Long-Term Gait Benefits With Post-Stroke Robotic Therapy
Patients with greater motor impairments have improved outcomes at discharge and two years
THURSDAY, Dec. 15 (HealthDay News) -- For stroke survivors with greater motor impairments, a combination of robotic assistance and conventional therapy is more effective at discharge and after two years than conventional therapy alone, according to a study published online Dec. 15 in Stroke.
Giovanni Morone, M.D., from the Santa Lucia Foundation in Rome, and colleagues investigated the long-term effects of robotic-assisted gait training in patients with a mild or severe leg paresis after subacute stroke. The motricity index was used to stratify 48 nonambulant individuals into high (<29) and low (≥29) motor impairment groups; participants from each group were randomly allocated to robotic or control therapy after an average of 20 days post-stroke. For three months, all participants underwent two daily therapy sessions, five days per week. In the first four weeks of inpatient therapy, the robotic group received 20 robotic-assisted gait training sessions and abbreviated conventional therapy, while control patients received conventional gait training alone. The functional ambulation category, Rivermead Mobility Index, and Barthel Index scores were administered before and after the inpatient stay, and two years after discharge.
The investigators found that, at discharge and at follow-up, the functional ambulatory category, Barthel Index, and Rivermead Mobility Index improved significantly more in the low motricity robotic group than in the control group. However, for the high motricity group, the conventional and robotic therapies were equally effective.
"The higher efficacy of the combination of robotic therapy and conventional therapy versus conventional therapy alone that was observed at discharge only in patients with greater motor impairments was sustained after two years," the authors write.