Article

The use of automated electromechanical devices for gait training in
neurological patients is increasing, yet the functional outcomes of well-defined
training programs using these devices and the characteristics of patients that
would most benefit are seldom reported in the literature. In an observational
study of functional outcomes, we aimed to provide a benchmark for expected change
in gait function in early stroke patients, from an intensive inpatient
rehabilitation program including both robotic and manual gait training. METHODS:
We followed 103 sub-acute stroke patients who met the clinical inclusion criteria
for Body Weight Supported Robotic Gait Training (BWSRGT). Patients completed an
intensive 8-week gait-training program comprising robotic gait training (weeks
0-4) followed by manual gait training (weeks 4-8). A change in clinical function
was determined by the following assessments taken at 0, 4 and 8 weeks (baseline,
mid-point and end-point respectively): Functional Ambulatory Categories (FAC), 10
m Walking Test (10 MWT), and Tinetti Gait and Balance Scales. RESULTS: Over half
of the patients made a clinically meaningful improvement on the Tinetti Gait
Scale (> 3 points) and Tinetti Balance Scale (> 5 points), while over 80% of the
patients increased at least 1 point on the FAC scale (0-5) and improved walking
speed by more than 0.2 m/s. Patients responded positively in gait function
regardless of variables gender, age, aetiology (hemorrhagic/ischemic), and
affected hemisphere. The most robust and significant change was observed for
patients in the FAC categories two and three. The therapy was well tolerated and
no patients withdrew for factors related to the type or intensity of training.
CONCLUSIONS: Eight-weeks of intensive rehabilitation including robotic and manual
gait training was well tolerated by early stroke patients, and was associated
with significant gains in function. Patients with mid-level gait dysfunction
showed the most robust improvement following robotic training.

Langue : ANGLAIS