The Effectiveness of Locomotor Therapy Using Robotic-assisted Gait Training in Subacute Stroke Patients: A Randomized Controlled Trial

Article Outline

• Disclosures
• Objective
• Design
• Setting
• Participants
• Interventions
• Main Outcome Measures
• Results
• Conclusions
• Copyright

Keywords: Rehabilitation, Robotic-assisted, Gait training, Locomotor

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Disclosures 

Z. Meiner, None.

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Objective 

To evaluate the effectiveness of early and prolonged locomotor treatment using a robotic-assisted gait training (RAGT) device (Lokomat™) on the functional outcomes of subacute stroke patients.

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Design 

A non-blinded prospective, randomized, controlled study.

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Setting 

Rehabilitation department in tertiary university medical center.

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Participants 

Sixty-seven subacute stroke patients in the first 3 months following the stroke were randomized into 2 groups as follows. Thirty-seven patients were treated by RAGT and 30 were treated by regular physiotherapy. Inclusion criteria were first stroke, independent ambulation before the stroke, and neurological severity between 6 and 20 according to the National Institutes of Health Stroke Scale (NIHSS).

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Interventions 

RAGT treatment was administered 3 times a week for 30 minutes, combined with regular physiotherapy for 6 weeks. Control patients received the equivalent additional time of regular physiotherapy.

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Main Outcome Measures 

The primary outcome was the ability to walk independently, assessed by the Functional Ambulatory Capacity scale (FAC). The secondary outcomes included the neurological status according to the NIHSS, functional motor assessment using the Stroke Activity Scale (SAS), and gait parameters including gait velocity, endurance, and number of climbed stairs.

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Results 

In the intention-to-treat analysis the RAGT group exhibited greater gains than control group in their ability to walk independently, as expressed by a higher FAC score (P < .01) and in their neurological status according to NIHSS (P < .01). Among those who achieved independent walking, non significant differences between groups were noted according to secondary outcome measures of gait parameters except from step climbing.

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Conclusions 

This controlled study showed that 6 weeks of locomotor therapy using RAGT combined with regular physiotherapy was superior to regular physiotherapy alone in achieving functional walking ability in subacute stroke patients.