Key result
Early robot-assisted gait training after stroke is linked to ~48% higher rates of independent walking.
Why the study?
Does robot-assisted gait training initiated within 1 week after stroke onset improve gait independence in individuals with hemiparesis compared to later initiation?
Cohort (n=36)
No
Does robot-assisted gait training initiated within 1 week after stroke onset improve gait independence in individuals with hemiparesis compared to later initiation?
Absolute Event Rate: 82.2% vs 55.6%
p-value: p=0.038
Initiating robot-assisted gait training within 7 days of stroke onset significantly reduces the time to achieve supervised gait compared to initiating it 8-90 days post-stroke.
BACKGROUND: Robot-assisted gait training (RAGT) is an effective method for treating gait disorders in individuals with stroke. However, no previous studies have demonstrated the effectiveness of RAGT in individuals with acute stroke. This study aimed to investigate the effects of RAGT initiation within 1 week after onset on degree of gait independence in individuals with hemiparetic stroke. METHODS: This retrospective cohort study used propensity-score matching. Individuals admitted to Fujita Health University Hospital after stroke onset and underwent RAGT between March 2017 and June 2023 were enrolled. Ninety-two individuals were eligible and grouped into the acute (≤ 7 days after the onset) and subacute groups (8-90 days after onset). RAGT was conducted using Welwalk, primarily comprising a knee-ankle-foot orthosis type robot worn on one paralyzed lower extremity, with training sessions lasting approximately 40 min/day, occurring 3-7 days/week. The primary outcome was the gait under supervision within 90 days of onset, which was compared between groups using the log-rank test. RESULTS: After propensity-score matching, 36 individuals were included in the analysis, including 18 each in the acute and subacute groups; the participant demographics were not significantly different between the groups. RAGT was initiated at a median of 6 and 25 days after onset in the acute and subacute groups, respectively. The Kaplan-Meier curves after the log-rank test showed a significantly higher percentage and shorter median days to achieve gait under supervision in the acute group than in the subacute group. The cumulative incidence of gait under supervision events at 90 days after onset was 82.2% and 55.6% in the acute and the subacute groups, respectively. Half of the individuals achieved gait under supervision within 49 days and 75 days in the acute and subacute groups, respectively (p = 0.038). No significant differences were observed in the dose of rehabilitation program and gait training per day from onset to achieving gait under supervision. CONCLUSION: Initiation of RAGT within 1 week after stroke onset in individuals with hemiparesis may reduce the number of days required to achieve gait under supervision and increase the percentage of gait under supervision.
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Kato et al. (2025) conducted a cohort in Hemiparetic stroke (n=36). Robot-assisted gait training initiation within 1 week after onset vs. Robot-assisted gait training initiation 8-90 days after onset was evaluated on Gait under supervision within 90 days of onset (p=0.038). Initiation of robot-assisted gait training within 1 week of stroke onset increased the 90-day cumulative incidence of gait under supervision compared to later initiation (82.2% vs 55.6%; P=0.038).
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