http://www.jneuroengrehab.com/content/9/1/57/abstract
Abstract (provisional)
Background
Clinical outcomes after robotic training are often not superior to conventional therapy.
One key factor responsible for this is the use of control strategies that provide
substantial guidance. This strategy not only leads to a reduction in volitional physical
effort, but also interferes with motor relearning.
Methods
We tested the feasibility of a novel training approach (active robotic training) using
a powered gait orthosis (Lokomat) in mitigating post-stroke gait impairments of a
52-year-old male stroke survivor. This gait training paradigm combined patient-cooperative
robot-aided walking with a target-tracking task. The training lasted for 4-weeks (12
visits, 3 [MULTIPLICATION SIGN] per week). The subject's neuromotor performance and
recovery were evaluated using biomechanical, neuromuscular and clinical measures recorded
at various time-points (pre-training, post-training, and 6-weeks after training).
Results
Active robotic training resulted in considerable increase in target-tracking accuracy
and reduction in the kinematic variability of ankle trajectory during robot-aided
treadmill walking. These improvements also transferred to overground walking as characterized
by larger propulsive forces and more symmetric ground reaction forces (GRFs). Training
also resulted in improvements in muscle coordination, which resembled patterns observed
in healthy controls. These changes were accompanied by a reduction in motor cortical
excitability (MCE) of the vastus medialis, medial hamstrings, and gluteus medius muscles
during treadmill walking. Importantly, active robotic training resulted in substantial
improvements in several standard clinical and functional parameters. These improvements
persisted during the follow-up evaluation at 6 weeks.
Conclusions
The results indicate that active robotic training appears to be a promising way of
facilitating gait and physical function in moderately impaired stroke survivors.
I am aviation structures and systems engineer, a former soldier and a film-maker, very able and fit, but shattered by an ischemic event on
ReplyDeleteDec 01/2012 while shopping in a city. I did not lose consciousness
from event to discharge from rehab, but loping like zombie. While the
paramedics were efficient and a credit, A&E was in weekend mode but eventually I was given the anti-thrombo injection(with many cautions) which seemed to work well, but thereafter the protocol all seemed to fall apart, and I experienced an saw several alarming , stress-creating episodes in both hospitals, and before being discharged I was taken by two lady physios to a hospital gym for assessment and remedial exercise, only to be barred from this as the non-medical NHS 'managers' had started 'surgical' building
operations on the gym interior, complete with scaffolding, cutting of panelling (with deadly plastic dust generation) cabling and noise -
all of which stressed the physios and myself !
I was discharged to my home-alone address, offered 'care' but
declined it since I wanted to work on my own recovery, which until that time mr self-recovery had seemed encouraging.,
However, further real 'physio' was denied, and remedial post-stroke
massage , recognized in civilized countries as often successful
in winning back normal mobility and confidence of those hit by
neuro-damage.
my admission report stated that I was seen by a neuropathic doctor. I never saw one or was examined by such a specialist,
neither on admission nor later. I requested to get a post-event
neuro prognosis, was given an appointment, but no assessment
was carried by the young doctor, who seemed not to too interested
in the four minutes I was given.
I suppose it is because I am past 50 that I am , with thousands of
others, left in limbo, which of course is resulting in a build-up of a
large sector of the UK population dependent upon costly drugs,
hospital visits and the destruction of many lives.and families.
By implementing proper and affordable regimes, such as massage,
robotics, natural herb-taking, Reiki, Music Therapy and electrical
stimulation
The NHS , as directed by its profit-seeking 'managers' is wrecking many lives.
I don't believe there are neuropathic doctors unless you are referring the the quackery of naturopathic doctors. Reiki and herb-taking would also be considered quackery.
DeleteThe only proven way to get back function is lots of repetition of movements.