title: Who may benefit from robotic-assisted gait training? A randomized clinical trial in patients with subacute stroke.
abstract: BACKGROUND
  Robotic-assisted walking training after stroke aims to enable highly impaired patients to walk independently, but results have been mixed.
  
  
  OBJECTIVE
  The authors aimed to identify the characteristics of patients who may be most likely to benefit.
  
  
  METHODS
  A total of 48 participants with motor and gait dysfunction following subacute stroke were stratified by the motricity index into high (<29) and low (≥ 29) motor impairment groups. Each arm was randomized to a robotic or control group (RG or CG) at a mean of 20 days after stroke. All patients underwent 2 therapy sessions per day, 5 days per week for 3 months. Those in the RG underwent 20 sessions of robotic-assisted gait training in the first 4 weeks of inpatient therapy using controlled endpoint trajectories and abbreviated conventional therapy, whereas the CG received only conventional gait training. The primary outcome was the functional ambulation category (FAC), and secondary measures were the Rivermead mobility index (RMI) and 6-minute walking distance, all evaluated at hospital admission and at discharge.
  
  
  RESULTS
  The lower motricity group assigned to an electromechanical device significantly improved in the FAC (P < .001), RMI (P = .001), and walking distance (P = .029). Conventional and robotic therapies were equivalent in the higher motricity arm.
  
  
  CONCLUSIONS
  Robotic therapy combined with conventional therapy may be more effective than conventional therapy alone in patients with greater motor impairment during inpatient stroke rehabilitation.
authors: Santa Lucia Foundation, IRCCS, Rome, Italy. g.morone@hsantalucia.it
authors: Giovanni
authors: G
authors: Morone
authors: Maura
authors: M
authors: Bragoni
authors: Marco
authors: M
authors: Iosa
authors: Domenico
authors: D
authors: De Angelis
authors: Vincenzo
authors: V
authors: Venturiero
authors: Paola
authors: P
authors: Coiro
authors: Luca
authors: L
authors: Pratesi
authors: Stefano
authors: S
authors: Paolucci
mesh_terms: D000328:Adult; D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005684:Gait / Q000502:physiology*; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D006429:Hemiplegia / Q000209:etiology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012371:Robotics / Q000379:methods*; D018401:Sample Size; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology