ABSTRACT
Here we report the case of a female patient in her 70s with right hemiplegic stroke and severe sensory impairment whose walking ability was improved by visual and auditory feedback provided by a Gait Exercise Assist Robot (GEAR)．The patient was diagnosed with a left thalamic hemorrhage. Upon being admitted to the convalescent rehabilitation ward, she reported feeling no sensations in her right upper or lower limbs according to the Stroke Impairment Assessment Set (SIAS；both superficial and positional sensations)．Additionally, she had a Berg Balance Scale (BBS) score of 16 and Functional Ambulation Categories (FAC) score of 0. The patient underwent the GEAR intervention for approximately 40 min daily. She was provided visual feedback, in which images of her feet and the sagittal plane were presented on the monitor in front of her；and auditory feedback, in which her paralyzed lower limbs were loaded. No significant improvement was noted in her superficial or positional senses based on the SIAS score at 2 months post-intervention；however, the BBS and FAC scores improved to 46 and 3 points, respectively. These findings suggest that, although it is difficult to improve sensory impairment, repetitive gait training via GEAR-provided visual and auditory feedback and assistive function may improve the gait and walking ability of stroke patients with severe sensory impairment.
ABSTRACT
We report a case of a patient with chronic stroke who improved his gait ability through weekly gait training using Gait Exercise Assist Robot (GEAR). A man in his 70s, who developed cerebral infarction 27 years ago, presented with right-sided hemiplegia. Before gait training, the patient's gait ability was assessed to be independent, but poor toe clearance was observed on the paralyzed side during the swing phase. Therefore, we started gait training using GEAR with the goal of improving his gait pattern. The patient underwent gait training using GEAR for 20 min/day, 1 day/week for 12 weeks, wherein the treadmill speed was increased as much as possible in order to improve the swing of the paralyzed lower limbs, and the visual and auditory feedback functions were also used to promote the load and swing of the paralyzed lower limbs. As a result, the overground gait velocity, Timed Up and Go Test, and 6-minute walking distance increased after 4 weeks. However, poor toe clearance was observed on the paralyzed side during the swing phase even after 12 weeks of the training. These results suggest that 4 weeks of gait training using GEAR (performed only 1 day/week) may effectively improve the gait ability of patients with chronic stroke. On the other hand, no improvement in gait pattern was observed, and further investigation is required in the future.
ABSTRACT
We report a case of a patient with chronic stroke who improved his gait ability through weekly gait training using Gait Exercise Assist Robot (GEAR). A man in his 70s, who developed cerebral infarction 27 years ago, presented with right-sided hemiplegia. Before gait training, the patient's gait ability was assessed to be independent, but poor toe clearance was observed on the paralyzed side during the swing phase. Therefore, we started gait training using GEAR with the goal of improving his gait pattern. The patient underwent gait training using GEAR for 20 min/day, 1 day/week for 12 weeks, wherein the treadmill speed was increased as much as possible in order to improve the swing of the paralyzed lower limbs, and the visual and auditory feedback functions were also used to promote the load and swing of the paralyzed lower limbs. As a result, the overground gait velocity, Timed Up and Go Test, and 6-minute walking distance increased after 4 weeks. However, poor toe clearance was observed on the paralyzed side during the swing phase even after 12 weeks of the training. These results suggest that 4 weeks of gait training using GEAR (performed only 1 day/week) may effectively improve the gait ability of patients with chronic stroke. On the other hand, no improvement in gait pattern was observed, and further investigation is required in the future.
ABSTRACT
PURPOSE: This study examined the effects of trunk control rehabilitation robot training (TCRRT) on the dynamic balance, lower extremity strength, gait ability and pain for bipolar hemiarthroplasty. METHODS: Hemiarthroplasty (n=28) patients participated in this study. The subjects were randomized into two groups: trunk control rehabilitation robot training group and control group. RESULTS: The TCRRT group showed significantly more improvement in the MFRT, MMT, 10MWT, TUG, and VAS compared to that before intervention (p<0.05). In addition, all tests were significantly greater in the experimental group than in the control group. CONCLUSION: These results suggest that TCRRT is feasible and effective for improving the dynamic balance, lower extremity strength, gait ability, and pain efficacy after bipolar hemiarthroplasty.