Is gait training with the elliptically based robotic gait trainer (EBRGT) feasible in ambulatory patients after stroke?

摘要

In response to the potential benefits of task specific training in rehabilitation of gait after stroke and the need for affordable, simple ways to implement it, our group designed the elliptically based robotic gait trainer (EBRGT). A design review of the EBRGT, covering the design goals, an overview of the mechanical and electrical design, and a discussion of the novelty of the device and why it may be beneficial for individuals with hemiparesis secondary to stroke is discussed (Chapter 2). To characterize the new device, a study was performed to determine if the EBRGT produced a gait pattern that mimicked level surface walking in healthy adults (chapter 3). Sagittal plane kinematic analysis suggested the EBRGT produced joint movement patterns that are similar to level surface walking at the hip and knee with less similarity between activities at the ankle. Electromyography (EMG) revealed that the EBRGT induced a cyclic muscle firing pattern that had some similarities when compared to level surface walking. We also examined the feasibility of ambulatory individuals after stroke to use the EBRGT and if their movement patterns were similar to healthy adults walking on the same device (Chapter 4). All six participants were able to walk on the device with minimal assistance. These participants had joint kinematics and EMG similar to healthy adults, suggesting that individuals with hemiparesis perform a gait like movement when using the EBRGT. Lastly, a study was performed to determine if the EBRGT could improve gait parameters and function in ambulatory individuals with hemiparesis after stroke (chapter 5). Four participants walked on the EBRGT 3x/week for 4 or 8 weeks. After the intervention, all 4 participants increased their preferred gait speed. One participant had an improvement in gait speed that indicated functional gains. The results of this research suggest that the EBRGT can produce a gait pattern that has some similarities to level surface walking and that it is feasible for ambulatory individuals with hemiparesis to use the device. The device may also improve gait parameters in ambulatory individuals after stroke, but future studies with a control group need to be performed.