Prospective, blinded, randomized crossover study of gait rehabilitation in stroke patients using the Lokomat gait orthosis
ABSTRACT Treadmill training with partial body weight support has been suggested as a useful strategy for gait rehabilitation after stroke. This prospective, blinded, randomized controlled study of gait retraining tested the feasibility and potential efficacy of using an electromechanical-driven gait orthosis (Lokomat) for treadmill training.
Sixteen stroke patients, mostly within 3 months after onset, were randomized into 2 treatment groups, ABA or BAB (A = 3 weeks of Lokomat training, B = 3 weeks of conventional physical therapy) for 9 weeks of treatment. The outcome measures were the EU-Walking Scale, Rivermead Motor Assessment Scale, 10-m timed walking speed, 6-minute timed walking distance, Motricity Index, Medical Research Council Scale of strength, and Ashworth Scale of tone.
The EU-Walking Scale, Rivermead Motor Assessment Scale, 6-minute timed walking distance, Medical Research Council Scale, and Ashworth Scale demonstrated significantly more improvement during the Lokomat training phase than during the conventional physical therapy phase within each 3-week interval.
Despite the small number of patients, the present data suggest that the Lokomat robotic assistive device provides innovative possibilities for gait training in stroke rehabilitation while eliminating prolonged repetitive movements in a nonergonomic position on the part of the physical therapist.
- SourceAvailable from: Christian Geroin
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ABSTRACT: Objective: The aim of this systematic review was to identify appropriate selection criteria of clinical scales for future trials, starting from those most commonly reported in the literature, according to their psychometric properties and International Classification of Functioning, Disability and Health (ICF) domains. Data sources: A computerized literature research of articles was conducted in MEDLINE, EMBASE, CINALH, Pub-Med, PsychINFO and Scopus databases. Study selection: Clinical trials evaluating the effects of elec-tromechanical and robot-assisted gait training trials in stroke survivors. Data extraction: Fifteen independent authors performed an extensive literature review. Data synthesis: A total of 45 scales was identified from 27 studies involving 966 subjects. The most commonly used outcome measures were: Functional Ambulation Category (18 studies), 10-Meter Walking Test (13 studies), Motricity Index (12 studies), 6-Minute Walking Test (11 studies), Riv-ermead Mobility Index (8 studies) and Berg Balance Scale (8 studies). According to the ICF domains 1 outcome measure was categorized into Body Function and Structure, 5 into Activity and none into Participation. Conclusion: The most commonly used scales evaluated the basic components of walking. Future studies should also in-clude instrumental evaluation. Criteria for scale selection should be based on the ICF framework, psychometric prop-erties and patient characteristics.Journal of rehabilitation medicine: official journal of the UEMS European Board of Physical and Rehabilitation Medicine 10/2013; 45(45):987-996. DOI:10.2340/16501977-1234 · 1.90 Impact Factor
- Neurorehabilitation 01/2013; 33(3):491-501. · 1.74 Impact Factor