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October 1, 2016MedicineOpen Access

Robot-assisted gait training improves brachial–ankle pulse wave velocity and peak aerobic capacity in subacute stroke patients with totally dependent ambulation

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Why the study?

Does robot-assisted gait therapy combined with conventional rehabilitation improve arterial stiffness and cardiopulmonary fitness in subacute stroke patients with dependent ambulation?

Population

60 subacute stroke patients with totally dependent ambulation and severe gait impairment, mean age 67.89 and…

Comparison

Robot-assisted gait therapy using an exoskeletal… vs Conventional rehabilitation therapy alone for 60…

Design

RCT, Randomly allocated in a 1:1 ratio, Assessor-blinded

Follow-up

4 weeks

Key result

Robot-assisted gait therapy combined with conventional rehabilitation therapy significantly reduced arterial stiffness and improved peak aerobic capacity compared to conventional therapy alone in subacute stroke patients.

Authors

EHEun Young HanSISang Hee ImBKBo Ryun Kim

Discussion

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Overview

Supports adding robot-assisted gait therapy to subacute stroke rehab; extends RCT evidence to cardiovascular and aerobic outcomes.

Study Design

Type

RCT (n=56)

Blinding

Single-blind

Randomization

1:1

Multicenter

No

Structured PICO

Does robot-assisted gait therapy combined with conventional rehabilitation improve arterial stiffness and cardiopulmonary fitness in subacute stroke patients with dependent ambulation?

P
Population
56 subacute stroke patients with totally dependent ambulation (mean age 65.7 years, 42.9% female) were randomized to receive robot-assisted gait training plus conventional therapy or conventional therapy alone for 4 weeks.
I
Intervention
Robot-assisted gait therapy (RAGT) using an exoskeletal robotic orthosis (Lokomat) for 30 minutes combined with conventional rehabilitation therapy for 30 minutes, 5 times a week for 4 weeks.
C
Comparator
Conventional rehabilitation therapy alone for 60 minutes, 5 times a week for 4 weeks.
O
Outcome
Brachial-ankle pulse wave velocity (baPWV) and cardiopulmonary fitness (peak aerobic capacity [VO2peak], peak heart rate, and exercise tolerance test duration) assessed after the 4-week intervention.surrogate

Main Result

Absolute Event Rate: 15.72% vs 16.42%

p-value: p=0.014

Robot-assisted gait training combined with conventional rehabilitation significantly improves arterial stiffness and peak aerobic capacity in subacute stroke patients compared to conventional rehabilitation alone.

Limitations

  • Relatively small number of subjects evaluated
  • Short intervention duration without long-term follow-up to evaluate secondary prevention
  • Did not assess or monitor the aerobic burden of RAGT during the intervention
  • Measured baPWV in the subacute phase only, without comparison to acute phase values
  • Did not measure individual VO2 during RAGT to confirm the amount of aerobic burden
  • Did not assess long-term effects on stroke recurrence, morbidity, or mortality
  • Small sample size requiring further large-scale studies

Cite This Study

Han et al. (2016) conducted an RCT in Subacute stroke with totally dependent ambulation (n=56). Robot-assisted gait therapy (RAGT) combined with conventional rehabilitation therapy vs. 60 minutes of conventional rehabilitation therapy, 5 times a week was evaluated on Brachial-ankle pulse wave velocity (baPWV) at 4 weeks (p=0.014). Robot-assisted gait therapy combined with conventional rehabilitation therapy significantly reduced arterial stiffness and improved peak aerobic capacity compared to conventional therapy alone in subacute stroke patients.

synapsesocial.com/papers/6a1ec1a2ae66660099a4481chttps://doi.org/10.1097/md.0000000000005078
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