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Updated: Jan 10, 2026
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A Rehabilitation Program of Exoskeleton-assisted Body Weight-Supported Treadmill Training with Non-immersive Virtual Reality for Stroke Patients
Published on: May 16, 2025
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Walking adaptability training for individuals after stroke (ATTAINS): study protocol for a randomized, waiting-list
Marijne Nieuwelink1,2, Katrijn Smulders3, Jip Kamphuis4
1Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands. m.nieuwelink@maartenskliniek.nl.
Trials
|November 28, 2025
Summary
This study evaluates C-mill augmented reality training for improving walking adaptability in people with stroke. Results will guide tailored rehabilitation strategies for chronic stroke survivors.
Area of Science:
- Neurorehabilitation
- Biomechanics
- Clinical Trials
Background:
- Chronic stroke survivors often struggle with gait adaptability, impacting daily independence.
- Walking adaptability is crucial for safe mobility in diverse environments.
- Augmented reality (AR) treadmill training (C-mill) shows potential for improving gait adaptability.
Purpose of the Study:
- To evaluate the efficacy of C-mill-based task-specific training on walking adaptability in chronic stroke survivors.
- To conduct a responder analysis to identify predictors of treatment success.
Main Methods:
- A single-center, randomized, waiting-list controlled trial involving 84 participants with chronic stroke.
- Participants received 10 hours of C-mill training over 5 weeks, or usual care followed by training.
- Primary outcomes included the Emory Functional Ambulation Profile obstacle subtask and the Walking Adaptability Ladder Test.
Main Results:
- The study is designed to detect significant effects on primary outcomes (EFAP-obstacle, WALT) with p < 0.025.
- Secondary outcomes include lab-based assessments of stepping and gait stability, clinical balance/walking tests, and home-based activity monitoring.
- Responder analysis will explore determinants of treatment effects across both groups.
Conclusions:
- Findings are expected to inform personalized walking adaptability training for stroke survivors.
- This research contributes to evidence-based neurorehabilitation strategies.
- Optimizing gait adaptability can enhance functional independence and reduce fall risk in chronic stroke.
