Robotic Restoration of Gait Function in Patients in the Early Recovery Period of Stroke

Autor: K A Petrushanskaya, L. Kh. Kodzokova, E V Pismennaya, Kotov Sv, E. V. Isakova, M. V. Romanova, V. Yu. Lijdvoy
Rok vydání: 2021
Předmět:
Zdroj: Neuroscience and Behavioral Physiology. 51:583-589
ISSN: 1573-899X
0097-0549
Popis: Objective. To compare the efficacy of restoration of gait function in patients in the early recovery period of ischemic stroke (IS) using a lower limb exoskeleton and an active-passive pedal bicycle trainer. Materials and methods. An open randomized study of 47 patients in the early recovery period of IS was undertaken. Patients in group 1 received a single rehabilitation course including exoskeleton exercises using an ExoAtlet exoskeleton; those of group 2 used a pedal trainer for active-passive training (five days per week for two weeks). Treatment results were assessed using a series of tests, including the Hauser Ambulation Index, the 10-m walking test, the Berg balance test, stabilometry, and gait biomechanics. Training courses were completed by 20 patients in group 1 and 21 in group 2. Results. Completion of training courses was followed by statistically significant increases in strength in the paretic muscles, postural stability, functional level, and walking speed in patients of both groups, though recovery was statistically significantly more marked in patients of group 1 (p < 0.05). Patients of group 1 showed a statistically significant decrease in the level of disability and an increase in the activities of daily living, changes being greater than those in group 2. Analysis of the main indicators of the statokinesiogram showed that improvements in patients of group 1 were greater, though statistically significant differences were seen only in the dynamics of the length and area of the curve in the test with the eyes open. Studies of gait biomechanics showed that gait function was altered: there was a statistically significant 2.2-fold reduction in movement speed, a 1.6-fold decrease in double stride length, an a 1.3-fold reduction in tempo compared with normal values. After completion of exercises, patients of group 1 displayed statistically significant increases in double stride length and walking speed and rate and a contraction in the locomotor cycle period. Conclusions. The study identified improvements to locomotion using instrumented rehabilitation using both an exoskeleton and an active-passive pedal trainer, though use of the exoskeleton had advantages, in that it produced statistically significantly greater recovery of strength, stability, and walking speed and symmetry over an analogous period using the trainer. A significant increase in postural stability was obtained with retention of the vertical posture.
Databáze: OpenAIRE
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