subacute stroke patients.
RCT Entities:
BACKGROUND:Poststroke gait disorders negatively impact activities of daily living. Rehabilitation for strokepatients is aimed at improving their walking ability, balance, and quality of life. Robot-assisted gait training (RAGT) is associated with an increased number of task-specific exercises, which may benefit poststroke motor learning. We investigated the effects of RAGT using Stride Management Assist (SMA, which increases walk ratio by inducing hip-joint flexion and extension) in subacute strokepatients with hemiplegia. METHODS: We conducted a single center, open-label randomized controlled trial in hemiplegiapatients who experienced a first ever stroke and were admitted to the convalescent rehabilitation ward. A total of 41 were divided into the control (20 patients) and experimental group (21 patients). A 10-day, conventional gait training program was carried out for the control group; and RAGT with SMA was used for the experimental group. The maximum walking speed and other gait parameters were compared preintervention and postintervention. The intergroup differences in the improvement ratio were compared using an intention-to-treat analysis. RESULTS: Ten-day intervention was completed by 36 patients. There was no difference between the 2 groups regarding gait parameters at intervention initiation. The improvement ratio of the maximum walking speed was significantly higher for the experimental group. Significant improvements were observed postintervention for maximum walking speed, paralysis-side step length, symmetry, and cadence in the experimental group. No adverse events attributable to the SMA were observed. CONCLUSIONS: Ten days of RAGT with the SMA was effective for improving gait disorders of subacute strokepatients.