title: Robot-assisted gait training in patients with Parkinson disease: a randomized controlled trial.
abstract: BACKGROUND
  . Gait impairment is a common cause of disability in Parkinson disease (PD). Electromechanical devices to assist stepping have been suggested as a potential intervention.
  
  
  OBJECTIVE
  . To evaluate whether a rehabilitation program of robot-assisted gait training (RAGT) is more effective than conventional physiotherapy to improve walking.
  
  
  METHODS
  . A total of 41 patients with PD were randomly assigned to 45-minute treatment sessions (12 in all), 3 days a week, for 4 consecutive weeks of either robotic stepper training (RST; n = 21) using the Gait Trainer or physiotherapy (PT; n = 20) with active joint mobilization and a modest amount of conventional gait training. Participants were evaluated before, immediately after, and 1 month after treatment. Primary outcomes were 10-m walking speed and distance walked in 6 minutes.
  
  
  RESULTS
  . Baseline measures revealed no statistical differences between groups, but the PT group walked 0.12 m/s slower; 5 patients withdrew. A statistically significant improvement was found in favor of the RST group (walking speed 1.22 ± 0.19 m/s [P = .035]; distance 366.06 ± 78.54 m [P < .001]) compared with the PT group (0.98 ± 0.32 m/s; 280.11 ± 106.61 m). The RAGT mean speed increased by 0.13 m/s, which is probably not clinically important. Improvements were maintained 1 month later.
  
  
  CONCLUSIONS
  . RAGT may improve aspects of walking ability in patients with PD. Future trials should compare robotic assistive training with treadmill or equal amounts of overground walking practice.
authors.affiliation: University of Verona, Verona, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Picelli
authors.forename: Camilla
authors.initials: C
authors.lastname: Melotti
authors.forename: Francesca
authors.initials: F
authors.lastname: Origano
authors.forename: Andreas
authors.initials: A
authors.lastname: Waldner
authors.forename: Antonio
authors.initials: A
authors.lastname: Fiaschi
authors.forename: Valter
authors.initials: V
authors.lastname: Santilli
authors.forename: Nicola
authors.initials: N
authors.lastname: Smania
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D017063:Outcome Assessment, Health Care; D010300:Parkinson Disease / Q000503:physiopathology* / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000295:instrumentation*; D012189:Retrospective Studies; D012371:Robotics; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016138:Walking