An electromechanical gait trainer for restoration of gait in hemiparetic stroke patients: preliminary results.
Modern concepts of gait rehabilitation after stroke favor a task-specific repetitive approach. In practice, the required physical effort of the therapists limits the realization of this approach. Therefore, a mechanized gait trainer enabling nonambulatory patients to have the repetitive practice of a gait-like movement without overstraining therapists was constructed. This preliminary study investigated whether an additional 4-week daily therapy on the gait trainer could improve gait ability in 14 chronic wheelchair-bound hemiparetic subjects. The 4 weeks of physiotherapy and gait-trainer therapy resulted in a relevant improvement of gait ability in all subjects. Velocity, cadence, and stride length improved significantly (p < 0.01). The kinesiologic electromyogram of selected lower-limb muscles revealed a more physiologic pattern. The confounding influence of spontaneous recovery, the lack of a control group, and the double amount of therapy limit the clinical relevance of this study. Nevertheless, the gait trainer seems feasible as an adjunctive tool in gait rehabilitation after stroke; further studies are needed.
Hesse
S
S
Klinik Berlin, Department of Neurological Rehabilitation, Free University Berlin, Germany. bhesse@zedat.fu-berlin.de
Werner
C
C
Uhlenbrock
D
D
von Frankenberg
S
S
Bardeleben
A
A
Brandl-Hesse
B
B
D000328:Adult; D000368:Aged; D004576:Electromyography; D015444:Exercise; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology* / Q000534:rehabilitation*; D020127:Recovery of Function; D020521:Stroke / Q000150:complications*; D013663:Teaching