Article

Gait impairment is a common cause of disability in Parkinson
disease (PD). Electromechanical devices to assist stepping have been suggested as
a potential intervention. OBJECTIVE: . To evaluate whether a rehabilitation
program of robot-assisted gait training (RAGT) is more effective than
conventional physiotherapy to improve walking. METHODS :
A total of 41 patients
with PD were randomly assigned to 45-minute treatment sessions (12 in all), 3
days a week, for 4 consecutive weeks of either robotic stepper training (RST; n =
21) using the Gait Trainer or physiotherapy (PT; n = 20) with active joint
mobilization and a modest amount of conventional gait training. Participants were
evaluated before, immediately after, and 1 month after treatment. Primary
outcomes were 10-m walking speed and distance walked in 6 minutes. RESULTS: .
Baseline measures revealed no statistical differences between groups, but the PT
group walked 0.12 m/s slower; 5 patients withdrew. A statistically significant
improvement was found in favor of the RST group (walking speed 1.22 +/- 0.19 m/s
[P = .035]; distance 366.06 +/- 78.54 m [P < .001]) compared with the PT group
(0.98 +/- 0.32 m/s; 280.11 +/- 106.61 m). The RAGT mean speed increased by 0.13
m/s, which is probably not clinically important. Improvements were maintained 1
month later. CONCLUSIONS: RAGT may improve aspects of walking ability in
patients with PD. Future trials should compare robotic assistive training with
treadmill or equal amounts of overground walking practice.

Langue : ANGLAIS