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A randomized comparative study of manually assisted versus robotic-assisted body weight supported treadmill training in persons with a traumatic brain injury

ESQUENAZI A; LEE S; PACKEL AT; BRAITMAN LE
PM & R , 2013, vol. 5, n° 4, p. 280-290
Doc n°: 163935
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1016/j.pmrj.2012.10.009
Descripteurs : AF3 - TRAUMATISME CRANIEN, VF - ROBOTIQUE

OBJECTIVES: (1) To compare the effects of robotic-assisted treadmill training
(RATT) and manually assisted treadmill training (MATT) in participants with
traumatic brain injury (TBI) and (2) to determine the potential impact on the
symmetry of temporal walking parameters, 6-minute walk test, and the mobility
domain of the Stroke Impact Scale, version 3.0 (SIS). DESIGN: Randomized
prospective study. SUBJECTS:
A total of 16 participants with TBI and a baseline
over ground walking self-selected velocity (SSV) of >/=0.2 m/s to 0.6 m/s
randomly assigned to either the RATT or MATT group. INTERVENTION: Gait training
for 45 minutes, 3 times a week with either RATT or MATT for a total of 18
training sessions. OUTCOME MEASURES: Primary: Overground walking SSV, maximal
velocity. Secondary: Spatiotemporal symmetry, 6-minute walk test, and SIS.
RESULTS: Between-group differences were not statistically significant for any
measure. However, from pretraining to post-training, the average SSV increased by
49.8% for the RATT group (P = .01) and by 31% for MATT group (P = .06). The
average maximal velocity increased by 14.9% for the RATT group (P = .06) and by
30.8% for the MATT group (P = .01). Less staffing and effort was needed for RATT
in this study. Step-length asymmetry ratio improved during SSV by 33.1% for the
RATT group (P = .01) and by 9.1% for the MATT group (P = .73). The distance
walked increased by 11.7% for the robotic group (P = .21) and by 19.3% for manual
group (P = .03). A statistically significant improvement in the mobility domain
of the SIS was found for both groups (P </= .03). CONCLUSIONS: The results of
this study demonstrate greater improvement in symmetry of gait (step length) for
RATT and no significant differences between RATT and MATT with regard to
improvement in gait velocity, endurance, and SIS. Our study provides evidence
that participants with a chronic TBI can experience improvements in gait
parameters with gait training with either MATT or RATT.
CI - Copyright (c) 2013 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS

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