Article

Robotic-assisted walking training after stroke aims to enable highly
impaired patients to walk independently, but results have been mixed.
The authors aimed to identify the characteristics of patients who may be most
likely to benefit. METHODS: A total of 48 participants with motor and gait
dysfunction following subacute stroke were stratified by the motricity index into
high (<29) and low (>/= 29) motor impairment groups. Each arm was randomized to a
robotic or control group (RG or CG) at a mean of 20 days after stroke. All
patients underwent 2 therapy sessions per day, 5 days per week for 3 months.
Those in the RG underwent 20 sessions of robotic-assisted gait training in the
first 4 weeks of inpatient therapy using controlled endpoint trajectories and
abbreviated conventional therapy, whereas the CG received only conventional gait
training. The primary outcome was the functional ambulation category (FAC), and
secondary measures were the Rivermead mobility index (RMI) and 6-minute walking
distance, all evaluated at hospital admission and at discharge. RESULTS: The
lower motricity group assigned to an electromechanical device significantly
improved in the FAC (P < .001), RMI (P = .001), and walking distance (P = .029).
Conventional and robotic therapies were equivalent in the higher motricity arm.
CONCLUSION: Robotic therapy combined with conventional therapy may be more
effective than conventional therapy alone in patients with greater motor
impairment during inpatient stroke rehabilitation.

Langue : ANGLAIS