Article

Modular lower extremity robotics may offer a valuable avenue for
restoring neuromotor control after hemiparetic stroke. Prior studies show that
visually guided and visually evoked practice with an ankle robot (anklebot)
improves paretic ankle motor control that translates into improved overground
walking. OBJECTIVE: To assess the feasibility and efficacy of daily anklebot
training during early subacute hospitalization poststroke. METHODS: Thirty-four
inpatients from a stroke unit were randomly assigned to anklebot (n = 18) or
passive manual stretching (n = 16) treatments. All suffered a first stroke with
residual hemiparesis (ankle manual muscle test grade 1/5 to 4/5), and at least
trace muscle activation in plantar- or dorsiflexion. Anklebot training employed
an "assist-as-needed" approach during >200 volitional targeted paretic ankle
movements, with difficulty adjusted to active range of motion and success rate.
Stretching included >200 daily mobilizations in these same ranges. All sessions
lasted 1 hour and assessments were not blinded. RESULTS: Both groups walked
faster at discharge; however, the robot group improved more in percentage change
of temporal symmetry (P = .032) and also of step length symmetry (P = .038), with
longer nonparetic step lengths in the robot (133%) versus stretching (31%)
groups. Paretic ankle control improved in the robot group, with increased peak (P
</= .001) and mean (P </= .01) angular speeds, and increased movement smoothness
(P </= .01). There were no adverse events. CONCLUSION: Though limited by small
sample size and restricted entry criteria, our findings suggest that modular
lower extremity robotics during early subacute hospitalization is well tolerated
and improves ankle motor control and gait patterning.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS