Robotic-assisted gait training in Parkinson's disease: a three-month follow-up randomized clinical trial

Abstract

Purpose: The aim of this study was to evaluate the efficacy of a robotic-assisted gait training (RAGT), together with a conventional exercise program (CEP), to improve PD ambulation, as compared to standard gait training.

Methods: Thirty-eight patients with mild PD stage (H&Y 2-2.5) were randomly assigned to an experimental group (EG) or a control group. The 19 patients in EG received 30 min RAGT (using Lokomat device), whereas the 19 controls received a conventional gait training; both groups received 30 min of CEP. Participants were evaluated before (T0), immediately after (T1), and 12 weeks after the end of treatment (T2), by using 10-MWT, Tinetti Test and the motor score of the UPDRS-III.

Results: We found that Tinetti Walking (TW) (X²(3) = 31.75; p < 0.001), Tinetti Balance (X²(3) = 74.07; p < 0.001), UPDRS-III (X²(3) = 6.87; p < 0.001) and GDS (X²(3) = 28.83; p < 0.001) scores were affected by the type of the rehabilitative treatment. At T2, we found a significant difference between the two groups for TW (t = 2.62; p < 0.02, d = 0.85). Concerning all the study outcomes, a significant improvement was observed from T0 to T1 in both groups. However, the functional motor gain at T2 was maintained only in the EG.

Conclusions: RAGT may significantly improve walking ability, motor function and for a maximum period of three months. Thus, our findings support the importance of a RAGT as a valid rehabilitative tool for PD.

Keywords: Neurodegenerative brain disorder; device-based therapy; gait disorders; lower extremity rehabilitation.