Feasibility of Robot-Assisted Gait Training with an End-Effector Type Device for Various Neurologic Disorders

Robots are being used to assist the recovery of walking ability for patients with neurologic disorders. This study aimed to evaluate the feasibility and functional improvement of training with robot-assisted gait training (RAGT) using the Morning Walk®, an end-effector type robot using footplates and saddle seat support. A total of 189 individuals (65.1% men, 34.9% women; mean age, 53.2 years; age range: 5–87 years) with brain lesions, spinal cord injuries, Parkinson's disease, peripheral neuropathies, and pediatric patients were involved in this retrospectively registered clinical trial. Each participant performed 30 minutes of RAGT, five times a week, for a total of 24 sessions. Failure was defined as an inability to complete all 24 sessions, and the reasons for discontinuation were analyzed. Parameters of Medical Research Council scales and Functional Ambulation Categories were analyzed before and after RAGT training. Among the 189 patients, 22 (11.6%) failed to complete the RAGT. The reasons included decreased cooperation, musculoskeletal pain, saddle seat discomfort, excessive body-weight support, joint spasticity or restricted joint motion, urinary incontinence from an indwelling urinary catheter, and fatigue. Comparison between the pre- and post-training motor and ambulatory functions showed significant improvement. The result of the study indicates that the Morning Walk® is feasible and safe and useful for functional improvement in patients with various neurologic disordersTRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0003627

Human-robot global Simulink modeling and analysis for an end-effector upper limb rehabilitation robot / 生物医学工程学杂志

Robot rehabilitation has been a primary therapy method for the urgent rehabilitation demands of paralyzed patients after a stroke. The parameters in rehabilitation training such as the range of the training, which should be adjustable according to each participant's functional ability, are the key factors influencing the effectiveness of rehabilitation therapy. Therapists design rehabilitation projects based on the semiquantitative functional assessment scales and their experience. But these therapies based on therapists' experience cannot be implemented in robot rehabilitation therapy. This paper modeled the global human-robot by Simulink in order to analyze the relationship between the parameters in robot rehabilitation therapy and the patients' movement functional abilities. We compared the shoulder and elbow angles calculated by simulation with the angles recorded by motion capture system while the healthy subjects completed the simulated action. Results showed there was a remarkable correlation between the simulation data and the experiment data, which verified the validity of the human-robot global Simulink model. Besides, the relationship between the circle radius in the drawing tasks in robot rehabilitation training and the active movement degrees of shoulder as well as elbow was also matched by a linear, which also had a remarkable fitting coefficient. The matched linear can be a quantitative reference for the robot rehabilitation training parameters.

A Review of Robot-Assisted Gait Training in Stroke Patients

While a variety of robot-assisted gait training systems have been widely applied for locomotor rehabilitation in stroke patients, the best supporting evidence for robot-assisted gait training systems remains unknown. The purpose of this study was to provide the best robot-assisted gait training and clinical evidence by comparing the effects of exoskeleton and end-effector type robot-assisted gait training in stroke rehabilitation. The present study underwent a review of the literature to determine the best clinical evidence of the most commonly utilized robot-assisted gait training paradigms (end-effector and exoskeleton types) in stroke gait rehabilitation. The review corroborates the compelling evidence that combined robot-assisted gait training was advantageous in stroke rehabilitation, as it offers additive special therapeutic effects that were not afforded by conventional therapy alone. Most importantly, the robot-assisted gait training paradigm provided more intensive, repetitive, accurate kinematic feedback and symmetrical gait practice, while reducing therapist labor, which is often not affordable in current stroke rehabilitation care. Both the robot-assisted gait training with either the end-effector type or exoskeleton type was beneficial for improving motor recovery, gait function, and balance in stroke patients when it was combined with the conventional physical therapy. The robot-assisted gait training should be used as an augmented gait intervention for stroke population.