Article

Although gait abnormality is one of the most disabling events following stroke,
cognitive, and psychological impairments can be devastating. The Lokomat is a
robotic that has been used widely for gait rehabilitation in several movement
disorders, especially in the acute and subacute phases. The aim of this study was
to evaluate the effectiveness of gait robotic rehabilitation in patients affected
by chronic stroke. Psychological impact was also taken into consideration. Thirty
patients (13 women and 17 men) affected by chronic stroke entered the study. All
participants underwent neurological examination with respect to ambulation,
Ashworth, Functional Independence Measure, and Tinetti scales to assess their
physical status, and Hamilton Rating Scale for Depression, Psychological General
Well-being Index, and Coping Orientation to Problem Experienced to evaluate the
Lokomat-related psychological impact before and after either a conventional
treatment or the robotic training. During each rehabilitation period (separated
by a no-treatment period), patients underwent a total of 40 1 h training sessions
(i.e. five times a week for 8 weeks). After the conventional treatment, the
patients did not achieve a significant improvement in the functional status,
except balance (P<0.001) and walking ability (P<0.01), as per the Tinetti scale.
Indeed, after the robotic rehabilitation, significant improvements were detected
in almost all the motor and psychological scales that we investigated,
particularly for Psychological General Well-being Index and Coping Orientation to
Problem Experienced. Manual and robotic-assisted body weight-supported treadmill
training optimizes the sensory inputs relevant to step training, repeated
practice, as well as neuroplasticity. Several controlled trials have shown a
superior effect of Lokomat treatment in stroke patients' walking ability and
velocity in particular. Therefore, our preliminary results proved that active
robotic training not only facilitates gait and physical function but also the
psychological status, even in patients affected by chronic stroke.

Langue : ANGLAIS