Training for walking efficiency with a wearable hip-assist robot in patients with stroke a pilot randomized controlled trial

Abstract

Background and Purpose-The purpose of this study was to investigate the effects of gait training with a newly developedwearable hip-assist robot on locomotor function and efficiency in patients with chronic stroke.Methods-Twenty-eight patients with stroke with hemiparesis were initially enrolled, and 26 patients completed therandomized controlled trial (14 in the experimental and 12 in the control groups). The experimental group participated ina gait training program over a total of 10 sessions, including 5 treadmill sessions and 5 over-ground gait training sessionswhile wearing a hip-assist robot, the Gait Enhancing and Motivating System (GEMS, Samsung Advanced Institute ofTechnology, Suwon, Republic of Korea). The control group received gait training without Gait Enhancing and MotivatingSystem. Primary outcome measured locomotor function and cardiopulmonary metabolic energy efficiency. Also,secondary outcome measured motor function and balance parameter.Results-Compared with the control group, the experimental group had significantly greater improvement in spatiotemporalgait parameters and muscle efforts after the training intervention (P<0.05). The net cardiopulmonary metabolic energycost (mL•kg-1•min-1) was also reduced by 14.71% in the experimental group after the intervention (P<0.01). Significantgroup×time interactions were observed for all parameters (P<0.05). Cardiopulmonary metabolic efficiency was stronglycorrelated with gait symmetry ratio in the experimental group (P<0.01).Conclusions-Gait training with Gait Enhancing and Motivating System was effective for improving locomotor functionand cardiopulmonary metabolic energy efficiency during walking in patients with stroke. These findings suggest thatrobotic locomotor training can be adopted for rehabilitation of patients with stroke with gait disorders.Clinical Trial Registration-URL: https://clinicaltrials.gov. Unique identifier: NCT02843828.