Assist-as-Needed Robot-Aided Gait Training Improves Walking Function in Individuals Following Stroke


A completely unique robot-aided assist-as-needed gait coaching paradigm has been developed recently. This paradigm encourages subjects' active participation during training. Previous pilot studies demonstrated that assist-as-needed robot-aided gait coaching (RAGT) improves treadmill walking performance post-stroke. However, it is not known if there is an over-ground transfer of the training effects from RAGT on treadmill or long-term retention of the effects. The purpose of this study was to look at the effects of assist-as-required RAGT on over-ground walking pattern post-stroke. Nine stroke subjects received RAGT with visual feedback of each subject's instantaneous ankle malleolus position relative to a target template for fifteen 40-minute sessions. Clinical evaluations and gait analyses were performed before, immediately when, and six months post-training. Stroke subjects demonstrated vital enhancements and some long-term retention of the enhancements in their self-selected over-ground walking speed, Dynamic Gait Index, Timed Up and Go, peak knee flexion angle throughout swing phase and total hip joint excursion over the entire gait cycle for his or her affected leg $(p < 0.05)$ . These preliminary results demonstrate that subjects improved their over-ground walking pattern and some clinical gait measures post-training suggesting that assist-as-needed RAGT together with visual feedback could be a good approach to boost over-ground walking pattern post-stroke.

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