Effect of assist-as-needed robotic gait training on the gait pattern post stroke: a randomized controlled trial

LOPES was first written up in Sept. 2007.

LOPES researchers hope to get the device into rehabilitation clinics by early 2012, with a mid-2012 target for introduction into the market. 

Is it available and does your hospital know about it? Have they been following this for the past 13 years? Or are they completely incompetent? But then it doesn't seem to work that well. 

Earlier research here:

• LOPES (1)

• LOPES Exoskeleton (1)

 

Effect of assist-as-needed robotic gait training on the gait pattern post stroke: a randomized controlled trial 

• J. F. Alingh,
• B. M. Fleerkotte,
• B. E. Groen,
• J. S. Rietman,
• V. Weerdesteyn,
• E. H. F. van Asseldonk,
• A. C. H. Geurts &
• J. H. Buurke 

Journal of NeuroEngineering and Rehabilitation volume 18, Article number: 26 (2021) Cite this article

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Abstract

Background

Regaining gait capacity is an important rehabilitation goal post stroke. Compared to clinically available robotic gait trainers, robots with an assist-as-needed approach and multiple degrees of freedom (AAN_mDOF) are expected to support motor learning, and might improve the post-stroke gait pattern. However, their benefits compared to conventional gait training have not yet been shown in a randomized controlled trial (RCT). The aim of this two-center, assessor-blinded, RCT was to compare the effect of AAN_mDOF robotic to conventional training on the gait pattern and functional gait tasks during post-stroke inpatient rehabilitation.

Methods

Thirty-four participants with unilateral, supratentorial stroke were enrolled (< 10 weeks post onset, Functional Ambulation Categories 3–5) and randomly assigned to six weeks of AAN_mDOF robotic (combination of training in LOPES-II and conventional gait training) or conventional gait training (30 min, 3–5 times a week), focused on pre-defined training goals. Randomization and allocation to training group were carried out by an independent researcher. External mechanical work (W_EXT), spatiotemporal gait parameters, gait kinematics related to pre-defined training goals, and functional gait tasks were assessed before training (T0), after training (T1), and at 4-months follow-up (T2).

Results

Two participants, one in each group, were excluded from analysis because of discontinued participation after T0, leaving 32 participants (AAN_mDOF robotic n = 17; conventional n = 15) for intention-to-treat analysis. In both groups, W_EXT had decreased at T1 and had become similar to baseline at T2, while gait speed had increased at both assessments. In both groups, most spatiotemporal gait parameters and functional gait tasks had improved at T1 and T2. Except for step width (T0–T1) and paretic step length (T0–T2), there were no significant group differences at T1 or T2 compared to T0. In participants with a pre-defined goal aimed at foot clearance, paretic knee flexion improved more in the AAN_mDOF robotic group compared to the conventional group (T0–T2).

Conclusions

Generally, AAN_mDOF robotic training was not superior to conventional training for improving gait pattern in subacute(What does subacute mean?) stroke survivors. Both groups improved their mechanical gait efficiency. Yet, AAN_mDOF robotic training might be more effective to improve specific post-stroke gait abnormalities such as reduced knee flexion during swing.

Trial registration Registry number Netherlands Trial Register (www.trialregister.nl): NTR5060. Registered 13 February 2015.