Wednesday, November 27, 2019

Robotic Resistance/Assistance Training Improves Locomotor Function in Individuals Post stroke: A Randomized Controlled Study

Can't tell from the abstract if this was done during spontaneous recovery and can't see any objective measurement of starting points. With no starting point this research is not repeatable.  'May' just means followup needed which will never occur under current non-existent leadership. 

Robotic Resistance/Assistance Training Improves Locomotor Function in Individuals Post  stroke: A Randomized Controlled Study

 Ming Wu, PhD,
a,b
Jill M. Landry, MSPT,
a
Janis Kim, MPT,
a
Brian D. Schmit, PhD,
a,b,c
Sheng-Che Yen, PT, PhD,
a
Jillian MacDonald, DPT
a
From the Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL;
 b
Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL; and
 c
Department of Biomedical Engineering, Marquette University, Milwaukee, WI. Current affiliation for Yen, Department of Physical Therapy, Northeastern University, Boston, MA.

Abstract


Objective:
 To determine whether providing a controlled resistance versus assistance to the paretic leg at the ankle during treadmill training will improve walking function in individuals post stroke.
Design:
 Repeated assessment of the same patients with parallel design and randomized controlled study between 2 groups.
Setting:
 Research units of rehabilitation hospitals.
Participants:
 Patients (N=30) with chronic stroke.
Intervention:
 Subjects were stratified based on self-selected walking speed and were randomly assigned to the resistance or assistance training group. For the resistance group, a controlled resistance load was applied to the paretic leg at the ankle to resist leg swing during treadmill walking. For the assistance group, a load that assists swing was applied.
Main Outcome Measures:
 Primary outcome measures were walking speed and 6-minute walking distance. Secondary measures included clinical assessments of balance, muscle tone, and quality of life. Outcome measures were evaluated before and after 6 weeks of training and at 8 weeks’ follow-up, and compared within group and between the 2 groups.
Results:
 After 6 weeks of robotic training, walking speed significantly increased for both groups, with no significant differences in walking speed gains observed between the 2 groups. In addition, 6-minute walking distance and balance significantly improved for the assistance group but not for the resistance group.
Conclusions:
 Applying a controlled resistance or an assistance load to the paretic leg during treadmill training may(NOT good enough, we need certainty) induce improvements in walking speed in individuals post stroke. Resistance training was not superior to assistance training in improving locomotor function in individuals post stroke. 

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