Slow Versus Fast Robot-Assisted Locomotor Training After Severe Stroke A Randomized Controlled Trial

Slow Versus Fast Robot-Assisted Locomotor Training After Severe Stroke A Randomized Controlled Trial

Author Rodrigues, Thais Amanda Google Scholar
Goroso, Daniel Gustavo Autor UNIFESP Google Scholar
Westgate, Philip M. Google Scholar
Carrico, Cheryl Google Scholar
Batistella, Linamara R. Google Scholar
Sawaki, Lumy Google Scholar
Abstract Background and Purpose: Robot-assisted locomotor training on a bodyweight-supported treadmill is a rehabilitation intervention that compels repetitive practice of gait movements. Standard treadmill speed may elicit rhythmic movements generated primarily by spinal circuits. Slower-than-standard treadmill speed may elicit discrete movements, which are more complex than rhythmic movements and involve cortical areas. Objective: Compare effects of fast (i.e., rhythmic) versus slow (i.e., discrete) robot-assisted locomotor training on a bodyweight-supported treadmill in subjects with chronic, severe gait deficit after stroke. Methods: Subjects (N = 18) were randomized to receive 30 sessions (5 d/wk) of either fast or slow robot-assisted locomotor training on a bodyweight-supported treadmill in an inpatient setting. Functional ambulation category, time up and go, 6-min walk test, 10-m walk test, Berg Balance Scale, and Fugl-Meyer Assessment were administered at baseline and postintervention. Results: The slow group had statistically significant improvement on functional ambulation category (first quartile-third quartile, P = 0.004), 6-min walk test (95% confidence interval [CI] = 1.8 to 49.0, P = 0.040), Berg Balance Scale (95% CI = 7.4 to 14.8, P < 0.0001), time up and go (95% CI = -79.1 to 5.0, P < 0.0030), and Fugl-Meyer Assessment (95% CI = 24.1 to 45.1, P < 0.0001). The fast group had statistically significant improvement on Berg Balance Scale (95% CI = 1.5 to 10.5, P = 0.02). Conclusions: In initial stages of robot-assisted locomotor training on a bodyweight-supported treadmill after severe stroke, slow training targeting discrete movement may yield greater benefit than fast training.
Keywords Cerebral Vascular Disorders
Lower Limb
Neurorehabilitation
Neuroplasticity
Physical Therapy
Motor Training
Walking
xmlui.dri2xhtml.METS-1.0.item-coverage Philadelphia
Language English
Sponsor Coordination of Improvement of Higher Level Personnel-CAPES
Cardinal Hill Rehabilitation Hospital Endowed Chair in Stroke and Spinal Cord Injury Rehabilitation
Date 2017
Published in American Journal Of Physical Medicine & Rehabilitation. Philadelphia, v. 96, n. 10, p. S165-S170, 2017.
ISSN 0894-9115 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent S165-S170
Origin http://dx.doi.org/10.1097/PHM.0000000000000810
Access rights Closed access
Type Article
Web of Science ID WOS:000411722400008
URI https://repositorio.unifesp.br/handle/11600/57305

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