title: Recovery of walking ability using a robotic device in subacute stroke patients: a randomized controlled study.
abstract: OBJECTIVE
  This study investigates the effectiveness of Lokomat + conventional therapy in recovering walking ability in non-ambulatory subacute stroke subjects involved in inpatient rehabilitation.
  
  
  METHODS
  Thirty first-ever stroke patients completed 8 weeks of intervention. One group (n = 16) received Lokomat therapy twice a week, combined with three times 30 min a week of conventional overground therapy. The second group (n = 14) received conventional assisted overground therapy only, during a similar amount of time (3.5 h a week). The intervention was part of the normal rehabilitation program. Primary outcome measure was walking speed. Secondary outcome measures assessed other walking- and mobility-related tests, lower-limb strength and quality of life measures. All outcome measures were assessed before and after the intervention and at wk 24 and wk 36 after start of the intervention.
  
  
  RESULTS
  Patients showed significant (p < 0.05) gains in walking speed, other walking- and mobility related tests, and strength of the paretic knee extensors relative to baseline at all assessments. However, there were no significant differences in improvements in any of the variables between groups at any time during the study.
  
  
  CONCLUSIONS
  These results indicate that substituting Lokomat therapy for some of conventional therapy is as effective in recovering walking ability in non-ambulatory stroke patients as conventional therapy alone. Implications for Rehabilitation Recovery of walking after stroke is important. Robot-assisted therapy is currently receiving much attention in research and rehabilitation practice as devices such as the Lokomat seem to be promising assistive devices. Technical developments, sub-optimal study designs in literature and new therapy insights warrant new effectiveness studies. RESULTS of a financially and practically feasible study indicate that substituting Lokomat therapy for some of conventional therapy is as effective in recovering walking ability in non-ambulatory stroke patients as compared to conventional overground therapy alone.
authors.affiliation: MOVE Research Institute Amsterdam, Faculty of Human Movement Science, VU University Amsterdam , Amsterdam , the Netherlands .
authors.forename: Michiel P M
authors.initials: MP
authors.lastname: van Nunen
authors.forename: Karin H L
authors.initials: KH
authors.lastname: Gerrits
authors.forename: Manin
authors.initials: M
authors.lastname: Konijnenbelt
authors.forename: Thomas W J
authors.initials: TW
authors.lastname: Janssen
authors.forename: Arnold
authors.initials: A
authors.lastname: de Haan
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000295:instrumentation*; D011788:Quality of Life; D020127:Recovery of Function; D012371:Robotics / Q000295:instrumentation*; D000071939:Stroke Rehabilitation; D016138:Walking
keywords: Lokomat; randomized controlled trial; stroke; walking