Effects of innovative hip-knee-ankle interlimb coordinated robot training on ambulation, cardiopulmonary function, depression, and fall confidence in acute hemiplegia

Article type: Research Article

Authors: Park, Chanhee^{a; b} | Oh-Park, Mooyeon^{c; d} | Dohle, Carolin^{c; d} | Bialek, Amy^e | Friel, Kathleen^e | Edwards, Dylan^f | Krebs, Hermano Igo^g | You, Joshua (Sung) H.^{a; b; *}

Affiliations: [a] Department of Physical Therapy, Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Yonsei University, Wonju, Republic of Korea | [b] Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea | [c] Burke Rehabilitation Hospital, White Plains, NY, USA | [d] Albert Einstein College of Medicine, Montefiore Health System, Bronx, New York, NY, USA | [e] Burke Neurological Institute, White Plains, NY, USA | [f] Moss Rehabilitation, Philadelphia, PA, USA | [g] Massachusetts Institute of Technology, Cambridge, MA, USA

Correspondence: [*] Address for correspondence: Joshua (Sung) H. You, PT, PhD, Director, Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Executive Director, “Good-Wellness Center” for Sports Wellness & Brain Fitness, Across Life Span Disabilities, Department of Physical Therapy, 1 Yonseidae-gil, Wonju, Kangwon-do 26493, Republic of Korea. Tel.: +82 33 760 2476; Fax: +82 33 760 2496; E-mail: neurorehab@yonsei.ac.kr.

Abstract: BACKGROUND:While Walkbot-assisted locomotor training (WLT) provided ample evidence on balance and gait improvements, the therapeutic effects on cardiopulmonary and psychological elements as well as fall confidence are unknown in stroke survivors. OBJECTIVE:The present study aimed to compare the effects of Walkbot locomotor training (WLT) with conventional locomotor training (CLT) on balance and gait, cardiopulmonary and psychological functions and fall confidence in acute hemiparetic stroke. METHODS:Fourteen patients with acute hemiparetic stroke were randomized into either the WLT (60 min physical therapy + 30 min Walkbot-assisted gait training) or CLT (60 min physical therapy + 30 min gait training) groups, 7 days/week over 2 weeks. Clinical outcomes included the Berg Balance Scale (BBS), Functional Ambulation Category (FAC), heart rate (HR), Borg Rating of Perceived Exertion (BRPE), Beck Depression Inventory-II (BDI-II), and the activities-specific balance confidence (ABC) scale. The analysis of covariance (ANCOVA) was conducted at P < 0.05. RESULTS:ANCOVA showed that WLT showed superior effects, compared to CLT, on FAC, HR, BRPE, BDI-II, and ABC scale (P < 0.05), but not on BBS (P = 0.061). CONCLUSIONS:Our results provide novel, promising clinical evidence that WLT improved balance and gait function as well as cardiopulmonary and psychological functions, and fall confidence in acute stroke survivors who were unable to ambulate independently.

Keywords: Neurorehabilitation, stroke, hemiplegia, robot-assisted gait training, Walkbot, cardiopulmonary function, psychological function

DOI: 10.3233/NRE-203086

Journal: NeuroRehabilitation, vol. 46, no. 4, pp. 577-587, 2020