Slow Versus Fast Robot-Assisted Locomotor Training After Severe Stroke: A Randomized Controlled Trial
Thais Amanda Rodrigues1, Daniel Gustavo Goroso, Philip M Westgate
1From the Department of Physical Therapy, Institute of Rehabilitation Lucy Montoro, São Paulo, Brazil (TAR); Department of Biomedical Engineering, Institute of Science and Technology, Federal University of São Paulo, São Paulo, Brazil (DGG); Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, Kentucky (PMW); Department of Physical Medicine and Rehabilitation, University of Kentucky, Lexington, Kentucky (CC, LS); Department of Physical Medicine and Rehabilitation, University of São Paulo, São Paulo, Brazil (LRB); and HealthSouth Cardinal Hill Rehabilitation Hospital, Lexington, Kentucky (LS).
Slow robot-assisted locomotor training on a bodyweight-supported treadmill, focusing on discrete movements, showed greater benefits for stroke survivors with severe gait deficits compared to fast training.
Area of Science:
- Neurorehabilitation
- Robotics in Medicine
- Stroke Recovery
Background:
- Robot-assisted locomotor training (RLT) on bodyweight-supported treadmills aids gait rehabilitation.
- Treadmill speed influences movement patterns: fast speeds promote rhythmic, spinal-circuit-driven movements, while slow speeds encourage discrete, cortically-involved movements.
Purpose of the Study:
- To compare the effects of fast (rhythmic) versus slow (discrete) RLT on bodyweight-supported treadmills.
- To evaluate outcomes in individuals with chronic, severe gait deficits following a stroke.
Main Methods:
- Eighteen subjects with severe post-stroke gait deficits were randomized to 30 sessions of either fast or slow RLT.
- Assessments included Functional Ambulation Category, Time Up and Go, 6-Minute Walk Test, 10-Meter Walk Test, Berg Balance Scale, and Fugl-Meyer Assessment.
Main Results:
- The slow RLT group demonstrated significant improvements in functional ambulation, 6-minute walk distance, balance (Berg Balance Scale), and motor function (Fugl-Meyer Assessment).
- The fast RLT group showed significant improvement only in balance (Berg Balance Scale).
Conclusions:
- Slow RLT targeting discrete movements may offer superior benefits in the early stages of rehabilitation for severe stroke patients compared to fast RLT.
- This suggests that the complexity of movement, rather than just repetition, is crucial for recovery.
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