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Feasibility and effects of patient-cooperative robot-aided gait training applied in a 4-week pilot trial

BACKGROUND: Functional training is becoming the state-of-the-art therapy approach for rehabilitation of individuals after stroke and spinal cord injury. Robot-aided treadmill training reduces personnel effort, especially when treating severely affected patients. Improving rehabilitation robots towar...

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Autores principales: Schück, Alex, Labruyère, Rob, Vallery, Heike, Riener, Robert, Duschau-Wicke, Alexander
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533836/
https://www.ncbi.nlm.nih.gov/pubmed/22650320
http://dx.doi.org/10.1186/1743-0003-9-31
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author Schück, Alex
Labruyère, Rob
Vallery, Heike
Riener, Robert
Duschau-Wicke, Alexander
author_facet Schück, Alex
Labruyère, Rob
Vallery, Heike
Riener, Robert
Duschau-Wicke, Alexander
author_sort Schück, Alex
collection PubMed
description BACKGROUND: Functional training is becoming the state-of-the-art therapy approach for rehabilitation of individuals after stroke and spinal cord injury. Robot-aided treadmill training reduces personnel effort, especially when treating severely affected patients. Improving rehabilitation robots towards more patient-cooperative behavior may further increase the effects of robot-aided training. This pilot study aims at investigating the feasibility of applying patient-cooperative robot-aided gait rehabilitation to stroke and incomplete spinal cord injury during a therapy period of four weeks. Short-term effects within one training session as well as the effects of the training on walking function are evaluated. METHODS: Two individuals with chronic incomplete spinal cord injury and two with chronic stroke trained with the Lokomat gait rehabilitation robot which was operated in a new, patient-cooperative mode for a period of four weeks with four training sessions of 45 min per week. At baseline, after two and after four weeks, walking function was assessed with the ten meter walking test. Additionally, muscle activity of the major leg muscles, heart rate and the Borg scale were measured under different walking conditions including a non-cooperative position control mode to investigate the short-term effects of patient-cooperative versus non-cooperative robot-aided gait training. RESULTS: Patient-cooperative robot-aided gait training was tolerated well by all subjects and performed without difficulties. The subjects trained more actively and with more physiological muscle activity than in a non-cooperative position-control mode. One subject showed a significant and relevant increase of gait speed after the therapy, the three remaining subjects did not show significant changes. CONCLUSIONS: Patient-cooperative robot-aided gait training is feasible in clinical practice and overcomes the main points of criticism against robot-aided gait training: It enables patients to train in an active, variable and more natural way. The limited number of subjects in this pilot trial does not permit valid conclusions on the effect of patient-cooperative robot-aided gait training on walking function. A large, possibly multi-center randomized controlled clinical trial is required to shed more light on this question.
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spelling pubmed-35338362013-01-03 Feasibility and effects of patient-cooperative robot-aided gait training applied in a 4-week pilot trial Schück, Alex Labruyère, Rob Vallery, Heike Riener, Robert Duschau-Wicke, Alexander J Neuroeng Rehabil Research BACKGROUND: Functional training is becoming the state-of-the-art therapy approach for rehabilitation of individuals after stroke and spinal cord injury. Robot-aided treadmill training reduces personnel effort, especially when treating severely affected patients. Improving rehabilitation robots towards more patient-cooperative behavior may further increase the effects of robot-aided training. This pilot study aims at investigating the feasibility of applying patient-cooperative robot-aided gait rehabilitation to stroke and incomplete spinal cord injury during a therapy period of four weeks. Short-term effects within one training session as well as the effects of the training on walking function are evaluated. METHODS: Two individuals with chronic incomplete spinal cord injury and two with chronic stroke trained with the Lokomat gait rehabilitation robot which was operated in a new, patient-cooperative mode for a period of four weeks with four training sessions of 45 min per week. At baseline, after two and after four weeks, walking function was assessed with the ten meter walking test. Additionally, muscle activity of the major leg muscles, heart rate and the Borg scale were measured under different walking conditions including a non-cooperative position control mode to investigate the short-term effects of patient-cooperative versus non-cooperative robot-aided gait training. RESULTS: Patient-cooperative robot-aided gait training was tolerated well by all subjects and performed without difficulties. The subjects trained more actively and with more physiological muscle activity than in a non-cooperative position-control mode. One subject showed a significant and relevant increase of gait speed after the therapy, the three remaining subjects did not show significant changes. CONCLUSIONS: Patient-cooperative robot-aided gait training is feasible in clinical practice and overcomes the main points of criticism against robot-aided gait training: It enables patients to train in an active, variable and more natural way. The limited number of subjects in this pilot trial does not permit valid conclusions on the effect of patient-cooperative robot-aided gait training on walking function. A large, possibly multi-center randomized controlled clinical trial is required to shed more light on this question. BioMed Central 2012-05-31 /pmc/articles/PMC3533836/ /pubmed/22650320 http://dx.doi.org/10.1186/1743-0003-9-31 Text en Copyright ©2012 Schück et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Schück, Alex
Labruyère, Rob
Vallery, Heike
Riener, Robert
Duschau-Wicke, Alexander
Feasibility and effects of patient-cooperative robot-aided gait training applied in a 4-week pilot trial
title Feasibility and effects of patient-cooperative robot-aided gait training applied in a 4-week pilot trial
title_full Feasibility and effects of patient-cooperative robot-aided gait training applied in a 4-week pilot trial
title_fullStr Feasibility and effects of patient-cooperative robot-aided gait training applied in a 4-week pilot trial
title_full_unstemmed Feasibility and effects of patient-cooperative robot-aided gait training applied in a 4-week pilot trial
title_short Feasibility and effects of patient-cooperative robot-aided gait training applied in a 4-week pilot trial
title_sort feasibility and effects of patient-cooperative robot-aided gait training applied in a 4-week pilot trial
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533836/
https://www.ncbi.nlm.nih.gov/pubmed/22650320
http://dx.doi.org/10.1186/1743-0003-9-31
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