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Gait Training with a Robotic Leg Brace After Stroke

A Randomized Controlled Pilot Study

Stein, Joel, MD; Bishop, Lauri, DPT; Stein, Daniel J., MD, MPH; Wong, Christopher Kevin, PT, PhD

American Journal of Physical Medicine & Rehabilitation: November 2014 - Volume 93 - Issue 11 - p 987–994
doi: 10.1097/PHM.0000000000000119
Original Research Articles

Objective Robot-aided exercise therapy is a promising approach to enhance walking ability in stroke survivors. This study was designed to test a new robotic knee brace for restoring mobility in stroke survivors.

Design Twenty-four ambulatory individuals with chronic hemiparesis after stroke were enrolled in this pilot study. The participants were randomly assigned in equal numbers to either treatment with the experimental device or to a group exercise program and received a total of 18 hrs of their assigned therapy during a 6-wk training period. The primary outcome was gait velocity, as measured with the 10-m walk test. Secondary measures included 6-min walk test, Timed Up and Go test, Five-Times-Sit-to-Stand test, Romberg test, Emory Functional Ambulation Profile, Berg Balance scale, and the California Functional Evaluation 40.

Results Twenty subjects completed the entire protocol and all follow-up visits. No significant differences between the two groups were found for the primary outcome measure at either the completion of training (week 6) or at the 3-mo follow-up (week 19), with inconsistent findings for secondary measures. No within-group changes were seen in the primary outcome measure (10-m walk test) in either group. Within-group improvements were seen in several of the secondary measures for both groups. No complications of robotic therapy were observed.

Conclusions Robotic therapy for ambulatory stroke patients with chronic hemiparesis using a robotic knee brace resulted in only modest functional benefits that were comparable with a group exercise intervention.

From the Department of Rehabilitation and Regenerative Medicine, Columbia University College of Physicians and Surgeons (JS, LB, CKW); Division of Rehabilitation Medicine, Weill Cornell Medical College (JS); Department of Rehabilitation Medicine, New York-Presbyterian Hospital, New York, New York (JS); and Department of Medicine, University of Virginia Medical Center, Charlottesville, Virginia (DJS).

All correspondence and requests for reprints should be addressed to: Joel Stein, MD, Department of Rehabilitation and Regenerative Medicine, Columbia University College of Physicians and Surgeons, Harkness Pavilion Room 1-165, New York, NY 10032.

Supported by Tibion, Inc (now part of AlterG, Fremont, CA), which provided feedback on study design, but did not participate in the conduct of the study, interpretation, or reporting of the results.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2014 by Lippincott Williams & Wilkins