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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Yeung, Ling-Fung Ockenfeld, Corinna Pang, Man-Kit Wai, Hon-Wah Soo, Oi-Yan Li, Sheung-Wai Tong, Kai-Yu |
| Abstract | Background Robot-assisted ankle-foot-orthosis (AFO) can provide immediate powered ankle assistance in post-stroke gait training. Our research team has developed a novel lightweight portable robot-assisted AFO which is capable of detecting walking intentions using sensor feedback of wearer’s gait pattern. This study aims to investigate the therapeutic effects of robot-assisted gait training with ankle dorsiflexion assistance. Methods This was a double-blinded randomized controlled trial. Nineteen chronic stroke patients with motor impairment at ankle participated in 20-session robot-assisted gait training for about five weeks, with 30-min over-ground walking and stair ambulation practices. Robot-assisted AFO either provided active powered ankle assistance during swing phase in Robotic Group (n = 9), or torque impedance at ankle joint as passive AFO in Sham Group (n = 10). Functional assessments were performed before and after the 20-session gait training with 3-month Follow-up. Primary outcome measure was gait independency assessed by Functional Ambulatory Category (FAC). Secondary outcome measures were clinical scores including Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS), Berg Balance Scale (BBS), Timed 10-Meter Walk Test (10MWT), Six-minute Walk Test (SMWT), supplemented by gait analysis. All outcome measures were performed in unassisted gait after patients had taken off the robot-assisted AFO. Repeated-measures analysis of covariance was conducted to test the group differences referenced to clinical scores before training. Results After 20-session robot-assisted gait training with ankle dorsiflexion assistance, the active ankle assistance in Robotic Group induced changes in gait pattern with improved gait independency (all patients FAC ≥ 5 post-training and 3-month follow-up), motor recovery, walking speed, and greater confidence in affected side loading response (vertical ground reaction force + 1.49 N/kg, peak braking force + 0.24 N/kg) with heel strike instead of flat foot touch-down at initial contact (foot tilting + 1.91°). Sham Group reported reduction in affected leg range of motion (ankle dorsiflexion − 2.36° and knee flexion − 8.48°) during swing. Conclusions Robot-assisted gait training with ankle dorsiflexion assistance could improve gait independency and help stroke patients developing confidence in weight acceptance, but future development of robot-assisted AFO should consider more lightweight and custom-fit design. Trial registration ClinicalTrials.gov NCT02471248 . Registered 15 June 2015 retrospectively registered. |
| Related Links | https://jneuroengrehab.biomedcentral.com/counter/pdf/10.1186/s12984-018-0394-7.pdf |
| Ending Page | 12 |
| Page Count | 12 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 17430003 |
| DOI | 10.1186/s12984-018-0394-7 |
| Journal | Journal of NeuroEngineering and Rehabilitation |
| Issue Number | 1 |
| Volume Number | 15 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2018-06-19 |
| Access Restriction | Open |
| Subject Keyword | Neurosciences Neurology Rehabilitation Medicine Biomedical Engineering and Bioengineering Stroke Robotics Exoskeletons Ankle foot orthosis Gait training |
| Content Type | Text |
| Resource Type | Article |
| Subject | Health Informatics Rehabilitation |
| Journal Impact Factor | 5.2/2023 |
| 5-Year Journal Impact Factor | 5.6/2023 |
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