Effects of Non-Suspended Robot-Assisted Ambulatory Training on Stroke Patients

Background: The study aimed to investigate the effects of non-suspended robot-assisted ambulatory training with approximately 80-100% weight-bearing during the stance phase on one leg and 0% weight-bearing support during the swing phase on the other leg on hemiplegic stroke patients who were unable to ambulate at baseline. Traditional robot-assisted gait training commonly provided substantial body-weight support (approximately 0-20% weight-bearing during the stance phase on one leg), whereas the present system enables near-normal weight-bearing during gait training. Methods: Pre- and post-assessments of Brunnstrom stage, standing balance, and the Barthel Index of Activities of Daily Living (ADL) were performed in sixty hemiplegic stroke patients (30 right-sided and 30 left-sided hemiplegia) with stroke onset less than 6 months and without ambulatory ability. A retrospective controlled study was performed using a non-suspended robot-assisted ambulatory training machine (RAATM) that provides approximately 80-100% weight-bearing during the stance phase on one leg for more than 150 min a month (>4500 guided steps), combined with a 4-week conventional rehabilitation program (RAATM group, n = 30). Outcomes were compared with those of an age-, affected side-, and baseline walking-ability-matched control group (control group, n = 30) that received only a 4-week conventional rehabilitation program. Results: The average accumulated intervention duration in the RAATM group was 246 ± 74 min, which received intervention of RAATM with 80-100% weight-bearing during the stance phase on one leg and 0% weight-bearing during the swing phase on the other leg. The pre-to-post changes in the Brunnstrom stage of the lower extremities, static standing balance score, dynamic standing balance score, mobility on level surfaces, stairs, and total Barthel Index score were significantly higher in the RAATM group than in the control group. Conclusions: Functions of lower extremities, standing balance, and mobility ability can be improved after intervention of non-suspended RAATM within a month. Non-suspended robot-assisted ambulatory training appeared to be an effective therapeutic approach for hemiplegic stroke patients pre-assessed without ambulatory ability.