Active robotic training improves locomotor function in a stroke survivor

Chandramouli Krishnan, Rajiv Ranganathan, Shailesh S. Kantak, Yasin Y. Dhaher, William Z. Rymer

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Background: Clinical outcomes after robotic training are often not superior to conventional therapy. One key factor responsible for this is the use of control strategies that provide substantial guidance. This strategy not only leads to a reduction in volitional physical effort, but also interferes with motor relearning. Methods. We tested the feasibility of a novel training approach (active robotic training) using a powered gait orthosis (Lokomat) in mitigating post-stroke gait impairments of a 52-year-old male stroke survivor. This gait training paradigm combined patient-cooperative robot-aided walking with a target-tracking task. The training lasted for 4-weeks (12 visits, 3×per week). The subjects neuromotor performance and recovery were evaluated using biomechanical, neuromuscular and clinical measures recorded at various time-points (pre-training, post-training, and 6-weeks after training). Results: Active robotic training resulted in considerable increase in target-tracking accuracy and reduction in the kinematic variability of ankle trajectory during robot-aided treadmill walking. These improvements also transferred to overground walking as characterized by larger propulsive forces and more symmetric ground reaction forces (GRFs). Training also resulted in improvements in muscle coordination, which resembled patterns observed in healthy controls. These changes were accompanied by a reduction in motor cortical excitability (MCE) of the vastus medialis, medial hamstrings, and gluteus medius muscles during treadmill walking. Importantly, active robotic training resulted in substantial improvements in several standard clinical and functional parameters. These improvements persisted during the follow-up evaluation at 6 weeks. Conclusions: The results indicate that active robotic training appears to be a promising way of facilitating gait and physical function in moderately impaired stroke survivors.

Original languageEnglish (US)
Article number57
JournalJournal of NeuroEngineering and Rehabilitation
Volume9
Issue number1
DOIs
StatePublished - Aug 22 2012
Externally publishedYes

Fingerprint

Robotics
Survivors
Gait
Stroke
Walking
Physical Exertion
Orthotic Devices
Muscles
Quadriceps Muscle
Biomechanical Phenomena
Ankle

Keywords

  • Gait training
  • Gait velocity
  • Hemiparesis
  • Muscle modes
  • Muscle Synergies
  • PCA
  • Skill acquisition
  • TMS
  • Variability
  • Visual feedback

ASJC Scopus subject areas

  • Rehabilitation
  • Health Informatics

Cite this

Active robotic training improves locomotor function in a stroke survivor. / Krishnan, Chandramouli; Ranganathan, Rajiv; Kantak, Shailesh S.; Dhaher, Yasin Y.; Rymer, William Z.

In: Journal of NeuroEngineering and Rehabilitation, Vol. 9, No. 1, 57, 22.08.2012.

Research output: Contribution to journalArticle

Krishnan, Chandramouli ; Ranganathan, Rajiv ; Kantak, Shailesh S. ; Dhaher, Yasin Y. ; Rymer, William Z. / Active robotic training improves locomotor function in a stroke survivor. In: Journal of NeuroEngineering and Rehabilitation. 2012 ; Vol. 9, No. 1.
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