Abstract
Background and Purpose. The purpose of this study was to investigate the feasibility, safety and efficacy of robot-assisted gait training with a newly developed wearable ankle robot in patients with subacute or chronic stroke.
Methods. Three patients with subacute or chronic ischemic stroke were enrolled and completed the three-day robot-assisted gait training based on a wearable ankle robot. The primary outcome is the safety of the newly developed ankle robot. The secondary outcomes include the improvement of gait function (assessed by 10 MWT, 6 MWT, TUG), improvement of FD (assessed by IMU), improvement of lower limb impairment (assessed by FMA-LE scale), and improvement of balance function (assessed by BBS).
Results. The improvement of 10MWT, 6MWT and TUG were observed in all three patients. It’s worth mentioning that the maximal changes of 10MWT, 6MWT and TUG of the three patients exceeded the MCID of each index. However, the change of FMA-LE and BBS were minimal and were lower than the MCID. Additionally, no adverse event is observed during the training period.
Conclusion. The ankle robot has good safety and robustness in clinical practice, and could induce considerable improvement in locomotor function in patients with subacute or chronic stroke of Brunnstrom V ~ VI stage. Robot-assisted gait training with this ankle robot can be adopted for rehabilitation of patients with subacute or chronic stroke in further longer term and larger scale clinical trial.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Collaborators G B D S.: Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the global burden of disease study 2016. Lancet Neurol 18(5), 439-458 (2019)
Grefkes, C., Fink, G.R.: Recovery from stroke: current concepts and future perspectives. Neurol. Res. Pract. 2, 17 (2020)
Cho, K.H., Lee, J.Y., Lee, K.J., et al.: Factors related to gait function in post-stroke patients. J. Phys. Ther. Sci. 26(12), 1941–1944 (2014)
Prenton, S., Hollands, K.L., Kenney, L.P.J., et al.: Functional electrical stimulation and ankle foot orthoses provide equivalent therapeutic effects on foot drop: A meta-analysis providing direction for future research. J Rehabil Med 50(2), 129–139 (2018)
Peishun, C., Haiwang, Z., Taotao, L., et al.: Changes in gait characteristics of stroke patients with foot drop after the combination treatment of foot drop stimulator and moving treadmill training. Neural Plast. 2021, 9480957 (2021)
Kwon, J., Park, J.H., Ku, S., et al.: A soft wearable robotic ankle-foot-orthosis for post-stroke patients. IEEE Robotics and Automation Letters 4(3), 2547–2552 (2019)
Santos, G.F., Jakubowitz, E., Pronost, N., et al.: Predictive simulation of post-stroke gait with functional electrical stimulation. Sci. Rep. 11(1), 21351 (2021)
Yan, T., Hui-Chan, C.W., Li, L.S.: Functional electrical stimulation improves motor recovery of the lower extremity and walking ability of subjects with first acute stroke: a randomized placebo-controlled trial. Stroke 36(1), 80–85 (2005)
Karniel, N., Raveh, E., Schwartz, I., et al.: Functional electrical stimulation compared with ankle-foot orthosis in subacute post stroke patients with foot drop: a pilot study. Assist. Technol. 33(1), 9–16 (2021)
Alnajjar, F., Zaier, R., Khalid, S., et al.: Trends and technologies in rehabilitation of foot drop: a systematic review. Expert Rev. Med. Devices 18(1), 31–46 (2021)
Coleman, E.R., Moudgal, R., Lang, K., et al.: Early rehabilitation after stroke: a narrative review. Curr. Atheroscler. Rep. 19(12), 59 (2017)
Hu, J.: Research on robot fuzzy neural network motion system based on artificial intelligence. Comput. Intell. Neurosci. 2022, 4347772 (2022)
Ploughman, M., Kelly, L.P.: Four birds with one stone? Reparative, neuroplastic, cardiorespiratory, and metabolic benefits of aerobic exercise poststroke. Curr. Opin. Neurol. 29(6), 684–692 (2016)
Fan, W., Zhang, Y., Wang, Q.M., et al.: An interactive motion-tracking system for home-based assessing and training reach-to-target tasks in stroke survivors-a preliminary study. Med. Biol. Eng. Comput. 58(7), 1529–1547 (2020)
Rodgers, H., Bosomworth, H., Krebs, H.I., et al.: Robot assisted training for the upper limb after stroke (RATULS): a multicentre randomised controlled trial. Lancet 394(10192), 51–62 (2019)
Dijk, W.V., Meijneke, C., Kooij, H.V.D.: Evaluation of the achilles ankle exoskeleton. IEEE Trans. Neural Syst. Rehabil. Eng. 25(2), 151–160 (2017)
Thalman, C.M., Hsu, J., Snyder, L., et al.: Design of a soft ankle-foot orthosis exosuit for foot drop assistance. In: Proceedings of the 2019 International Conference on Robotics and Automation (ICRA), F 20–24 May 2019 (2019)
Fong, J., Rouhani, H., Tavakoli, M.: A therapist-taught robotic system for assistance during gait therapy targeting foot drop. IEEE Robotics and Automation Letters 4(2), 407–413 (2019)
Lee, M., Kim, J., Hyung, S., et al.: A compact ankle exoskeleton with a multiaxis parallel linkage mechanism. IEEE/ASME Trans. Mechatron. 26(1), 191–202 (2021)
Conroy, S., Roy, A., Magder, L., et al.: Treadmill Integrated Robot-Assisted Ankle Dorsiflexion Training for Stroke Rehabilitation: A Randomized Controlled Trial (2020)
Mirelman, A., Bonato, P., Deutsch, J.E.: Effects of training with a robot-virtual reality system compared with a robot alone on the gait of individuals after stroke. Stroke 40(1), 169–174 (2009)
Wu, Y.N., Hwang, M., Ren, Y., et al.: Combined passive stretching and active movement rehabilitation of lower-limb impairments in children with cerebral palsy using a portable robot. Neurorehabil. Neural Repair 25(4), 378–385 (2011)
Moucheboeuf, G., Griffier, R., Gasq, D., et al.: Effects of robotic gait training after stroke: a meta-analysis. Ann. Phys. Rehabil. Med. 63(6), 518–534 (2020)
Wiart, L., Rosychuk, R.J., Wright, F.V.: Evaluation of the effectiveness of robotic gait training and gait-focused physical therapy programs for children and youth with cerebral palsy: a mixed methods RCT. BMC Neurol. 16, 86 (2016)
Bergmann, J., Krewer, C., Bauer, P., et al.: Virtual reality to augment robot-assisted gait training in non-ambulatory patients with a subacute stroke: a pilot randomized controlled trial. Eur. J. Phys. Rehabil. Med. 54(3), 397–407 (2018)
Yeung, L.F., Ockenfeld, C., Pang, M.K., et al.: Randomized controlled trial of robot-assisted gait training with dorsiflexion assistance on chronic stroke patients wearing ankle-foot-orthosis. J. Neuroeng. Rehabil. 15(1), 51 (2018)
Rampeltshammer, W.F., Keemink, A.Q.L., Kooij, H.V.D.: An improved force controller with low and passive apparent impedance for series elastic actuators. IEEE/ASME Trans. Mechatron. 25(3), 1220–1230 (2020)
Khalid, Y.M., Gouwanda, D., Parasuraman, S.: A review on the mechanical design elements of ankle rehabilitation robot. Proc. Inst. Mech. Eng. H 229(6), 452–463 (2015)
Zhong, B., Guo, K., Yu, H., Zhang, M.: Toward gait symmetry enhancement via a cable-driven exoskeleton powered by series elastic actuators. IEEE Robot. Automat. Lett. 7(2), 786–793 (2022)
Schroder, J., Truijen, S., Van Criekinge, T., et al.: Feasibility and effectiveness of repetitive gait training early after stroke: a systematic review and meta-analysis. J Rehabil Med 51(2), 78–88 (2019)
Beom-Chan, L., Dae-Hee, K., Younsun, S., et al.: Development and assessment of a novel ankle rehabilitation system for stroke survivors. Annu Int. Conf. IEEE Eng. Med. Biol. Soc. 2017, 3773–3776 (2017)
Yeung, L.F., Lau, C.C.Y., Lai, C.W.K., et al.: Effects of wearable ankle robotics for stair and over-ground training on sub-acute stroke: a randomized controlled trial. J. Neuroeng. Rehabil.Rehabil. 18(1), 19 (2021)
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
About this paper
Cite this paper
Huang, R. et al. (2023). The Feasibility, Safety and Efficacy of Robot-Assisted Gait Training Based on a Wearable Ankle Robot in Stroke Rehabilitation. In: Yang, H., et al. Intelligent Robotics and Applications. ICIRA 2023. Lecture Notes in Computer Science(), vol 14269. Springer, Singapore. https://doi.org/10.1007/978-981-99-6489-5_48
Download citation
DOI: https://doi.org/10.1007/978-981-99-6489-5_48
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-99-6488-8
Online ISBN: 978-981-99-6489-5
eBook Packages: Computer ScienceComputer Science (R0)