Efficacy of End-Effector Robot-Assisted Gait Training in Subacute Stroke Patients
Severe Stroke, Acute Stroke, Mild Stroke
About this trial
This is an interventional treatment trial for Severe Stroke focused on measuring Stroke, Robot, Hemiparesis, Gait Training, Rehabilitation, Functional Recovery, Robot-Assisted Gait Training
Eligibility Criteria
Inclusion Criteria:
- first cerebral stroke
- 2 weeks up to 6 months post the acute event (subacute patients)
- age between 18-80 years
- ability to fit into the end-effector footplates
- no significant limitation of joint range of motion
- ability to tolerate upright standing for 60 seconds
- ability to walk unassisted or with little assistance
- ability to give written consent
- compliance with the study procedures
Exclusion Criteria:
- contractures of the hip, knee, or ankle joints that might limit the range of motion during gait
- medical issue that precludes full weight bearing and ambulation (e.g. orthopaedic injuries, pain, severe osteoporosis, or severe spasticity)
- cognitive and/or communicative disability (e.g. due to brain injury): inability to understand the instructions required for the study
- cardiac pathologies, anxiety or psychosis that might interfere with the use of the equipment or testing
Written informed consent was obtained from each subject.
Sites / Locations
- IRCCS San Raffaele Pisana
- Fondazione Don Carlo Gnocchi Onlus
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Robotic Group (RG)
Conventional Group (CG)
Robotic Group (RG) will perform, in addition to conventional therapy, gait training using an end-effector robotic device for Robot-Assisted Gait Training (RAGT), 3 times/week for 20 sessions. During the training, patients will be asked to walk, at a varying speed, for 45 minutes and a partial Body Weight Support (BWS). Participants will start with 30-40% of BWS and an initial speed of 1.5 km/h; increasing to a maximum of between 2.2 and 2.5 km/h and reducing the initial BWS to 15%. The therapist will provide any help during sessions if required. Over 45 minutes, the patient simulates a minimum of 300 steps; patients could rest during the session, though they will be asked to walk continuously for a minimum of 5 minutes during each session.
Conventional Group (CG) will perform conventional gait rehabilitation program. The treatment will include: muscle strengthening exercises and stretching of the lower limb, and static and dynamic exercises for the recovery of balance in the supine and standing positions using assistive devices; training gait exercises with parallel bars or in open spaces performed both with and without assistive devices; training to climb up and down stairs; exercises to improve proprioception in the supine, sitting and standing positions, using a proprioceptive footboard; exercises to improve trunk control.