title: Can Lowering the Guidance Force of Robot-Assisted Gait Training Induce a Sufficient Metabolic Demand in Subacute Dependent Ambulatory Patients With Stroke?
abstract: To assess the effects of guidance force (GF) and gait speed (GS) on cardiorespiratory responses and energy cost in subacute dependent ambulatory patients with stroke.
  
  
  
  Cross-sectional study.
  
  
  
  University rehabilitation hospital.
  
  
  
  Patients with subacute stroke (N=10; mean age, 64.50±19.20y) who were dependent ambulators (functional ambulation category ≤2).
  
  
  
  Patients participated in cardiorespiratory tests during robot-assisted gait training. Subjects walked at a fixed percentage (50%) of body weight support and various percentages of GF (100%, 80%, and 60%) and GS (1.4 and 1.8km/h). The therapist encouraged patients to maximize their locomotor ability.
  
  
  
  During the cardiorespiratory tests, oxygen consumption (V˙o2), heart rate, and respiratory exchange ratio were measured continuously to assess cardiometabolic demands.
  
  
  
  There were no significant differences in cardiometabolic demands according to GS (1.4 vs 1.8km/h). There were no significant differences in cardiometabolic demands according to GF at a GS of 1.4km/h. However, lowering GF decreased V˙o2when comparing GFs of 100% (6.89±2.38mL/kg/min), 80% (6.46±1.73mL/kg/min), and 60% (5.77±1.71mL/kg/min) at a GS of 1.8km/h (P=.03).
  
  
  
  Lowering the GF of robot-assisted gait training at a higher GS cannot induce a sufficient cardiometabolic demand for subacute dependent ambulatory patients with stroke. This implies that it is important to take the patient's functional ability into consideration when choosing training protocols.
authors.affiliation: Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Republic of Korea.
authors.forename: So Young
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Republic of Korea. Electronic address: clearblue10@naver.com.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Han
authors.affiliation: Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Republic of Korea.
authors.forename: Bo Ryun
authors.initials: BR
authors.lastname: Kim
authors.affiliation: Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Min Ho
authors.initials: MH
authors.lastname: Chun
authors.affiliation: Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Republic of Korea.
authors.forename: Yong Ki
authors.initials: YK
authors.lastname: Lee
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D051341:Dependent Ambulation; D004734:Energy Metabolism / Q000502:physiology*; D005080:Exercise Test / Q000379:methods*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000378:metabolism* / Q000534:rehabilitation*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology*; D012371:Robotics / Q000379:methods*; D020521:Stroke / Q000378:metabolism* / Q000503:physiopathology*; D000071939:Stroke Rehabilitation / Q000379:methods*
keywords: Energy metabolism; Oxygen consumption; Rehabilitation; Robotics; Stroke