Effect of robotic-assisted gait training on functional independence measure scores in patients with acquired brain...

Many individuals with acquired brain injury require inpatient rehabilitation services. Robotic devices, including robotic exoskeletons for gait training, have been shown to optimize rehabilitation efforts and functional outcomes. The purpose of this study was to investigate the effect of robotic-assisted gait training using the Ekso GT robotic-assisted gait training device (Ekso Bionics) on Functional Independence Measure (FIM) scores in patients with subacute acquired brain injuries.

This retrospective study assessed patients who participated in traditional physical therapy during an acute neurological rehabilitation stay; study group participants also received at least 3 robotic-assisted gait training sessions during their rehabilitation stay. Patient medical records were reviewed retrospectively to collect patient demographic and clinical data, including patient age and sex, admission date, acquired brain injury category, number of robotic-assisted gait training sessions and session details, length of stay, and admission and discharge FIM overall scores, as well as the scores for the gait, transfer, motor, and cognition FIM subscales. Change in FIM score was used as the primary outcome measure.

The study group and the control group each included 56 patients (study group: 44 patients with cerebrovascular accident, 12 with traumatic brain injury; control group: 45 patients with cerebrovascular accident, 11 with traumatic brain injury). Summary statistics revealed similar characteristics between the groups in all areas except mean length of stay, which was significantly longer in the study group (P = 0.04) compared to the control group. Analysis of variance was used to assess the treatment effect between the study and control groups; no significant difference was found between the 2 groups in change in FIM scores between admission and discharge. Regression analysis showed a significant difference between the baseline and discharge scores in the study group for all 5 FIM categories assessed (overall, gait, transfer, motor, and cognition).

These results indicate that robotic walking devices, when used for gait training in patients with acquired brain injury, led to similar improvements in FIM scores compared with traditional gait training. No negative effects were observed associated with the use of this robotic walking device in patients recovering from acquired brain injury.