Long-term Effect of Robot-assisted Step Training on the Strength of the Lower Extremity and Gait Speed in a Chronic Stroke Patient: A Preliminary Study (장기간의 로봇 보조 스텝훈련이 만성 뇌졸중 환자의 하지 근력과 보행속도에 미치는 영향: 예비 연구)

Se-Jung Oh (오세정); 차용준; Jongseok Hwang (황종석)

Long-term Effect of Robot-assisted Step Training on the Strength of the Lower Extremity and Gait Speed in a Chronic Stroke Patient: A Preliminary Study

Journal of the Korean Society of Physical Medicine
Abbr : J Korean Soc Phys Med
2022, 17(4), pp.65~73
Publisher : The Korean Society of Physical Medicine
Research Area : Medicine and Pharmacy > Physical Therapy > Other physical therapy
Received : October 11, 2022
Accepted : October 22, 2022
Published : November 30, 2022

Se-Jung Oh ¹, 차용준 ¹, Jongseok Hwang ²

¹대전대학교
²영남대학교

Accredited

ABSTRACT

PURPOSE: The present research examined the effects of progressive robot-assisted step training on the strength of the lower extremity and gait speed of an individual with stroke through changes between the baseline and the intervention stage (1, 3, 6, 9, and 12 months). METHODS: A single-subject (A-B) design was performed for a chronic stroke patient aged 70 years old. The robot-assisted step training was conducted three times a week during 12 months (40 minutes/session), and the assessment was conducted a total of seven times between the baseline and the intervention (No. 1, 3, 6, 9, and 12 months) to determine the effect of the intervention. RESULTS: As a result of the intervention, the muscle strength at the lower extremity of the paralysis side increased by the greatest extent 12 months after the intervention compared to the baseline, and the gait speed via the 10-meter walk test was increased as well. CONCLUSION: Long-term robot-assisted step training might be an effective intervention for improving the strength of the paretic lower extremity muscles and gait speed in stroke patients with difficulty walking independently. Further studies with sufficient sample sizes and a randomized control group will be needed to evaluate the long-term effects of robotic stepping rehabilitation.

KEYWORDS

Gait speed, Robot-assisted step training, Strength, Stroke

Citation status

* References for papers published after 2023 are currently being built.

[journal] Lo EH / 2003 / Mechanisms, challenges and opportunities in stroke / Nat Rev Neurosci 4(5) : 399~415

[journal] Kuznetsov AN / 2013 / Early poststroke rehabilitation using a robotic tilt-table stepper and functional electrical stimulation / Stroke Res Treat : 946056~

[journal] Mikołajewsk EJAiC / 2013 / Associations between results of post-stroke NDT-Bobath rehabilitation in gait parameters, ADL and hand functions / Adv Clin Exp Med 22(5) : 731~738

[journal] Guiu-Tula FX / 2017 / The Efficacy of the proprioceptive neuromuscular facilitation (PNF) approach in stroke rehabilitation to improve basic activities of daily living and quality of life: a systematic review and meta-analysis protocol / BMJ Open 7(12) : e016739~

[journal] Schwartz I / 2009 / The effectiveness of locomotor therapy using robotic-assisted gait training in subacute stroke patients: A randomized controlled trial / PM R 1(6) : 516~523

[journal] Lang CE / 2007 / Counting repetitions:an observational study of outpatient therapy for people with hemiparesis post-stroke / J Neurol Phys Ther 31(1) : 3~10

[journal] Boyd LA / 2006 / Explicit information interferes with implicit motor learning of both continuous and discrete movement tasks after stroke / J Neurol Phys Ther 30(2) : 46~57

[journal] Fine MS / 2006 / Motor adaptation to single force pulses: sensitive to direction but insensitive to within-movement pulse placement and magnitude / J Neurophysiol 96(2) : 710~720

[journal] Werner C / 2002 / Treadmill training with partial body weight support and an electromechanical gait trainer for restoration of gait in subacute stroke patients: A randomized crossover study / Stroke 33(12) : 2895~2901

[journal] Hwang J / 2018 / Effects of Walkbot gait training on kinematics, kinetics, and clinical gait function in paraplegia and quadriplegia / NeuroRehabil 42(4) : 481~489

[journal] 황종석 / 2021 / Effect of an End-effector Type of Robotic Gait Training on Stand Capability, Locomotor Function, and Gait Speed in Individuals with Spastic Cerebral Palsy / 대한물리의학회지 / 대한물리의학회 16(3) : 123~130

[journal] Stein JJAjopm / 2012 / rehabilitation. Robotics in rehabilitation:technology as destiny / Am J Phys Med Rehabil. LWW : 199~203

[journal] Morone G / 2011 / Who may benefit from robotic-assisted gait training? A randomized clinical trial in patients with subacute stroke / Neurorehabilit Neural Repair 25(7) : 636~644

[journal] Bruni MF / 2018 / What does best evidence tell us about robotic gait rehabilitation in stroke patients: A systematic review and meta-analysis / J Clin Neurosci 48 : 11~17

[journal] Mehrholz J / 2012 / Electromechanical-assisted gait training after stroke: a systematic review comparing end-effector and exoskeleton devices / J Rehabil Med 44(3) : 193~199

[journal] Mehrholz J / 2020 / Electromechanicalassisted training for walking after stroke / Cochrane Database Syst Rev 10(10) : CD006185~

[journal] Lefmann S / 2017 / The effectiveness of robotic-assisted gait training for paediatric gait disorders:systematic review / J Neuroeng Rehabil 14(1) : 1~

[journal] Calabro RS / 2015 / Do post-stroke patients benefit from robotic verticalization? A pilot-study focusing on a novel neurophysiological approach / Restor Neurol Neurosc 33(5) : 671~681

[journal] Saengsuwan J / 2015 / Feasibility of cardiopulmonary exercise testing and training using a robotics-assisted tilt table in dependent-ambulatory stroke patients / J Neuroeng Rehabil 12(1) : 88~

[journal] Solopova IA / 2011 / Assisted leg displacements and progressive loading by a tilt table combined with FES promote gait recovery in acute stroke / NeuroRehabil 29(1) : 67~77

[journal] Kautz SA / 1998 / Relationships between timing of muscle excitation and impaired motor performance during cyclical lower extremity movement in post-stroke hemiplegia / Brain 121(3) : 515~526

[journal] Furlan R / 2000 / Oscillatory patterns in sympathetic neural discharge and cardiovascular variables during orthostatic stimulus / Circulation 101(8) : 886~892

[journal] Czell D / 2004 / Influence of passive leg movements on blood circulation on the tilt table in healthy adults / J Neuroeng Rehabil 1(1) : 4~

[journal] Daunoraviciene K / 2018 / Necessity of early-stage verticalization in patients with brain and spinal cord injuries: Preliminary study / Technol Health Care 26(S2) : 613~623

[journal] Ancona E / 2019 / Effect of verticalization with Erigo® in the acute rehabilitation of severe acquired brain injury / Neurol Sci 40(10) : 2073~2080

[journal] Kumar S / 2020 / Comparison between Erigo tilt-table exercise and conventional physiotherapy exercises in acute stroke patients: a randomized trial / Arch Physiother 10(1) : 1~9

[book] Kendall FP / 2005 / Muscles:testing and function with posture and pain / Lippincott, Williams, & Wilkins

[journal] 권오국 / 2014 / Effects of Closed and Open Kinetic Chain Exercises on Knee Extensor Strength and Balance in Patients with Early Stroke / 대한물리의학회지 / 대한물리의학회 9(2) : 223~231

[journal] Mentiplay BF / 2015 / Assessment of lower limb muscle strength and power using hand-held and fixed dynamometry: A reliability and validity study / PLoS One 10(10) : e0140822~

[journal] Collen FM / 1990 / Mobility after stroke: reliability of measures of impairment and disability / Int Disabil Stud 12(1) : 6~9

[journal] Tyson S / 2009 / The psychometric properties and clinical utility of measures of walking and mobility in neurological conditions: a systematic review / Clin Rehabil 23(11) : 1018~1033

[journal] Wieser M / 2010 / Temporal and spatial patterns of cortical activation during assisted lower limb movement / Exp Brain Res 203(1) : 181~191

[journal] Yadav R / 2020 / Comparison between Erigo robotic tilt table exercises and Traditional exercises in rehabilitation of stroke patients: A follow up study / BJMHS 2(8) : 371~379

[journal] Dias D / 2007 / Can we improve gait skills in chronic hemiplegics? A randomised control trial with gait trainer / Eura Medicophys 43(4) : 499~504

[journal] Bhagchandani N / 2012 / Reciprocal inhibition post-stroke is related to reflex excitability and movement ability / Clin Neurophysiol 123(11) : 2239~2246

[journal] Weiller C / 1992 / Functional reorganization of the brain in recovery from striatocapsular infarction in man / Ann Neurol 31(5) : 463~472

[journal] Dragert K / 2013 / High-intensity unilateral dorsiflexor resistance training results in bilateral neuromuscular plasticity after stroke / Exp Brain Res 225(1) : 93~104

[journal] Smania N / 2011 / Improved gait after repetitive locomotor training in children with cerebral palsy / Am J Phys Med Rehabil 90(2) : 137~149

[journal] Dorsch S / 2021 / The relationship between strength of the affected leg and walking speed after stroke varies according to the level of walking disability: A systematic review / Phys Ther 101(12) : 1~8

[journal] Kolb B / 1998 / Brain plasticity and behavior / Annu Rev Psychol 49(1) : 43~64

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