Shaping neuroplasticity by using powered exoskeletons in patients with stroke: a randomized clinical trial

Autor: Rocco Salvatore Calabrò, Antonino Naro, Margherita Russo, Placido Bramanti, Luigi Carioti, Tina Balletta, Antonio Buda, Alfredo Manuli, Serena Filoni, Alessia Bramanti
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Journal of NeuroEngineering and Rehabilitation, Vol 15, Iss 1, Pp 1-16 (2018)
Druh dokumentu: article
ISSN: 1743-0003
DOI: 10.1186/s12984-018-0377-8
Popis: Abstract Background The use of neurorobotic devices may improve gait recovery by entraining specific brain plasticity mechanisms, which may be a key issue for successful rehabilitation using such approach. We assessed whether the wearable exoskeleton, Ekso™, could get higher gait performance than conventional overground gait training (OGT) in patients with hemiparesis due to stroke in a chronic phase, and foster the recovery of specific brain plasticity mechanisms. Methods We enrolled forty patients in a prospective, pre-post, randomized clinical study. Twenty patients underwent Ekso™ gait training (EGT) (45-min/session, five times/week), in addition to overground gait therapy, whilst 20 patients practiced an OGT of the same duration. All individuals were evaluated about gait performance (10 m walking test), gait cycle, muscle activation pattern (by recording surface electromyography from lower limb muscles), frontoparietal effective connectivity (FPEC) by using EEG, cortico-spinal excitability (CSE), and sensory-motor integration (SMI) from both primary motor areas by using Transcranial Magnetic Stimulation paradigm before and after the gait training. Results A significant effect size was found in the EGT-induced improvement in the 10 m walking test (d = 0.9, p
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