Article

OBJECTIVE: To test the feasibility of patient-cooperative robotic gait training
for improving locomotor function of a chronic stroke survivor with severe
lower-extremity motor impairments. DESIGN: Single-subject crossover design.
SETTING: Performed in a controlled laboratory setting. PARTICIPANT: A 62-year-old
man with right temporal lobe ischemic stroke was recruited for this study. The
baseline lower-extremity Fugl-Meyer score of the subject was 10 on a scale of 34,
which represented severe impairment in the paretic leg. However, the subject had
a good ambulation level (community walker with the aid of a stick cane and
ankle-foot orthosis) and showed no signs of sensory or cognitive impairments.
INTERVENTIONS: The subject underwent 12 sessions (3 times per week for 4wk) of
conventional robotic training with the Lokomat, where the robot provided full
assistance to leg movements while walking, followed by 12 sessions (3 times per
week for 4wk) of patient-cooperative robotic control training, where the robot
provided minimal guidance to leg movements during walking. MAIN OUTCOME MEASURES:
Clinical outcomes were evaluated before the start of the intervention,
immediately after 4 weeks of conventional robotic training, and immediately after
4 weeks of cooperative control robotic training. These included: (1)
self-selected and fast walking speed, (2) 6-minute walk test, (3) Timed Up & Go
test, and (4) lower-extremity Fugl-Meyer score. RESULTS: Results showed that
clinical outcomes changed minimally after full guidance robotic training, but
improved considerably after 4 weeks of reduced guidance robotic training.
CONCLUSIONS: The findings from this case study suggest that cooperative control
robotic training is superior to conventional robotic training and is a feasible
option to restoring locomotor function in ambulatory stroke survivors with severe
motor impairments. A larger trial is needed to verify the efficacy of this
advanced robotic control strategy in facilitating gait recovery after stroke.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS