Efficacy of Electromechanical-Assisted Gait Training on Walking Ability and Symmetry After Brain Injury: A Multicenter Randomized Controlled Trial

Background: Electromechanical-assisted gait training might be one of the most effective interventions to promote motor recovery after brain injury. But many studies still have difficulties to clarify the difference with conventional gait training.Objective: To evaluate the effectiveness of electromechanical-assisted gait training compared to conventional gait training on walking ability and symmetry in stroke patients.Methods: Patients with stroke (n = 144) were randomly assigned to control (physical therapist-assisted gait training) and experimental groups (electromechanical gait training). Both types of gait training were performed for 30 minutes each day, 5 days a week for 4 weeks. Main outcome measures are changes in functional ambulatory category (FAC). Secondary outcomes were walking abilities and walking symmetries of swing time and step length. Results: FAC showed significant improvement after 4 weeks intervention in both groups. Walking abilities showed significant improvement after intervention, but, walking symmetries did not in both groups. According to sub-group analysis of stroke duration of 90 days, FAC and walking abilities in both groups showed significant improvement in subacute group compared to chronic group. However, walking symmetries did not show any significant changes in subacute and chronic group. Swing time asymmetry in the experimental group showed significant improvement in chronic group while it did not in the control group.Conclusion: Electromechanical-assisted gait training by Exowalk® was shown to be as effective as conventional gait training with a physiotherapist. Electromechanical-assisted gait training for four weeks can change gait patterns close to normal by reducing swing time asymmetry in chronic stroke patients.Trial registration: KCT0003411 Clinical Research Information Service (CRIS), Republic of Korea.