ORIGINAL ARTICLE   Free access

European Journal of Physical and Rehabilitation Medicine 2018 December;54(6):827-36

DOI: 10.23736/S1973-9087.18.05077-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Robot-assisted gait training effectively improved lateropulsion in subacute stroke patients: a single-blinded randomized controlled trial

Nari YUN ¹, Min C. JOO ¹, Seung-Chan KIM ², Min-Su KIM ¹ ✉

¹ Department of Rehabilitation Medicine, Wonkwang University School of Medicine, Iksan, Republic of Korea; ² Department of Statistics, Pukyong National University, Busan, Republic of Korea

BACKGROUND: Some stroke patients are known to use nonparetic extremities to push toward the paretic side, a movement known as lateropulsion. Lateropulsion impairs postural balance and interferes with rehabilitation.
AIM: The aim of the present study was to investigate the effect of robot-assisted gait training (RAGT) on recovery from lateropulsion compared with conventional physical therapy (CPT).
DESIGN: This was a single-blinded, randomized controlled trial.
SETTING: Participants were recruited from a rehabilitation department of a tertiary hospital.
POPULATION: Patients diagnosed with lateropulsion after a stroke.
METHODS: Thirty-six subacute stroke patients with lateropulsion were recruited. RAGT was performed in the experimental group (N.=18), and CPT was performed in the control group (N.=18). The participants received treatment for 3 weeks, 30 minutes per day, 5 days per week. Outcomes were assessed before the intervention (T0), immediately after the intervention (T1), and 4 weeks after the intervention (T2). The Burke Lateropulsion Scale (BLS) was evaluated as a primary outcome to assess the severity of lateropulsion. The secondary outcome measures were the Berg Balance Scale (BBS), the Postural Assessment Scale for Stroke (PASS), and Somatosensory Evoked Potentials (SSEP).
RESULTS: After intervention, the experimental group showed greater improvement in the BLS score at T1 (experimental group: Δ=-1.9, control group: Δ=-1.1, P=0.032) and T2 (experimental group: Δ=-2.8, control group: Δ=-6.5, P<0.001) than the control group. In addition, the BBS was significantly improved in the experimental group at T1 (experimental group: Δ=+7.1, control group: Δ=+1.9, P<0.001) and T2 (experimental group: Δ=+13.0, control group: Δ=+6.1, P<0.001). There were significant between-group differences in the PASS at T1 (experimental group: Δ=+3.2, control group: Δ=+1.6, P=0.014) and T2 (experimental group: Δ=+8.8, control group: Δ=+4.3, P<0.001).
CONCLUSIONS: RAGT ameliorated lateropulsion and balance function more effectively than CPT in subacute stroke patients.
CLINICAL REHABILITATION IMPACT: Early RAGT may be recommended for patients with lateropulsion after stroke.

KEY WORDS: Rehabilitation - Robotics - Stroke