Sunday, May 22, 2016

Accumulated Evidence of Robotic Gait Trainings now included in the AHA Stroke Rehabilitation Guidelines

You can see how long before your stroke department starts following these.  My doctor at the time thought the Lokomat wasn't any good. I however loved it because it felt like normal walking and the therapists used it constantly.
https://www.linkedin.com/groups/1774685/1774685-6138302618323136513
The newest Guidelines for Adult Stroke Rehabilitation and Recovery by the American Heart Association (AHA)/American Stroke Association (ASA) have just been published (Winstein et al. 2016). Whereas in earlier Guidelines, evidence on electromechanically assisted gait training was often considered to be insufficient to draw conclusions, these new Guidelines now cite level A evidence that the benefits of using electromechanical gait trainers for stroke rehabilitation outweigh the harms. Specifically, the following recommendations were made:

► Robot-assisted movement training to improve motor function and mobility after stroke in combination with conventional therapy may be considered.
» Evidence Class IIb (Benefit outweighs risks) level A (Data derived from multiple RCTs or Meta Analyses)
► Mechanically assisted walking (treadmill, electromechanical gait trainer, robotic device, servo-motor) with body weight support may be considered for patients who are nonambulatory or have low ambulatory ability early after stroke.
» Evidence Class IIb (Benefit outweighs risks) level A (Data derived from multiple RCTs or Meta Analyses)
► Virtual reality may be beneficial for the improvement of gait.
» Evidence Class IIb (Benefit outweighs risks) level B (Data derived from a single RCT or nonrandomized studies)

This is a big step and shows that the research efforts in this field over the past years are starting to affect every-day clinical practice. Congratulations to all those who dedicated their time and efforts to this research for the benefit of our patients. May this success provide motivation to further push the field forward.

Winstein, C. J. et al. (2016). "Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association." Stroke. Epub ahead of print. May 4th 2016.

http://stroke.ahajournals.org/content/early/2016/05/04/STR.0000000000000098.abstrac
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