Robot-assisted gait training for balance and lower extremity function in patients with infratentorial stroke: a single-blinded randomized controlled trial

Did your doctor even tell you where your stroke was located? And show you a 3d picture of it? Mine didn't even tell me I had a stroke, I had a CVA. With no objective description or location of the damage area your doctor can never prescribe appropriate protocols that will address such damage. Yes I know this doesn't exist today, and until it does stroke rehab will stay in the dark ages. Which is why full recovery from stroke is only 10% rather than the expected 100%.  I expect a lot from our stroke doctors and as of right now they are complete failures.  That comment should get me flamed by thousands of doctors. I look forward to their justification for only getting 10% of survivors fully recovered.

In anatomy, the infratentorial region of the brain is the area located below the tentorium cerebelli. The area of the brain above the tentorium cerebelli is the supratentorial region. The infratentorial region contains the cerebellum, while the supratentorial region contains the cerebrum.

Robot-assisted gait training for balance and lower extremity function in patients with infratentorial stroke: a single-blinded randomized controlled trial

• Ha Yeon Kim,
• Joon-Ho Shin,
• Sung Phil Yang,
• Min A. Shin &
• Stephanie Hyeyoung Lee 

Journal of NeuroEngineering and Rehabilitation volume 16, Article number: 99 (2019) | Download Citation

Abstract

Background

Balance impairments are common in patients with infratentorial stroke. Although robot-assisted gait training (RAGT) exerts positive effects on balance among patients with stroke, it remains unclear whether such training is superior to conventional physical therapy (CPT). Therefore, we aimed to investigate the effects of RAGT combined with CPT and compared them with the effects of CPT only on balance and lower extremity function among survivors of infratentorial stroke.(You'll have to ask your doctor what robot-assisted gait training is and whether your hospital has it.)

Methods

This study was a single-blinded, randomized controlled trial with a crossover design conducted at a single rehabilitation hospital. Patients (n = 19; 16 men, three women; mean age: 47.4 ± 11.6 years) with infratentorial stroke were randomly allocated to either group A (4 weeks of RAGT+CPT, followed by 4 weeks of CPT+CPT) or group B (4 weeks of CPT+CPT followed by 4 weeks of RAGT+CPT). Changes in dynamic and static balance as indicated by Berg Balance Scale scores were regarded as the primary outcome measure. Outcome measures were evaluated for each participant at baseline and after each 4-week intervention period.

Results

No significant differences in outcome-related variables were observed between group A and B at baseline. In addition, no significant time-by-group interactions were observed for any variables, indicating that intervention order had no effect on lower extremity function or balance. Significantly greater improvements in secondary functional outcomes such as lower extremity Fugl-Meyer assessment (FMA-LE) and scale for the assessment and rating of ataxia (SARA) were observed following the RAGT+CPT intervention than following the CPT+CPT intervention.

Conclusion

RAGT produces clinically significant improvements in balance and lower extremity function in individuals with infratentorial stroke. Thus, RAGT may be useful for patients with balance impairments secondary to other pathologies.

Trial registration

ClinicalTrials.gov Identifier NCT02680691. Registered 09 February 2016; retrospectively registered.