Effects of gait training using a two-joint control robot on gait patterns in patients with stroke: a non-randomized Clinical trial

Tatsuya Teramae, Kohsuke Okada, Yuichiro Hosoi, Takayuki Kamimoto, Tomoyuki Noda, Koshiro Haruyama, Haruna Ukigai, Tetsuya Tsuji, Michiyuki Kawakami
Purpose:

We aimed to verify the impact of gait training using a gait robot that controls knee and ankle joints with pneumatic artificial muscles on gait patterns in patients with chronic stroke. 

Methods:

The study was designed as a non-randomized controlled trial. The subjects were 24 patients with chronic stroke trained to gait using a gait robot that controls knee and ankle joints with pneumatic artificial muscles (RAGT, n=12) and trained to gait using a treadmill (Treadmill training, n=12). Both groups trained for 3 sets of 10 minutes for 10 days under the supervision of a medical doctor and a physiotherapist. The primary outcome was gait analysis using a three-dimensional motion analysis system (Vicon Nexus) and a floor reaction force meter (ANIMA) under barefoot conditions. Secondary outcomes were comfortable gait speed (CGS) and 6-minute walking distance (6MD). The training effects of each group were analyzed using the pre-and post-intervention assessment items. The Wilcoxon Signed-rank test validated within-group comparisons, and two-way ANOVA validated between-group comparisons.

Results:

Each training group showed improvements in CGS and 6MD pre- and post-intervention, but no significant differences existed. In the RAGT group, the normalized cross-correlation coefficient (F-Value = 8.54, p0.01), which indicates the similarity of the left and right knee joint angle waveforms during gait, and the propulsive force (F-Value = 5.50, p0.05) on the paretic side significantly improved compared to the Treadmill training group. 

Conclusion(s):

The results of this study suggest that gait training using a gait robot that controls knee and ankle joints with pneumatic artificial muscles may contribute to the improvement of gait patterns and propulsive force on the palsy side in patients with chronic stroke.

Implications:

We suggest that gait training using a gait robot that controls knee and ankle joints for patients with chronic stroke may be a new gait rehabilitation method that suppresses abnormal gait patterns and promotes the reacquisition of an efficient gait pattern.

Funding acknowledgements:
This study was supported by AMED (Grant Number JP22he2202017).
Keywords:
patients with chronic stroke
RAGT
gait pattern
Primary topic:
Disability and rehabilitation
Second topic:
Neurology: stroke
Third topic:
Innovative technology: robotics
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Keio University School of Medicine Ethics Committee
Provide the ethics approval number:
20190246
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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