Who May Benefit From Robotic-Assisted Gait Training?: A Randomized Clinical Trial in Patients With Subacute Stroke
Background. Robotic-assisted walking training after stroke aims to enable highly impaired patients to walk independently, but results have been mixed. Objective. The authors aimed to identify the characteristics of patients who may be most likely to benefit. Methods. A total of 48 participants with...
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| Veröffentlicht in: | Neurorehabilitation and neural repair 2011-09, Vol.25 (7), p.636-644 |
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| creator | Morone, Giovanni Bragoni, Maura Iosa, Marco De Angelis, Domenico Venturiero, Vincenzo Coiro, Paola Pratesi, Luca Paolucci, Stefano |
| description | Background. Robotic-assisted walking training after stroke aims to enable highly impaired patients to walk independently, but results have been mixed. Objective. The authors aimed to identify the characteristics of patients who may be most likely to benefit. Methods. A total of 48 participants with motor and gait dysfunction following subacute stroke were stratified by the motricity index into high ( |
| doi_str_mv | 10.1177/1545968311401034 |
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Robotic-assisted walking training after stroke aims to enable highly impaired patients to walk independently, but results have been mixed. Objective. The authors aimed to identify the characteristics of patients who may be most likely to benefit. Methods. A total of 48 participants with motor and gait dysfunction following subacute stroke were stratified by the motricity index into high (<29) and low (≥29) motor impairment groups. Each arm was randomized to a robotic or control group (RG or CG) at a mean of 20 days after stroke. All patients underwent 2 therapy sessions per day, 5 days per week for 3 months. Those in the RG underwent 20 sessions of robotic-assisted gait training in the first 4 weeks of inpatient therapy using controlled endpoint trajectories and abbreviated conventional therapy, whereas the CG received only conventional gait training. The primary outcome was the functional ambulation category (FAC), and secondary measures were the Rivermead mobility index (RMI) and 6-minute walking distance, all evaluated at hospital admission and at discharge. Results. The lower motricity group assigned to an electromechanical device significantly improved in the FAC (P < .001), RMI (P = .001), and walking distance (P = .029). Conventional and robotic therapies were equivalent in the higher motricity arm. Conclusion. Robotic therapy combined with conventional therapy may be more effective than conventional therapy alone in patients with greater motor impairment during inpatient stroke rehabilitation.</description><identifier>ISSN: 1545-9683</identifier><identifier>EISSN: 1552-6844</identifier><identifier>DOI: 10.1177/1545968311401034</identifier><identifier>PMID: 21444654</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Admissions ; Adult ; Aged ; Clinical trials ; Exercise Therapy - methods ; Female ; Gait ; Gait - physiology ; Gait Disorders, Neurologic - etiology ; Gait Disorders, Neurologic - rehabilitation ; Hemiplegia - etiology ; Hemiplegia - rehabilitation ; Hospitals ; Humans ; Male ; Middle Aged ; Mobility ; Neurology ; Objectives ; Patients ; Rehabilitation ; robotics ; Robotics - methods ; Sample Size ; Stroke ; Stroke - complications ; Stroke Rehabilitation ; Therapy ; Treatment Outcome ; Walking ; Walking - physiology</subject><ispartof>Neurorehabilitation and neural repair, 2011-09, Vol.25 (7), p.636-644</ispartof><rights>The Author(s) 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c353t-b54bc14aaed99862973f5e75fc8c331b91f7ec1f3d812675a93e6c5c4795303e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1545968311401034$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1545968311401034$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21444654$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morone, Giovanni</creatorcontrib><creatorcontrib>Bragoni, Maura</creatorcontrib><creatorcontrib>Iosa, Marco</creatorcontrib><creatorcontrib>De Angelis, Domenico</creatorcontrib><creatorcontrib>Venturiero, Vincenzo</creatorcontrib><creatorcontrib>Coiro, Paola</creatorcontrib><creatorcontrib>Pratesi, Luca</creatorcontrib><creatorcontrib>Paolucci, Stefano</creatorcontrib><title>Who May Benefit From Robotic-Assisted Gait Training?: A Randomized Clinical Trial in Patients With Subacute Stroke</title><title>Neurorehabilitation and neural repair</title><addtitle>Neurorehabil Neural Repair</addtitle><description>Background. Robotic-assisted walking training after stroke aims to enable highly impaired patients to walk independently, but results have been mixed. Objective. The authors aimed to identify the characteristics of patients who may be most likely to benefit. Methods. A total of 48 participants with motor and gait dysfunction following subacute stroke were stratified by the motricity index into high (<29) and low (≥29) motor impairment groups. Each arm was randomized to a robotic or control group (RG or CG) at a mean of 20 days after stroke. All patients underwent 2 therapy sessions per day, 5 days per week for 3 months. Those in the RG underwent 20 sessions of robotic-assisted gait training in the first 4 weeks of inpatient therapy using controlled endpoint trajectories and abbreviated conventional therapy, whereas the CG received only conventional gait training. The primary outcome was the functional ambulation category (FAC), and secondary measures were the Rivermead mobility index (RMI) and 6-minute walking distance, all evaluated at hospital admission and at discharge. Results. The lower motricity group assigned to an electromechanical device significantly improved in the FAC (P < .001), RMI (P = .001), and walking distance (P = .029). Conventional and robotic therapies were equivalent in the higher motricity arm. Conclusion. Robotic therapy combined with conventional therapy may be more effective than conventional therapy alone in patients with greater motor impairment during inpatient stroke rehabilitation.</description><subject>Admissions</subject><subject>Adult</subject><subject>Aged</subject><subject>Clinical trials</subject><subject>Exercise Therapy - methods</subject><subject>Female</subject><subject>Gait</subject><subject>Gait - physiology</subject><subject>Gait Disorders, Neurologic - etiology</subject><subject>Gait Disorders, Neurologic - rehabilitation</subject><subject>Hemiplegia - etiology</subject><subject>Hemiplegia - rehabilitation</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mobility</subject><subject>Neurology</subject><subject>Objectives</subject><subject>Patients</subject><subject>Rehabilitation</subject><subject>robotics</subject><subject>Robotics - methods</subject><subject>Sample Size</subject><subject>Stroke</subject><subject>Stroke - complications</subject><subject>Stroke Rehabilitation</subject><subject>Therapy</subject><subject>Treatment Outcome</subject><subject>Walking</subject><subject>Walking - physiology</subject><issn>1545-9683</issn><issn>1552-6844</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkM9LwzAYhoMobk7vnqQ3T9F8-dEkJ5nDTWEiyMRjSdN0dqzNTNrD_ns7ph4E2en74H3e5_AidAnkBkDKWxBc6FQxAE6AMH6EhiAExani_Hj3c4F3-QCdxbgihDKlySkaUOCcp4IPEX__8Mmz2Sb3rnFl1SbT4Ovk1ee-rSwex1jF1hXJzPTRIpiqqZrl3Tk6Kc06uovvO0Jv04fF5BHPX2ZPk_EcWyZYi3PBcwvcGFdorVKqJSuFk6K0yjIGuYZSOgslKxTQVAqjmUutsFxqwQhzbISu995N8J-di21WV9G69do0zncx08BSSUHog6TSjEqgvfcgqRQQKQnvSbInbfAxBldmm1DVJmwzINlu_uzv_H3l6lve5bUrfgs_e_cA3gPRLF228l1o-gH_F34BPRCJSw</recordid><startdate>201109</startdate><enddate>201109</enddate><creator>Morone, Giovanni</creator><creator>Bragoni, Maura</creator><creator>Iosa, Marco</creator><creator>De Angelis, Domenico</creator><creator>Venturiero, Vincenzo</creator><creator>Coiro, Paola</creator><creator>Pratesi, Luca</creator><creator>Paolucci, Stefano</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7TS</scope><scope>7X8</scope></search><sort><creationdate>201109</creationdate><title>Who May Benefit From Robotic-Assisted Gait Training?</title><author>Morone, Giovanni ; Bragoni, Maura ; Iosa, Marco ; De Angelis, Domenico ; Venturiero, Vincenzo ; Coiro, Paola ; Pratesi, Luca ; Paolucci, Stefano</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-b54bc14aaed99862973f5e75fc8c331b91f7ec1f3d812675a93e6c5c4795303e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Admissions</topic><topic>Adult</topic><topic>Aged</topic><topic>Clinical trials</topic><topic>Exercise Therapy - methods</topic><topic>Female</topic><topic>Gait</topic><topic>Gait - physiology</topic><topic>Gait Disorders, Neurologic - etiology</topic><topic>Gait Disorders, Neurologic - rehabilitation</topic><topic>Hemiplegia - etiology</topic><topic>Hemiplegia - rehabilitation</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mobility</topic><topic>Neurology</topic><topic>Objectives</topic><topic>Patients</topic><topic>Rehabilitation</topic><topic>robotics</topic><topic>Robotics - methods</topic><topic>Sample Size</topic><topic>Stroke</topic><topic>Stroke - complications</topic><topic>Stroke Rehabilitation</topic><topic>Therapy</topic><topic>Treatment Outcome</topic><topic>Walking</topic><topic>Walking - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Morone, Giovanni</creatorcontrib><creatorcontrib>Bragoni, Maura</creatorcontrib><creatorcontrib>Iosa, Marco</creatorcontrib><creatorcontrib>De Angelis, Domenico</creatorcontrib><creatorcontrib>Venturiero, Vincenzo</creatorcontrib><creatorcontrib>Coiro, Paola</creatorcontrib><creatorcontrib>Pratesi, Luca</creatorcontrib><creatorcontrib>Paolucci, Stefano</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>MEDLINE - Academic</collection><jtitle>Neurorehabilitation and neural repair</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Morone, Giovanni</au><au>Bragoni, Maura</au><au>Iosa, Marco</au><au>De Angelis, Domenico</au><au>Venturiero, Vincenzo</au><au>Coiro, Paola</au><au>Pratesi, Luca</au><au>Paolucci, Stefano</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Who May Benefit From Robotic-Assisted Gait Training?: A Randomized Clinical Trial in Patients With Subacute Stroke</atitle><jtitle>Neurorehabilitation and neural repair</jtitle><addtitle>Neurorehabil Neural Repair</addtitle><date>2011-09</date><risdate>2011</risdate><volume>25</volume><issue>7</issue><spage>636</spage><epage>644</epage><pages>636-644</pages><issn>1545-9683</issn><eissn>1552-6844</eissn><abstract>Background. Robotic-assisted walking training after stroke aims to enable highly impaired patients to walk independently, but results have been mixed. Objective. The authors aimed to identify the characteristics of patients who may be most likely to benefit. Methods. A total of 48 participants with motor and gait dysfunction following subacute stroke were stratified by the motricity index into high (<29) and low (≥29) motor impairment groups. Each arm was randomized to a robotic or control group (RG or CG) at a mean of 20 days after stroke. All patients underwent 2 therapy sessions per day, 5 days per week for 3 months. Those in the RG underwent 20 sessions of robotic-assisted gait training in the first 4 weeks of inpatient therapy using controlled endpoint trajectories and abbreviated conventional therapy, whereas the CG received only conventional gait training. The primary outcome was the functional ambulation category (FAC), and secondary measures were the Rivermead mobility index (RMI) and 6-minute walking distance, all evaluated at hospital admission and at discharge. Results. The lower motricity group assigned to an electromechanical device significantly improved in the FAC (P < .001), RMI (P = .001), and walking distance (P = .029). Conventional and robotic therapies were equivalent in the higher motricity arm. Conclusion. Robotic therapy combined with conventional therapy may be more effective than conventional therapy alone in patients with greater motor impairment during inpatient stroke rehabilitation.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>21444654</pmid><doi>10.1177/1545968311401034</doi><tpages>9</tpages></addata></record> |
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| subjects | Admissions Adult Aged Clinical trials Exercise Therapy - methods Female Gait Gait - physiology Gait Disorders, Neurologic - etiology Gait Disorders, Neurologic - rehabilitation Hemiplegia - etiology Hemiplegia - rehabilitation Hospitals Humans Male Middle Aged Mobility Neurology Objectives Patients Rehabilitation robotics Robotics - methods Sample Size Stroke Stroke - complications Stroke Rehabilitation Therapy Treatment Outcome Walking Walking - physiology |
| title | Who May Benefit From Robotic-Assisted Gait Training?: A Randomized Clinical Trial in Patients With Subacute Stroke |
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