Article

A task-specific repetitive approach in gait rehabilitation after CNS
lesion is well accepted nowadays. To ease the therapists' and patients' physical
effort, the past two decades have seen the introduction of gait machines to
intensify the amount of gait practice. Two principles have emerged, an
exoskeleton- and an endeffector-based approach. Both systems share the harness
and the body weight support. With the end-effector-based devices, the patients'
feet are positioned on two foot plates, whose movements simulate stance and swing
phase. This article provides an overview on the end-effector based
machine's effectiveness regarding the restoration of gait. METHODS: For the
electromechanical gait trainer GT I, a meta analysis identified nine controlled
trials (RCT) in stroke subjects (n = 568) and were analyzed to detect differences
between end-effector-based locomotion + physiotherapy and physiotherapy alone.
RESULTS: Patients practising with the machine effected in a superior gait ability
(210 out of 319 patients, 65.8% vs. 96 out of 249 patients, 38.6%, respectively,
Z = 2.29, p = 0.020), due to a larger training intensity. Only single RCTs have
been reported for other devices and etiologies.
CONCLUSION: The introduction of
end-effector based gait machines has opened a new succesful chapter in gait
rehabilitation after CNS lesion.

Langue : ANGLAIS