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Randomized Controlled Trial
. 2023 Apr 28;20(1):54.
doi: 10.1186/s12984-023-01168-x.

Gait training with a wearable powered robot during stroke rehabilitation: a randomized parallel-group trial

Daichi Miyagawa  1 , Akira Matsushima  2 , Yoichi Maruyama  1 , Noriaki Mizukami  3 , Mikio Tetsuya  4 , Minoru Hashimoto  4   5 , Kunihiro Yoshida  6   7
Affiliations
Randomized Controlled Trial

Gait training with a wearable powered robot during stroke rehabilitation: a randomized parallel-group trial

Daichi Miyagawa et al. J Neuroeng Rehabil. .

Abstract

Background: We have developed a wearable rehabilitation robot, "curara®," and examined its immediate effect in patients with spinocerebellar degeneration and stroke, but its rehabilitative effect has not been clarified. The purpose of this study was to examine the effect of this device on gait training in stroke patients.

Methods: Forty stroke patients were enrolled in this study. The participants were divided randomly into two groups (groups A and B). The participants assigned to group A received RAGT with curara® type 4, whereas those in group B received conventional therapist-assisted gait training. The clinical trial period was 15 days. The participants performed 10 sessions of gait training (5 times per week) each lasting 30 ± 5 min per day. The 10-m walking time (10mWT), and 6-minute walking distance (6MWD) were evaluated as the main outcomes. Timed up and go and Berg Balance Scale (BBS) were also examined. Gait parameters (stride duration and length, standard deviation of stride duration and length, cadence, ratio of the stance/swing phases, minimum/maximum knee joint angle, and minimum/maximum hip joint angle) were measured using a RehaGait®. The items other than BBS were measured on days 0, 7, and 14, whereas BBS was measured on days 0 and 14. The improvement rate was calculated as the difference of values between days 14 and 0 divided by the value on day 0. The improvement rates of the 10mWT and 6MWD were set as the main outcomes.

Results: The data of 35 participants were analyzed. There was no significant difference in the main outcomes between both groups at the end of gait training. As for intragroup changes, gait speed, stride length, stride duration, and cadence were improved significantly between days 0 and 14 in each group. When examining the interaction effect between the day of measurement and group, stride duration (p = 0.006) and cadence (p = 0.012) were more significantly improved in group A than in group B.

Conclusions: This novel wearable powered robot may have the potential to improve gait speed of individuals in stroke rehabilitation.

Trial registration: Japan Registry of Clinical Trials (jRCTs032180163). Registered on February 22, 2019; https://jrct.niph.go.jp/en-latest-detail/jRCTs032180163 . UMIN CLINICAL TRIALS REGISTRY (UMIN000034237): Registered on September 22, 2018; https://center6.umin.ac.jp/cgi-open-bin/icdr/ctr_view.cgi?recptno=R000038939 .

Keywords: Hemiparesis; Randomized controlled trial; Robot-assisted gait training; Stroke rehabilitation; Wearable rehabilitation robot.

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Conflict of interest statement

Mr, Miyagawa, Dr. Matsushima, Mr. Maruyama and Mr. Tetsuya have no competing interests.

Dr. Mizukami is funded by the Japan Society for the Promotion of Science (Grant-in-Aid for Young Scientists).

Dr. Mizukami is funded by the Japan Society for the Promotion of Science grants (Grant-in-Aid for Scientific Research (C) and Challenging Research [Exploratory]), and was funded by the Japan Society for Promotion of Science grants (Grant-in-Aid for Scientific Research [B]), Tokyo Metropolitan Industrial Technology Research Institute grants (Robot industry activation business), and AMED grants (Robot care equipment development and standardization business).

Dr. Yoshida is funded by Health and Labour Sciences Research Grants (Research Committee of the Ataxia, Research on Policy Planning and Evaluation for Rare and Intractable Diseases, The Ministry of Health, Labour, and Welfare, Japan).

References

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