title: Over-ground and robotic-assisted locomotor training in adults with chronic stroke: a blinded randomized clinical trial.
abstract: OBJECTIVE
  The purpose was to compare the effectiveness of robotic-assisted body weight supported treadmill training using the Lokomat(®) to over-ground gait training (OGT) in adults with chronic stroke.
  
  
  METHODS
  Participants were randomly assigned to the Lokomat(®) or OGT interventions. Both protocols included 40 sessions over 8 weeks. Primary outcome measures were the 10-meter walk test and 6-minute walk distance. Secondary measures included the Functional Independence Measure(TM) locomotion score, Fugl-Meyer Lower Extremity Motor Score (FM-LE), Barthel Index, and Stroke Impact Scale. Blinded assessors tested the participants at baseline, post-intervention, and 3-month follow-up.
  
  
  RESULTS
  Eleven Lokomat(®) and nine OGT participants completed the study. Within group differences in the FM-LE score and Barthel Index occurred over time from baseline to post-intervention and baseline to 3-month follow-up. No other within group differences and no between group differences were observed.
  
  
  CONCLUSIONS
  Although walking measures did not show significant changes between groups, LE motor function and physical functional levels improved over time within both groups. The Lokomat(®) may allow aggressive locomotor training, particularly for the lower functioning patients who wish to improve walking ability due to apparent eased therapist physical burden, when compared to OGT, although an increased risk of skin breakdown is present.
authors.affiliation: School of Physical Therapy, Texas Woman's University, Houston, TX 77030, USA. ckelley@twu.edu
authors.forename: Carolyn P
authors.initials: CP
authors.lastname: Kelley
authors.forename: Jason
authors.initials: J
authors.lastname: Childress
authors.forename: Corwin
authors.initials: C
authors.lastname: Boake
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Noser
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D002908:Chronic Disease; D004311:Double-Blind Method; D005080:Exercise Test / Q000379:methods; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008124:Locomotion / Q000502:physiology; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D018570:Risk Assessment; D012371:Robotics / Q000295:instrumentation* / Q000379:methods; D012720:Severity of Illness Index; D012737:Sex Factors; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D013647:Task Performance and Analysis; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*