[Abstract] Improving abnormal gait patterns by using a Gait Exercise Assist Robot (GEAR) in chronic stroke subjects: A randomized, controlled, pilot trial

Abstract

Background

Although the Gait Exercise Assist Robot (GEAR) has been reported to effectively improve gait of hemiplegic patients, no study has investigated its use in chronic stroke patients. It is possible to facilitate gait reorganization by gait training with less compensation using the GEAR even in chronic stroke patients.

Research question

What are the effects of GEAR training on the abnormal gait patterns of chronic stroke subjects?

Methods

Subjects were randomly assigned to either the GEAR group (n = 8) or the treadmill group (n = 11). Each group underwent 20 sessions (40 min/day, 5 days/week). The changes in the 10 types of abnormal gait patterns were evaluated using a three-dimensional motion analysis system and the Global Rating of Change (GRC) scale before and after the intervention, and at 1-month and 3-month follow-up assessment.

Results

In the GEAR group, hip hiking at a 1-month follow-up assessment was markedly lesser than that before the intervention, and the excessive hip external rotation at 3-month follow-up assessment was notably lesser than that after the intervention, but the change in excessive hip external rotation was in the normal range. In the treadmill group, knee extensor thrust at a 1-month follow-up assessment was strikingly lesser than that before the intervention, but the difference was in the normal range. In the GEAR group, the GRC scale scores were considerably higher after the intervention, at a 1-month, and 3-month follow-up assessment than those before the intervention. But, in the treadmill group, only the GRC scale score at a 1-month follow-up assessment was visibly higher than that before the intervention.

Significance

Gait training using the GEAR may be more effective than treadmill-training in improving the swing phase in chronic stroke subjects.

via Improving abnormal gait patterns by using a Gait Exercise Assist Robot (GEAR) in chronic stroke subjects: A randomized, controlled, pilot trial – ScienceDirect

[Abstract + References] Using a Collaborative Robot to the Upper Limb Rehabilitation – Conference paper

Abstract

Rehabilitation is a relevant process for the recovery from dysfunctions and improves the realization of patient’s Activities of Daily Living (ADLs). Robotic systems are considered an important field within the development of physical rehabilitation, thus allowing the collection of several data, besides performing exercises with intensity and repeatedly. This paper addresses the use of a collaborative robot applied in the rehabilitation field to help the physiotherapy of upper limb of patients, specifically shoulder. To perform the movements with any patient the system must learn to behave to each of them. In this sense, the Reinforcement Learning (RL) algorithm makes the system robust and independent of the path of motion. To test this approach, it is proposed a simulation with a UR3 robot implemented in V-REP platform. The main control variable is the resistance force that the robot is able to do against the movement performed by the human arm.

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via Using a Collaborative Robot to the Upper Limb Rehabilitation | SpringerLink

[Abstract] Error-augmented bimanual therapy for stroke survivors

Abstract 

BACKGROUND:Stroke recovery studies have shown the efficacy of bimanual training on upper limb functional recovery and others have shown the efficacy of feedback technology that augments error.

OBJECTIVE:In a double-blinded randomized controlled study (N = 26), we evaluated the short-term effects of bilateral arm training to foster functional recovery of a hemiparetic arm, with half of our subjects unknowingly also receiving error augmentation (where errors were visually and haptically enhanced by a robot).

METHODS:Twenty-six individuals with chronic stroke were randomly assigned to practice an equivalent amount of bimanual reaching either with or without error augmentation. Participants were instructed to coordinate both arms while reaching to two targets (one for each arm) in three 45-minute treatments per week for two weeks, with a follow-up visit after one week without treatment.

RESULTS:Subjects’ 2-week gains in Fugl-Meyer score averaged 2.92, and we also observed improvements Wolf Motor Functional Ability Scale average 0.21, and Motor Activity Log of 0.58 for quantity and 0.63 for quality of life scores. The extra benefit of error augmentation over the three weeks became apparent in Fugl-Meyer score only after removing an outlier from consideration.

CONCLUSIONS:This modest advantage of error augmentation was detectable over a short interval encouraging further research in interactive self-rehabilitation systems that can enhance error motor recovery.

via Error-augmented bimanual therapy for stroke survivors – IOS Press