Abnormal synergistic gait mitigation in acute stroke using an innovative ankle–knee–hip interlimb humanoid robot

Background: 

Although patients with hemiparetic stroke undergo various treatments to improve gait and movement, it remains unknown how spasticity and associated synergistic patterns change after robot-assisted and conventional treatment. 

Objective: 

To compare the effects of innovative ankle–knee–hip interlimb coordinated humanoid robot training (ICT) combined with conventional physical therapy (ICT-C) and conventional physical therapy and gait training (CPT-G) on abnormal spasticity and synergistic gait patterns. 

Method: 

• Compare the therapeutic effects on abnormal lower-extremity synergistic pattern using the standardized Fugl-Meyer Assessment of Lower Extremity (FMA-LE)
• Investigate the biomechanical changes on Kinematic and kinetic gait parameters before and after ICT 
• Compare the effect on spasticity using the Modified Ashworth Scale (MAS)

Result: 

1. ICT-C demonstrated more positive effects in clinical spasticity and abnormal synergy control than CPT-G alone. 
2. The kinematic analysis demonstrated that mean Hip and Knee joint angular displacements had improved by 8% and 16%, respectively. as a function of ICT-C.
3. The mean post-ICT knee joint angle (M = 26.69, SD = 1.10) was more increased than the mean pre-ICT knee joint angle (M = 22.42, SD = 0.61; t (9) = − 14.59; P = 0.00) in the ICT-C group, indicating improved knee joint movement after ICT-C in patients with hemiparetic stroke. 
4. The kinetic analysis revealed substantial enhancements in active force, resistive force, and stiffness in the hip(55%; − 197%; − 113%), knee(97%; − 92%; − 67%), and ankle(70%; − 13%; − 68%) putatively as a function of ICT-C. Notably, gait-related active force gains in the hip, knee, and ankle joints improved by 13%–197% in ICT-C. 
5. The clinical FMA-LE and MAS data revealed that the abnormal synergy pattern was significantly reduced along with improvements in spasticity in the ankle and hip joints, as evidenced by increased volitional movement with synergy in FMA-LE. 
6. Also, correlational statistics demonstrated that the hip, knee, and ankle joints’ resistive stiffness was moderately related to spasticity in the hip extension, knee extension, ankle dorsiflexion, and ankle plantarflexion muscles and inversely correlated with volitional movement with synergy in FMA-LE. 

Conclusion: 

ICT with conventional therapy as a successful intervention for abnormal spasticity, synergistic, and altered biomechanical gait impairments in patients with acute stroke. 

View Walkbot clinical papers

#WALKBOT #RobotAssistedGaitTraining   #RoboticGaitTraining #LowerLimbRehabilitationRobot #RoboticRehabilitation #GaitTraining #RehabilitationRobot #Rehabilitation #Stroke #CerebralPalsy  #Neuroplasticity