What does best evidence tell us about robotic gait rehabilitation in stroke patients: A systematic review and meta-analysis

•Recovery of walking function is one of the main goals of patients after stroke.•RAGT may be considered a valuable tool in improving gait abnormalities.•The earlier the gait training starts, the better the motor recovery. Studies about electromechanical-assisted devices proved the validity and effec...

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Veröffentlicht in:Journal of clinical neuroscience Jg. 48; S. 11 - 17
Hauptverfasser: Bruni, Maria Federica, Melegari, Corrado, De Cola, Maria Cristina, Bramanti, Alessia, Bramanti, Placido, Calabrò, Rocco Salvatore
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Scotland Elsevier Ltd 01.02.2018
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ISSN:0967-5868, 1532-2653, 1532-2653
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Abstract •Recovery of walking function is one of the main goals of patients after stroke.•RAGT may be considered a valuable tool in improving gait abnormalities.•The earlier the gait training starts, the better the motor recovery. Studies about electromechanical-assisted devices proved the validity and effectiveness of these tools in gait rehabilitation, especially if used in association with conventional physiotherapy in stroke patients. The aim of this study was to compare the effects of different robotic devices in improving post-stroke gait abnormalities. A computerized literature research of articles was conducted in the databases MEDLINE, PEDro, COCHRANE, besides a search for the same items in the Library System of the University of Parma (Italy). We selected 13 randomized controlled trials, and the results were divided into sub-acute stroke patients and chronic stroke patients. We selected studies including at least one of the following test: 10-Meter Walking Test, 6-Minute Walk Test, Timed-Up-and-Go, 5-Meter Walk Test, and Functional Ambulation Categories. Stroke patients who received physiotherapy treatment in combination with robotic devices, such as Lokomat or Gait Trainer, were more likely to reach better results, compared to patients who receive conventional gait training alone. Moreover, electromechanical-assisted gait training in association with Functional Electrical Stimulations produced more benefits than the only robotic treatment (−0.80 [−1.14; −0.46], p > .05). The evaluation of the results confirm that the use of robotics can positively affect the outcome of a gait rehabilitation in patients with stroke. The effects of different devices seems to be similar on the most commonly outcome evaluated by this review.
AbstractList •Recovery of walking function is one of the main goals of patients after stroke.•RAGT may be considered a valuable tool in improving gait abnormalities.•The earlier the gait training starts, the better the motor recovery. Studies about electromechanical-assisted devices proved the validity and effectiveness of these tools in gait rehabilitation, especially if used in association with conventional physiotherapy in stroke patients. The aim of this study was to compare the effects of different robotic devices in improving post-stroke gait abnormalities. A computerized literature research of articles was conducted in the databases MEDLINE, PEDro, COCHRANE, besides a search for the same items in the Library System of the University of Parma (Italy). We selected 13 randomized controlled trials, and the results were divided into sub-acute stroke patients and chronic stroke patients. We selected studies including at least one of the following test: 10-Meter Walking Test, 6-Minute Walk Test, Timed-Up-and-Go, 5-Meter Walk Test, and Functional Ambulation Categories. Stroke patients who received physiotherapy treatment in combination with robotic devices, such as Lokomat or Gait Trainer, were more likely to reach better results, compared to patients who receive conventional gait training alone. Moreover, electromechanical-assisted gait training in association with Functional Electrical Stimulations produced more benefits than the only robotic treatment (−0.80 [−1.14; −0.46], p > .05). The evaluation of the results confirm that the use of robotics can positively affect the outcome of a gait rehabilitation in patients with stroke. The effects of different devices seems to be similar on the most commonly outcome evaluated by this review.
Studies about electromechanical-assisted devices proved the validity and effectiveness of these tools in gait rehabilitation, especially if used in association with conventional physiotherapy in stroke patients. The aim of this study was to compare the effects of different robotic devices in improving post-stroke gait abnormalities. A computerized literature research of articles was conducted in the databases MEDLINE, PEDro, COCHRANE, besides a search for the same items in the Library System of the University of Parma (Italy). We selected 13 randomized controlled trials, and the results were divided into sub-acute stroke patients and chronic stroke patients. We selected studies including at least one of the following test: 10-Meter Walking Test, 6-Minute Walk Test, Timed-Up-and-Go, 5-Meter Walk Test, and Functional Ambulation Categories. Stroke patients who received physiotherapy treatment in combination with robotic devices, such as Lokomat or Gait Trainer, were more likely to reach better results, compared to patients who receive conventional gait training alone. Moreover, electromechanical-assisted gait training in association with Functional Electrical Stimulations produced more benefits than the only robotic treatment (-0.80 [-1.14; -0.46], p > .05). The evaluation of the results confirm that the use of robotics can positively affect the outcome of a gait rehabilitation in patients with stroke. The effects of different devices seems to be similar on the most commonly outcome evaluated by this review.
Studies about electromechanical-assisted devices proved the validity and effectiveness of these tools in gait rehabilitation, especially if used in association with conventional physiotherapy in stroke patients.BACKGROUNDStudies about electromechanical-assisted devices proved the validity and effectiveness of these tools in gait rehabilitation, especially if used in association with conventional physiotherapy in stroke patients.The aim of this study was to compare the effects of different robotic devices in improving post-stroke gait abnormalities.OBJECTIVEThe aim of this study was to compare the effects of different robotic devices in improving post-stroke gait abnormalities.A computerized literature research of articles was conducted in the databases MEDLINE, PEDro, COCHRANE, besides a search for the same items in the Library System of the University of Parma (Italy). We selected 13 randomized controlled trials, and the results were divided into sub-acute stroke patients and chronic stroke patients. We selected studies including at least one of the following test: 10-Meter Walking Test, 6-Minute Walk Test, Timed-Up-and-Go, 5-Meter Walk Test, and Functional Ambulation Categories.METHODSA computerized literature research of articles was conducted in the databases MEDLINE, PEDro, COCHRANE, besides a search for the same items in the Library System of the University of Parma (Italy). We selected 13 randomized controlled trials, and the results were divided into sub-acute stroke patients and chronic stroke patients. We selected studies including at least one of the following test: 10-Meter Walking Test, 6-Minute Walk Test, Timed-Up-and-Go, 5-Meter Walk Test, and Functional Ambulation Categories.Stroke patients who received physiotherapy treatment in combination with robotic devices, such as Lokomat or Gait Trainer, were more likely to reach better results, compared to patients who receive conventional gait training alone. Moreover, electromechanical-assisted gait training in association with Functional Electrical Stimulations produced more benefits than the only robotic treatment (-0.80 [-1.14; -0.46], p > .05).RESULTSStroke patients who received physiotherapy treatment in combination with robotic devices, such as Lokomat or Gait Trainer, were more likely to reach better results, compared to patients who receive conventional gait training alone. Moreover, electromechanical-assisted gait training in association with Functional Electrical Stimulations produced more benefits than the only robotic treatment (-0.80 [-1.14; -0.46], p > .05).The evaluation of the results confirm that the use of robotics can positively affect the outcome of a gait rehabilitation in patients with stroke. The effects of different devices seems to be similar on the most commonly outcome evaluated by this review.CONCLUSIONSThe evaluation of the results confirm that the use of robotics can positively affect the outcome of a gait rehabilitation in patients with stroke. The effects of different devices seems to be similar on the most commonly outcome evaluated by this review.
Author Melegari, Corrado
Bruni, Maria Federica
De Cola, Maria Cristina
Bramanti, Alessia
Bramanti, Placido
Calabrò, Rocco Salvatore
Author_xml – sequence: 1
  givenname: Maria Federica
  surname: Bruni
  fullname: Bruni, Maria Federica
  organization: Università degli studi di Parma, Parma, Italy
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  fullname: Melegari, Corrado
  organization: Università degli studi di Parma, Parma, Italy
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  surname: De Cola
  fullname: De Cola, Maria Cristina
  organization: IRCCS Centro Neurolesi “Bonino Pulejo”, Messina, Italy
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  fullname: Bramanti, Alessia
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  givenname: Rocco Salvatore
  surname: Calabrò
  fullname: Calabrò, Rocco Salvatore
  email: salbro77@tiscali.it, roccos.calabro@irccsme.it
  organization: IRCCS Centro Neurolesi “Bonino Pulejo”, Messina, Italy
BackLink https://www.ncbi.nlm.nih.gov/pubmed/29208476$$D View this record in MEDLINE/PubMed
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Keywords Gait rehabilitation
Stroke
Lokomat
End-effector
Exoskeleton
Robotics
Language English
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PublicationTitle Journal of clinical neuroscience
PublicationTitleAlternate J Clin Neurosci
PublicationYear 2018
Publisher Elsevier Ltd
Publisher_xml – name: Elsevier Ltd
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Snippet •Recovery of walking function is one of the main goals of patients after stroke.•RAGT may be considered a valuable tool in improving gait abnormalities.•The...
Studies about electromechanical-assisted devices proved the validity and effectiveness of these tools in gait rehabilitation, especially if used in association...
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SubjectTerms End-effector
Evidence-Based Medicine
Exoskeleton
Gait Disorders, Neurologic - rehabilitation
Gait rehabilitation
Humans
Lokomat
Robotics
Stroke
Stroke Rehabilitation - methods
Treatment Outcome
Title What does best evidence tell us about robotic gait rehabilitation in stroke patients: A systematic review and meta-analysis
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