High-speed Robot-assisted Gait Training on Gait Speed in Individuals with Hemiplegia Due to Stroke: Single-case Design with Multiple Cases

Yoshiaki Maki, Shigeo Tanabe, Masanari Yamada
Purpose:

This study aimed to evaluate whether high-speed RAGT using Welwalk WW-1000, a one-leg-assisted gait robot, is more effective than conventional treadmill gait training in improving gait speed using a single-case design with multiple cases.

Methods:

The participants were five individuals with stroke who were admitted to a convalescent rehabilitation ward (aged 48–72 years, 61–122 days post-onset, Fugl–Meyer Assessment lower limb motor score 14–20 points, Functional Ambulation Categories 3–4, comfortable gait speed 0.22–0.52 m/s, maximum gait speed 0.28–0.69 m/s). This study used an AB single-case design with eight days of conventional treadmill gait training in period A and eight days of high-speed RAGT in period B. In both periods, the participants completed two sets of 5-min training sessions as part of their usual physical therapy. Comfortable and maximum gait speeds were measured three times before each training day and the mean value was calculated. The Tau-U analysis, which accounted for the trends in period A for each participant, was used to calculate the effect sizes. The effect sizes (Tau) from period B compared with period A were combined using a single-case effect size calculator ver. 0.7.3 (Pustejovsky JE, et al., 2023) for the meta-analysis.

Results:

The mean training gait speed for the five participants was 0.50 ± 0.11 m/s on the treadmill and 0.75 ± 0.08 m/s during RAGT. Tau-U values for the five participants ranged from 0.16–0.98 for comfortable gait speed and 0.08–0.97 for maximum gait speed. The meta-analysis showed Tau = 0.66 for comfortable gait speed and Tau = 0.77 for maximum gait speed, both indicating large change.

Conclusion(s):

High-speed gait training with the assistance of a robot enables faster gait training than conventional treadmill gait training, improving comfortable and maximum gait speeds in individuals with stroke.

Implications:

This study may establish new knowledge regarding interventions for persons with stroke who have had limited benefits from conventional interventions in clinical settings. This could lead to the development of large-scale clinical trials, applied research on different patient groups, and advancements in the design and functionality of robotic gait training devices.

Funding acknowledgements:
No funding.
Keywords:
stroke
robot
gait speed
Primary topic:
Neurology: stroke
Second topic:
Innovative technology: robotics
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Ethics Committee of Ukai Rehabilitation Hospital
Provide the ethics approval number:
0025
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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