Antioxidant Efficacy of Hwangryunhaedok-tang through Nrf2 and AMPK Signaling Pathway against Neurological Disorders In Vivo and In Vitro.

Alzheimer's disease (AD) is a representative cause of dementia and is caused by neuronal loss, leading to the accumulation of aberrant neuritic plaques and the formation of neurofibrillary tangles. Oxidative stress is involved in the impaired clearance of amyloid beta (Aß), and Aß-induced oxidative stress causes AD by inducing the formation of neurofibrillary tangles. Hwangryunhaedok-tang (HHT, Kracie K-09®), a traditional herbal medicine prescription, has shown therapeutic effects on various diseases. However, the studies of HHT as a potential treatment for AD are insufficient. Therefore, our study identified the neurological effects and mechanisms of HHT and its key bioactive compounds against Alzheimer's disease in vivo and in vitro. In a 5xFAD mouse model, our study confirmed that HHT attenuated cognitive impairments in the Morris water maze (MWM) test and passive avoidance (PA) test. In addition, the prevention of neuron impairment, reduction in the protein levels of Aß, and inhibition of cell apoptosis were confirmed with brain tissue staining. In HT-22 cells, HHT attenuates tBHP-induced cytotoxicity, ROS generation, and mitochondrial dysfunction. It was verified that HHT exerts a neuroprotective effect by activating signaling pathways interacting with Nrf2, such as MAPK/ERK, PI3K/Akt, and LKB1/AMPK. Among the components, baicalein, a bioavailable compound of HHT, exhibited neuroprotective properties and activated the Akt, AMPK, and Nrf2/HO-1 pathways. Our findings indicate a mechanism for HHT and its major bioavailable compounds to treat and prevent AD and suggest its potential.

Assistive technology on upper extremity function for stroke patients: A systematic review with meta-analysis.

BACKGROUND: In stroke rehabilitation, the selection of appropriate assistive devices is of paramount importance for patients. Specifically, the choice of device can significantly influence the functional recovery of the upper limb, impacting their overall activities or functional tasks. OBJECTIVES: This review aimed to comprehensively analyze and summarize the clinical evidence from randomized controlled trials (RCTs) regarding the therapeutic effects of commonly used assistive devices on upper extremity function in patients with stroke. METHODS: To evaluate assistive devices for patients with stroke, we summarized qualitatively throughout synthesis of results, such as therapeutic intervention, intensity, outcome, and summary of results, and examined risk of bias, heterogeneity, mean difference, 95% confidence interval, and I-squared value. To analyze, we used RoB 2 and RevMan 5.4. RESULTS: The qualitative synthesis included 31 RCTs. The randomization process and the reporting of results showed minimal bias, but there were issues with bias from intended interventions, and missing outcome data presented some concerns. The quantitative synthesis included 16 RCTs. There was a significant difference in the Fugl-Meyer assessment-upper extremity functioning (FMA-UE) scores between the groups, with a total mean difference (95% confidence interval) of 2.40 (0.21, 4.60), heterogeneity values were Tau2 = 0.32, chi-square = 8.22, degrees of freedom = 8 (p = 0.41), and I2 = 3% for FMA-UE and the test for the overall effect produced Z = 2.14 (p = 0.03) in patients with chronic stroke. However, there was no significant difference in all other outcome measures. CONCLUSIONS: Upper-limb robots did not demonstrate significant superiority over conventional treatments in improving function of upper limbs, with the exception of FMA-UE scores for patients with chronic stroke. The mean difference of FMA-UE was also lower than minimally important difference. Nonetheless, the usage of upper-limb robots may contribute to enhanced function for patients with stroke, as those devices support clinicians and enable a greater number of movement repetitions within specific time frames.

Cushing syndrome and glucocorticoids: T-cell lymphopenia, apoptosis, and rescue by IL-21.

BACKGROUND: Pediatric endogenous Cushing syndrome (eCs) is mainly caused by pituitary corticotropin-producing adenomas, and most glucocorticoid-dependent effects progressively regress upon tumor removal. eCs reproduces long-term, high-dose glucocorticoid therapy, representing a clean, natural, and unbiased model in which to study glucocorticoid bona fide effects on immunity. OBJECTIVE: We performed extensive immunologic studies in otherwise healthy pediatric patients with eCs before and 6 to 13 months after tumor resection, as well as in in vitro glucocorticoid-treated control cells. METHODS: Flow cytometry, immunoblotting, enzyme-linked immunosorbent assay, real-time quantitative PCR, and RNA-Seq techniques were used to characterize patients' and in vitro glucocorticoid treated cells. RESULTS: Reduced thymic output, decreased naive T cells, diminished proliferation, and increased T-cell apoptosis were detected before surgery; all these defects eventually normalized after tumor removal in patients. In vitro studies also showed increased T-cell apoptosis, with correspondingly diminished NF-κB signaling and IL-21 levels. In this setting, IL-21 addition upregulated antiapoptotic BCL2 expression and rescued T-cell apoptosis in a PI3K pathway-dependent manner. Similar and reproducible findings were confirmed in eCs patient cells as well. CONCLUSIONS: We identified decreased thymic output and lymphocyte proliferation, together with increased apoptosis, as the underlying causes to T-cell lymphopenia in eCs patients. IL-21 was decreased in both natural and in vitro long-term, high-dose glucocorticoid environments, and in vitro addition of IL-21 counteracted the proapoptotic effects of glucocorticoid therapy. Thus, our results suggest that administration of IL-21 in patients receiving long-term, high-dose glucocorticoid therapy may contribute to ameliorate lymphopenia and the complications associated to it.

Clinical exome sequencing of 1000 families with complex immune phenotypes: Toward comprehensive genomic evaluations.

BACKGROUND: Prospective genetic evaluation of patients at this referral research hospital presents clinical research challenges. OBJECTIVES: This study sought not only a single-gene explanation for participants' immune-related presentations, but viewed each participant holistically, with the potential to have multiple genetic contributions to their immune phenotype and other heritable comorbidities relevant to their presentation and health. METHODS: This study developed a program integrating exome sequencing, chromosomal microarray, phenotyping, results return with genetic counseling, and reanalysis in 1505 individuals from 1000 families with suspected or known inborn errors of immunity. RESULTS: Probands were 50.8% female, 71.5% were ≥18 years, and had diverse immune presentations. Overall, 327 of 1000 probands (32.7%) received 361 molecular diagnoses. These included 17 probands with diagnostic copy number variants, 32 probands with secondary findings, and 31 probands with multiple molecular diagnoses. Reanalysis added 22 molecular diagnoses, predominantly due to new disease-gene associations (9 of 22, 40.9%). One-quarter of the molecular diagnoses (92 of 361) did not involve immune-associated genes. Molecular diagnosis was correlated with younger age, male sex, and a higher number of organ systems involved. This program also facilitated the discovery of new gene-disease associations such as SASH3-related immunodeficiency. A review of treatment options and ClinGen actionability curations suggest that at least 251 of 361 of these molecular diagnoses (69.5%) could translate into ≥1 management option. CONCLUSIONS: This program contributes to our understanding of the diagnostic and clinical utility whole exome analysis on a large scale.

The molecular basis and cellular effects of distinct CD103 expression on CD4 and CD8 T cells.

Integrin CD103 mediates the adhesion and tissue retention of T cells by binding to E-cadherin which is abundant on epithelial cells. Notably, CD103 is highly expressed on CD8 T cells but conspicuously absent on most CD4 T cells. The mechanism controlling such lineage-specific expression of CD103 remains unclear. Using a series of genetically engineered mouse models, here, we demonstrate that the regulatory mechanism of CD103 expression is distinct between CD4 and CD8 T cells, and that the transcription factor Runx3 plays an important but not an essential role in this process. We further found that the availability of integrin ß7 which heterodimerizes with CD103 was necessary but also constrained the surface expression of CD103. Notably, the forced surface expression of CD103 did not significantly alter the thymic development of conventional T cells but severely impaired the generation of MHC-II-restricted TCR transgenic T cells, revealing previously unappreciated aspects of CD103 in the selection and maturation of CD4 T cells. Unlike its effect on CD4 T cell development, however, CD103 overexpression did not significantly affect CD4 T cells in peripheral tissues. Moreover, the frequency and number of CD4 T cells in the small intestine epithelium did not increase even though E-cadherin is highly expressed in this tissue. Collectively, these results suggest that most mature CD4 T cells are refractory to the effects of CD103 expression, and that they presumably utilize CD103-independent pathways to control their tissue retention and residency.

Complex and Multilayered Role of IL-21 Signaling during Thymic Development.

Unlike IL-7, which is known to be critical for T cell thymic development, the role of IL-21 in this process is still controversial. IL-21 has been shown to accelerate thymic recovery in mice treated with glucocorticoids and revives the peripheral T cell pool in aged animals. However, mice with a defect in IL-21 signaling exhibit normal thymic cellularity, challenging the importance of this cytokine in the thymic developmental process. Using mixed bone marrow chimeric mice, our studies describe a multilayered role for IL-21 in thymopoiesis. In this system, IL-21R-deficient cells are unable to compete with wild-type populations at different stages of the thymic development. Using a mixed bone marrow chimeric animal model, IL-21 seems to be involved as early as the double-negative 1 stage, and the cells from the knockout compartment have problems transitioning to subsequent double-negative stages. Also, similar to IL-7, IL-21 seems to be involved in the positive selection of double-positive lymphocytes and appears to play a role in the migration of single-positive T cells to the periphery. Although not as critical as IL-7, based on our studies, IL-21 plays an important complementary role in thymic T cell development, which, to date, has been underrecognized.

CD4 effector T cell differentiation is controlled by IL-15 that is expressed and presented in trans.

T cells are both producers and consumers of cytokines, and autocrine cytokine signaling plays a critical role in T cell immunity. IL-15 is a homeostatic cytokine for T cells that also controls inflammatory immune responses. An autocrine role of T cell-derived IL-15, however, remains unclear. Here we examined IL-15 expression and signaling upon effector T cell differentiation in mice, and, surprisingly, found that CD4 T cells did not express IL-15. CD4 T cells lacked Il15 gene reporter activity, did not contain IL-15 transcripts, and did not produce IL-15Rα, the proprietary IL-15 receptor required for IL-15 trans-presentation. Moreover, IL-15 failed to inhibit Th17 cell differentiation and failed to generate Foxp3+ Treg cells in vitro. IL-2, which utilizes the same IL-2Rß/γc receptor complex, however, successfully did so. Exogenous IL-15 only exerted bioactivity and controlled T cell differentiation when it was trans-presented by IL-15Rα. Consequently, IL-15Rα-bound IL-15, but not free IL-15, suppressed Th17 cell differentiation and induced Treg cell generation. Collectively, these results reveal the absence of an IL-15 autocrine loop in CD4 T cells and strongly suggest that IL-15 trans-presentation by non-CD4 T cells is the primary mechanism via which IL-15 controls CD4 effector T cell differentiation.

Knee injury and osteoarthritis outcome score of Korean national ice hockey players.

[Purpose] To investigate sports injuries in Korean national ice hockey players by surveying parts, times, types, frequency, cure, and prevention types of sports injuries and provide basic data for injury prevention and performance improvement of ice hockey players. Another purpose of this study was to evaluate the incidence of ice hockey injuries according to age and the relationship between etiological factors and injuries in high school students. [Subjects and Methods] This was a cross-sectional study. Eighteen female ice hockey players in Korean elite athletes were recruited for this study. This study was conducted by a self-administered questionnaire survey using Knee Injury and Osteoarthritis Outcome Score (KOOS) of national ice hockey players. [Results] Participants were injured mainly during training. Injuries were caused by skate, puck-contact, and body check. Five subscales of KOOS were significantly correlated with each other except that the correlation between activities of daily living and quality of life was insignificant. [Conclusion] For injury prevention in national team ice hockey players, full gear is recommended. In addition, therapist in the field needs to conduct injury prevention through consistent observations and counseling in order to prevent injury and improve performance. Ice hockey players also need sufficient rest with systematic and scientific training for injury prevention and performance improvement.

Treadmill Training with Virtual Reality Improves Gait, Balance, and Muscle Strength in Children with Cerebral Palsy.

Independent walking is an important goal of clinical and community-based rehabilitation for children with cerebral palsy (CP). Virtual reality-based rehabilitation therapy is effective in motivating children with CP. This study investigated the effects of treadmill training with virtual reality on gait, balance, muscular strength, and gross motor function in children with CP. Eighteen children with spastic CP were randomly divided into the virtual reality treadmill training (VRTT) group (9 subjects, mean age, 10.2 years) and treadmill training (TT) group (9 subjects, mean age, 9.4 years). The groups performed their respective programs as well as conventional physical therapy 3 times/week for 8 weeks. Muscle strength was assessed using a digitalized manual muscle tester. Gross motor function was assessed using the Gross Motor Functional Measure (GMFM). Balance was assessed using the Pediatric Balance Scale (PBS). Gait speed was assessed using the 10-meter walk test (10MWT), and gait endurance was assessed using the 2-minute walk test (2MWT). After training, gait and balance was improved in the VRTT compared to the TT group (P < 0.05). Muscular strength was significantly greater in the VRTT group than the TT group, except for right hamstring strength. The improvements in GMFM (standing) and PBS scores were greater in the VRTT group than the TT group (P < 0.05). Furthermore, the VRTT group showed the higher values of 10MWT and 2MWT compared to the TT group (P < 0.05). In conclusion, VRTT programs are effective for improving gait, balance, muscular strength, and gross motor function in children with CP.

Relationship between manual dexterity and the unified parkinson's disease rating scale-motor exam.

[Purpose] The purpose of this study was to examine the relationships between manual dexterity and the Unified Parkinson's Disease Rating Scale-Motor Exam as a clinical tool for quantifying upper extremity function in persons with Parkinson's disease. [Subjects and Methods] Thirty-two persons with idiopathic Parkinson's disease participated in this study. This study measured two clinical outcomes, the box-and-block test and the Unified Parkinson's Disease Rating Scale-Motor Exam, to investigate the relationships between manual dexterity and the Unified Parkinson's Disease Rating Scale-Motor Exam. [Results] The box-and-block test on the more affected side was positive relationship with the box-and-block test on the less affected side. The Unified Parkinson's Disease Rating Scale-motor exam score had a negative correlation with the box-and-block test results for both sides. [Conclusion] A positive association was noted between manual dexterity and motor function in patients with idiopathic Parkinson disease. The results of this study suggest that the box-and-block test and the Unified Parkinson's Disease Rating Scale-Motor Exam are good clinical measures that quantify upper extremity function and are necessary for the accurate evaluation of patients and to plan intervention strategies.

Effects of scapular stabilization exercise on neck posture and muscle activation in individuals with neck pain and forward head posture.

[Purpose] The purpose of this study was to investigate the effects of scapular stabilization exercise on neck posture, muscle activity, pain, and quality of life in individuals with neck pain and forward head posture. [Subjects and Methods] Fifteen participants were recruited according to the selection criteria and were randomly allocated to the scapular stabilization group (n=8) and the control group (n=7). The scapular stabilization group underwent training for 30 minutes a day, 3 times a week for 4 weeks; the control group performed relaxation exercises for 4 weeks. [Results] After training the scapular stabilization group showed significant improvement on the craniovertebral angle, upper trapezius muscle activity, serratus anterior muscle activity, Neck Disability Index scores, Visual Analog Scale scores, and World Health Organization Quality of Life Assessment-BREF scores compared to those in the control group. [Conclusion] Scapular stabilization exercise can help improve the head posture and pain in the patients with neck pain and forward head posture. Controlling the muscular activities through scapular stabilization exercise also improves the patients' quality of life.

Effects of the height of shoe heels on muscle activation of cervical and lumbar spine in healthy women.

[Purpose] The purpose of this study was to investigate the effects of different height of high heels on muscle activation of the paraspinalis cervicis and erector spinae in healthy young women. [Subjects and Methods] Thirteen healthy women were recruited in this study. To examine the effects of different heights of heels on muscle activation, the paraspinalis cervicis (cervical spine) and erector spinae (lumbar spine) were measured at the time of heel strike and toe off during gait on three different conditions (barefoot, 4 cm high heels, and 10 cm high heels). There are no previous trials or reports that have evaluated this approach in patients with chronic neck pain. [Results] A significant increase in muscle activation of the paraspinalis cervicis and erector spinae at heel strike and toe off (except that of the paraspinalis cervicis at toe off in healthy subjects) was observed in the under 10 cm high heel condition as, compared to that with barefoot condition, in all the subjects. [Conclusion] The height of the high heels affects to the activation demand of the paraspinalis cervicis and erector spinae in patients with neck pain.

Pure and palladium-loaded Co3O4 hollow hierarchical nanostructures with giant and ultraselective chemiresistivity to xylene and toluene.

Pure and palladium-loaded Co3O4 hollow hierarchical nanostructures consisting of nanosheets have been prepared by solvothermal self-assembly. The nanostructures exhibited an ultrahigh response and selectivity towards p-xylene and toluene. The responses (resistance ratio) of the palladium-loaded Co3O4 hollow hierarchical nanostructures to 5 ppm of p-xylene and toluene were as high as 361 and 305, respectively, whereas the selectivity values (response ratios) towards p-xylene and toluene over interference from ethanol were 18.1 and 16.1, respectively. We attributed the giant response and unprecedented high selectivity towards methylbenzenes to the abundant adsorption of oxygen by Co3O4, the high chemiresistive variation in the Co3O4 nanosheets (thickness≈11 nm), and the catalytic promotion of the specific gas-sensing reaction. The morphological design of the p-type Co3O4 nanostructures and loading of the palladium catalyst have paved a new way to monitoring the most representative indoor air pollutants in a highly selective, sensitive, and reliable manner.

Multicomponent exercise for physical fitness of community-dwelling elderly women.

[Purpose] The purpose of this study was to identify whether a 4-week multicomponent exercise program could improve the level of physical fitness of community-dwelling elderly women. [Subjects and Methods] Twenty-two healthy community-dwelling elderly women were randomly allocated to either an experimental or a control group. Experimental subjects performed a multicomponent exercise program that consisted of balance, strengthening, and stretching exercises for 4 weeks, whereas the control subjects did not perform any specific exercise. The subjects' level of physical fitness was assessed prior to and after training using the Senior Fitness Test which assesses muscle strength, flexibility, dynamic balance/agility, aerobic endurance, and body composition. [Results] Subjects in the experimental group showed significant improvements in lower and upper body strength, lower and upper body flexibility, dynamic balance/agility following training, but not in aerobic endurance or body composition. Significant group differences were shown in lower and upper body strength, lower body flexibility, and dynamic balance/agility. [Conclusion] The results suggest that a multicomponent training program that consists of balance, strengthening, and stretching exercises is a relevant intervention for the improvement of the level of physical fitness of community-dwelling elderly women.

Test-retest reliability of the Quebec user evaluation of satisfaction with assistive technology 2.0-Korean version for individuals with spinal cord injury.

[Purpose] The study purpose was to investigate the test-retest reliability of the Quebec User Evaluation of Satisfaction with assistive Technology 2.0-Korean version (QUEST-K) for individuals with traumatic spinal cord injury. [Subjects and Methods] Seventy participants with spinal cord injury were enrolled in this study. The participants were assessed using the QUEST-K in two sessions conducted 3 days apart. This study also utilized the spinal cord independence measure III and modified Barthel index for determining their validity concurrently with the QUEST-K. [Results] The test-retest reliability (intraclass correlation coefficient 0.855) of the QUEST-K was high, indicating a good agreement. The results of the QUEST-K testing were not substantially positively correlated with those of the spinal cord independence measure III (r = -0.075) and Modified Barthel Index (r=-0.138). [Conclusion] The test-retest reliability of the QUEST-K was high in individuals with spinal cord injury. The QUEST-K could be a reliable measure for evaluating the satisfaction with assistive technology during functional performance in patients with spinal cord injury. The ability of the QUEST-K to detect actual changes is acceptable for research and clinical settings.

Weight-shift training improves trunk control, proprioception, and balance in patients with chronic hemiparetic stroke.

Trunk instability is one of main problems in survivors following stroke. We investigated the effects of weight-shift training (WST) on an unstable surface in sitting position on trunk control, proprioception, and balance in individuals with chronic hemiparetic stroke. Eighteen participants with chronic hemiparetic stroke were recruited and were allocated to either WST or control group. The WST group received a weight-shift training program for 30 min and then received a conventional exercise program for 30 min, while the control group received conventional exercise program for 60 min, five times a week for four weeks for both groups. In this randomized control study, we used three outcome measures: trunk reposition error (TRE), Trunk Impairment Scale (TIS), and Timed Up and Go (TUG) test. TRE was measured by each participant's reposition error to the target angle during his/her active trunk movement. TIS and TUG were examined for trunk control abilities and dynamic balance abilities, respectively. After training, TRE showed significantly greater improvement in the WST group (mean change, 1.67 ± 1.45˚) than the control group (mean change, 0.08 ± 1.05˚). The TIS score was significantly higher in the WST group (mean change, 2.33 ± 1.50) than the control group (mean change, 0.13 ± 0.83). The TUG test also showed a significant improvement in the WST group (mean change, 5.03 ± 1.88 sec) than the control group (mean change, 2.59 ± 1.86 sec). Our findings indicate that weight-shift training is beneficial for improving trunk control and proprioception in patients with chronic hemiparetic stroke.

Rehabilitative effects of electrical stimulation on gait performance in stroke patients: A systematic review with meta-analysis.

BACKGROUND: Electrical stimulation techniques are widely utilized for rehabilitation management in individuals with stroke patients. OBJECTIVES: This review aims to summarize the rehabilitative effects of electrical stimulation therapy on gait performance in stroke patients. METHODS: This review included randomized controlled trials (RCT) investigating the therapeutic effects of electrical stimulation in stroke patients throughout five databases. This review qualitatively synthesized 20 studies and quantitatively analyzed 11 RCTs. RESULTS: Functional electrical stimulation (FES) was the most commonly used electrical stimulation type to improve postural stability and gait performance in stroke patients. The clinical measurement tools commonly used in the three studies to assess the therapeutic effects of FES were Berg balance scale (BBS), 10-meter walk test (10MWT), 6-minute walk test (6mWT), and gait velocity. The BBS score and gait velocity had positive effects in the FES group compared with the control group, but the 10MWT and 6mWT showed the same effects between the two groups. The heterogeneity of BBS scores was also high. CONCLUSION: The results of this review suggest that electrical stimulation shows little evidence of postural stability and gait performance in stroke patients, although some electrical stimulations showed positive effects on postural stability and gait performance.

Visual display terminal syndrome and its associated factors among university students during the COVID-19 pandemic.

BACKGROUND: Ever since the start of the coronavirus disease 2019 (COVID-19) pandemic, students have been spending an increasingly longer time staring at electrical devices to take online courses. OBJECTIVE: This study aimed to investigate the effect of the virtual class environment on eye and musculoskeletal problems in university students during the COVID-19 pandemic. METHODS: A total of 365 university students were enrolled in this study. They completed an online survey to examine the effects of online learning on eye and musculoskeletal health during the COVID-19 pandemic. The questionnaires consisted of four sections: demographic and general information, environmental and work factors, device-related factors, and visual display terminal syndrome (VDTS). RESULTS: Participants have been taking online classes of 14.5 hours per week during the COVID-19 pandemic. They reported the mean daily usage of digital devices of 4.8±2.2 hours before the pandemic but this increased to 8.1±2.9 during the pandemic. Eye fatigue and neck, shoulder, and back pain have also been reported. The mean VDTS score was significantly influenced by gender, obesity, daily exercise, regular breaks, wear of blue light-blocking glasses, daily hours of electronic device use, and illumination of room. CONCLUSION: The results of this study showed that university students taking online classes suffered more from VDTS, especially in eye fatigue and neck, lower back, and shoulder pain during COVID-19 pandemic than prior. This study suggests that it is necessary to take breaks in online classes and regularly provide appropriate eye exercise and physical activity to prevent VDTS.

Assistive Technology Involving Postural Control and Gait Performance for Adults with Stroke: A Systematic Review and Meta-Analysis.

This study aimed to comprehensively summarize assistive technology devices for postural control and gait performance in stroke patients. In the study, we searched for randomized controlled trials (RCTs) published until 31 December 2022 in four electrical databases. The most frequently applied assistive technology devices involving postural stability and gait function for stroke patients were robot-assistive technology devices. Out of 1065 initially retrieved citations that met the inclusion criteria, 30 RCTs (12 studies for subacute patients and 18 studies for chronic patients) were included in this review based on eligibility criteria. The meta-analysis included ten RCTs (five studies for subacute patients and five for chronic patients) based on the inclusion criteria of the data analysis. After analyzing, the variables, only two parameters, the Berg balance scale (BBS) and the functional ambulation category (FAC), which had relevant data from at least three studies measuring postural control and gait function, were selected for the meta-analysis. The meta-analysis revealed significant differences in the experimental group compared to the control group for BBS in both subacute and chronic stroke patients and for the FAC in chronic stroke patients. Robot-assistive training was found to be superior to regular therapy in improving postural stability for subacute and chronic stroke patients but not gait function. This review suggests that robot-assistive technology devices should be considered in rehabilitative approaches for postural stability and gait function for subacute and chronic stroke patients.