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Ankle Training With a Robotic Device Improves Hemiparetic Gait After a Stroke

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Ankle Training With a Robotic Device Improves Hemiparetic Gait After a Stroke

Auteurs : Larry W. Forrester [États-Unis] ; Anindo Roy [États-Unis] ; Hermano Igo Krebs [États-Unis] ; Richard F. Macko [États-Unis]

Source :

Neurorehabilitation and neural repair [ 1545-9683 ] ; 2010.

RBID : PMC:3565577

Abstract

Background

Task-oriented therapies such as treadmill exercise can improve gait velocity after stroke, but slow velocities and abnormal gait patterns often persist, suggesting a need for additional strategies to improve walking.

Objectives

To determine the effects of a 6-week visually guided, impedance controlled, ankle robotics intervention on paretic ankle motor control and gait function in chronic stroke.

Methods

This was a single-arm pilot study with a convenience sample of 8 stroke survivors with chronic hemiparetic gait, trained and tested in a laboratory. Subjects trained in dorsiflexion–plantarflexion by playing video games with the robot during three 1-hour training sessions weekly, totaling 560 repetitions per session. Assessments included paretic ankle ranges of motion, strength, motor control, and overground gait function.

Results

Improved paretic ankle motor control was seen as increased target success, along with faster and smoother movements. Walking velocity also increased significantly, whereas durations of paretic single support increased and double support decreased.

Conclusions

Robotic feedback training improved paretic ankle motor control with improvements in floor walking. Increased walking speeds were comparable with reports from other task-oriented, locomotor training approaches used in stroke, suggesting that a focus on ankle motor control may provide a valuable adjunct to locomotor therapies.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3565577

DOI: 10.1177/1545968310388291
PubMed: 21115945
PubMed Central: 3565577

Affiliations:

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Le document en format XML

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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Task-oriented therapies such as treadmill exercise can improve gait velocity after stroke, but slow velocities and abnormal gait patterns often persist, suggesting a need for additional strategies to improve walking.</p>
</sec>
<sec id="S2"><title>Objectives</title>
<p id="P2">To determine the effects of a 6-week visually guided, impedance controlled, ankle robotics intervention on paretic ankle motor control and gait function in chronic stroke.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P3">This was a single-arm pilot study with a convenience sample of 8 stroke survivors with chronic hemiparetic gait, trained and tested in a laboratory. Subjects trained in dorsiflexion–plantarflexion by playing video games with the robot during three 1-hour training sessions weekly, totaling 560 repetitions per session. Assessments included paretic ankle ranges of motion, strength, motor control, and overground gait function.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">Improved paretic ankle motor control was seen as increased target success, along with faster and smoother movements. Walking velocity also increased significantly, whereas durations of paretic single support increased and double support decreased.</p>
</sec>
<sec id="S5"><title>Conclusions</title>
<p id="P5">Robotic feedback training improved paretic ankle motor control with improvements in floor walking. Increased walking speeds were comparable with reports from other task-oriented, locomotor training approaches used in stroke, suggesting that a focus on ankle motor control may provide a valuable adjunct to locomotor therapies.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
  <pmc-dir>properties manuscript</pmc-dir>
  <front><journal-meta><journal-id journal-id-type="nlm-journal-id">100892086</journal-id>
<journal-id journal-id-type="pubmed-jr-id">22207</journal-id>
<journal-id journal-id-type="nlm-ta">Neurorehabil Neural Repair</journal-id>
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<issn pub-type="epub">1552-6844</issn>
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<article-meta><article-id pub-id-type="pmid">21115945</article-id>
<article-id pub-id-type="pmc">3565577</article-id>
<article-id pub-id-type="doi">10.1177/1545968310388291</article-id>
<article-id pub-id-type="manuscript">NIHMS434237</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Ankle Training With a Robotic Device Improves Hemiparetic Gait After a Stroke</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Forrester</surname>
<given-names>Larry W.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Roy</surname>
<given-names>Anindo</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Krebs</surname>
<given-names>Hermano Igo</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Macko</surname>
<given-names>Richard F.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A4">4</xref>
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</contrib-group>
<aff id="A1"><label>1</label>
University of Maryland, Baltimore, MD, USA</aff>
<aff id="A2"><label>2</label>
VA RR&D Maryland Exercise and Robotics Center of Excellence, Baltimore, MD, USA</aff>
<aff id="A3"><label>3</label>
Massachusetts Institute of Technology, Cambridge, MA, USA</aff>
<aff id="A4"><label>4</label>
Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA</aff>
<author-notes><corresp id="FN1">Corresponding Author: Larry W. Forrester, Department of Physical Therapy & Rehabilitation Science, University of Maryland School of Medicine, 100 Penn Street, Suite 115, Baltimore, MD 21201, USA, <email>lforrester@som.umaryland.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>23</day>
<month>1</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="epub"><day>29</day>
<month>11</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="ppub"><month>5</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>06</day>
<month>2</month>
<year>2013</year>
</pub-date>
<volume>25</volume>
<issue>4</issue>
<fpage>369</fpage>
<lpage>377</lpage>
<permissions><copyright-statement>© The Author(s) 2011</copyright-statement>
<copyright-year>2011</copyright-year>
</permissions>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">Task-oriented therapies such as treadmill exercise can improve gait velocity after stroke, but slow velocities and abnormal gait patterns often persist, suggesting a need for additional strategies to improve walking.</p>
</sec>
<sec id="S2"><title>Objectives</title>
<p id="P2">To determine the effects of a 6-week visually guided, impedance controlled, ankle robotics intervention on paretic ankle motor control and gait function in chronic stroke.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P3">This was a single-arm pilot study with a convenience sample of 8 stroke survivors with chronic hemiparetic gait, trained and tested in a laboratory. Subjects trained in dorsiflexion–plantarflexion by playing video games with the robot during three 1-hour training sessions weekly, totaling 560 repetitions per session. Assessments included paretic ankle ranges of motion, strength, motor control, and overground gait function.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">Improved paretic ankle motor control was seen as increased target success, along with faster and smoother movements. Walking velocity also increased significantly, whereas durations of paretic single support increased and double support decreased.</p>
</sec>
<sec id="S5"><title>Conclusions</title>
<p id="P5">Robotic feedback training improved paretic ankle motor control with improvements in floor walking. Increased walking speeds were comparable with reports from other task-oriented, locomotor training approaches used in stroke, suggesting that a focus on ankle motor control may provide a valuable adjunct to locomotor therapies.</p>
</sec>
</abstract>
<kwd-group><kwd>stroke</kwd>
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<kwd>ankle robot</kwd>
<kwd>hemiparetic gait</kwd>
</kwd-group>
<funding-group><award-group><funding-source country="United States">National Institute on Aging : NIA</funding-source>
<award-id>P30 AG028747 || AG</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>États-Unis</li>
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<region><li>Maryland</li>
<li>Massachusetts</li>
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<tree><country name="États-Unis"><region name="Maryland"><name sortKey="Forrester, Larry W" sort="Forrester, Larry W" uniqKey="Forrester L" first="Larry W." last="Forrester">Larry W. Forrester</name>
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<name sortKey="Forrester, Larry W" sort="Forrester, Larry W" uniqKey="Forrester L" first="Larry W." last="Forrester">Larry W. Forrester</name>
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<name sortKey="Macko, Richard F" sort="Macko, Richard F" uniqKey="Macko R" first="Richard F." last="Macko">Richard F. Macko</name>
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<name sortKey="Macko, Richard F" sort="Macko, Richard F" uniqKey="Macko R" first="Richard F." last="Macko">Richard F. Macko</name>
<name sortKey="Roy, Anindo" sort="Roy, Anindo" uniqKey="Roy A" first="Anindo" last="Roy">Anindo Roy</name>
<name sortKey="Roy, Anindo" sort="Roy, Anindo" uniqKey="Roy A" first="Anindo" last="Roy">Anindo Roy</name>
</country>
</tree>
</affiliations>
</record>

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Ankle Training With a Robotic Device Improves Hemiparetic Gait After a Stroke

Ankle Training With a Robotic Device Improves Hemiparetic Gait After a Stroke

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Abstract

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