Overground walking training with the i-Walker, a robotic servo-assistive device, enhances balance in patients with subacute stroke: a randomized controlled trial.
Study Goal
The researchers aimed to evaluate the effects of overground robotic walking training using the i-Walker on walking performance, balance, gait stability, and falls in patients with mild subacute stroke.
Results Summary
The i-Walker group showed significant improvements in balance, walking speed (10-m test), endurance (6-min test), and gait stability, along with a reduced number of falls compared to the control group.
Population
Patients with mild subacute stroke.
Effective Dosage
Two daily 40-minute sessions, 5 days a week for 4 weeks (20 sessions with i-Walker, 20 sessions standard therapy).
Duration
4 weeks.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
overground robotic walking training performed with the servo-assistive robotic rollator (i-Walker) | increase | walking performance | patients affected by mild/moderate stroke | - | improved | #1 |
overground robotic walking training performed with the servo-assistive robotic rollator (i-Walker) | increase | balance | patients affected by mild/moderate stroke | - | improved | #2 |
overground robotic walking training performed with the servo-assistive robotic rollator (i-Walker) | increase | gait stability | patients affected by mild/moderate stroke | - | increased | #3 |
overground robotic walking training performed with the servo-assistive robotic rollator (i-Walker) | decrease | falls in the community | patients affected by mild/moderate stroke | - | reduced | #4 |
overground robotic walking training performed with the servo-assistive robotic rollator (i-Walker) | increase | balance improvement (Tinetti) | patients with mild subacute stroke | 68.4 ± 27.6 % vs. 48.1 ± 33.9 % | higher treatment effectiveness | #5 |
overground robotic walking training performed with the servo-assistive robotic rollator (i-Walker) | increase | 10-m timed walking test | patients with mild subacute stroke | F(1,40) = 14.252, p = 0.001 | significant interaction between group and time | #6 |
overground robotic walking training performed with the servo-assistive robotic rollator (i-Walker) | increase | 6-min timed walking test | patients with mild subacute stroke | F(1,40) = 7.883, p = 0.008 | significant interaction between group and time | #7 |
overground robotic walking training performed with the servo-assistive robotic rollator (i-Walker) | decrease | latero-lateral upper body accelerations | patients with mild subacute stroke | F = 4.727, p = 0.036 | reduced | #8 |
overground robotic walking training performed with the servo-assistive robotic rollator (i-Walker) | decrease | number of falls at home | patients with mild subacute stroke | - | reduced | #9 |
BACKGROUND: Patients affected by mild stroke benefit more from physiological overground walking training than walking-like training performed in place using specific devices. The aim of the study was to evaluate the effects of overground robotic walking training performed with the servo-assistive robotic rollator (i-Walker) on walking, balance, gait stability and falls in a community setting in patients with mild subacute stroke. METHODS: Forty-four patients were randomly assigned to two different groups that received the same therapy in two daily 40-min sessions 5 days a week for 4 weeks. Twenty sessions of standard therapy were performed by both groups. In the other 20 sessions the subjects enrolled in the i-Walker-Group (iWG) performed with the i-Walker and the Control-Group patients (CG) performed the same amount of conventional walking oriented therapy. Clinical and instrumented gait assessments were made pre- and post-treatment. The follow-up observation consisted of recording the number of fallers in the community setting after 6 months. RESULTS: Treatment effectiveness was higher in the iWG group in terms of balance improvement (Tinetti: 68.4 ± 27.6 % vs. 48.1 ± 33.9 %, p = 0.033) and 10-m and 6-min timed walking tests (significant interaction between group and time: F(1,40) = 14.252, p = 0.001; and F(1,40) = 7.883, p = 0.008, respectively). When measured, latero-lateral upper body accelerations were reduced in iWG (F = 4.727, p = 0.036), suggesting increased gait stability, which was supported by a reduced number of falls at home. CONCLUSIONS: A robotic servo-assisted i-Walker improved walking performance and balance in patients affected by mild/moderate stroke, leading to increased gait stability and reduced falls in the community. TRIAL REGISTRATION: This study was registered on anzctr.org.au (July 1, 2015; ACTRN12615000681550 ).