Effects of Robot-assisted Gait Therapy on Locomotor Recovery in Stroke Patients

OBJECTIVE: To investigate the effects of robot-assisted gait therapy on locomotor recovery in hemiparetic patients after stroke. METHOD: Twenty five stroke patients were randomly divided into 2 groups. Robotic training group received 30 minutes of robot-assisted gait therapy, 3 times a week for 4 weeks, while control group received conventional gait training with same duration and frequency as robotic group. Outcome was measured using Motricity index, Fugl-Meyer assessment (FMA), function ambulation category, modified motor assessment scale, 10-meter gait speed, isometric torque, Ashworth scale, gait analysis, body tissue composition, and Beck's depression inventory (BDI). RESULTS: Robotic training group showed significant improvement in motor functions measured by Motricity Index, FMA, 10-meter gait speed, isometric torque of hip compared with the baseline and with those of control group. Ashworth scale of hip, BDI, and muscle mass showed significantly greater improvement in robotic training group than control group. In gait analysis, stride length of unaffected leg demonstrated significant improvement in robotic training group (p<0.05). CONCLUSION: The robot-assisted gait therapy with body weight-support is considered to facilitate locomotor recovery of the hemiparetic stroke patient.

Neuroplasticity Induced by Robot-assisted Gait Training in a Stroke Patient: A case report

In this case study, we investigated the effects of robot-assisted gait training on the plasticity of motor system in a stroke patient using functional MRI. A patient who suffered from the left hemiparesis following the right MCA infarction performed gait training with a robot-assisted gait orthosis. Before and after gait training, motor performances were assessed and functional MRIs were acquired with motor activation task of affected lower limb. After gait training with a robot-assisted orthosis, the patient's motor performances were improved and cortical activities were changed. Activation in the ipsilesional primary sensorimotor cortex was increased and cortical reorganization was induced in a way that nearby regions were recruited for the movement of affected lower limb. The results of this study showed that gait training with a robot-assisted orthosis induced cortical reorganization of the motor network that resulted in enhancement of motor performance of the lower limb.