Training of chronic stroke patients in the gait rehabilitation device lopes.

Hoek, J. van den (Joëlle) (2009) Training of chronic stroke patients in the gait rehabilitation device lopes. thesis, Human Movement Sciences.

Text vandenHoek.pdf Restricted to Registered users only Download (16MB)

Abstract

Abstract. Robotic training devices are promising tools in the rehabilitation of gait in stroke patients, because these devices can offer task-specific and intensive gait training without putting high physical demands on therapists. The first generation devices use control mechanisms in which a specific walking pattern is enforced upon the patient and the patient is not required to generate activity. The robotic gait trainer LOPES uses an impedance control mechanism, which means that active participation of the patients is necessary and that assistive forces are applied where needed. The purpose of this study was to determine the effectiveness of training with LOPES on walking speed and the recovery of function in the paretic leg. Nine ambulatory, chronic stroke patients (mean time post stroke = 32 months) were included in this study. The participants were randomly assigned to an experimental (5 participants) and a control group (4 participants). The experimental group received selective support to improve foot clearance, merely by inducing more knee flexion during swing. The control group received no specific support. The training consisted of 18 training sessions of 45 minutes in LOPES. The recovery of function was quantified by changes in the propulsive impulse and changes in muscle activity. Outcome measures included gait speed (ms), propulsive impulse (Ns), paretic propulsion (% of total propulsive impulse), step length symmetry and relative duration of muscle activity within a phase of the gait cycle (% ). Results demonstrated an almost consistent increase in walking velocity and an increase in propulsive impulse in both the paretic and the nonparetic leg. The contribution of the paretic leg to the total propulsion showed an increase for three participants in the experimental group and for one participant in the control group. The step length symmetry and patterns of muscle activity did not show consistent changes. Although statistical analyses did not show beneficial effects for training with robotic support, there was a trend in favor of the experimental group. In conclusion, training in LOPES shows promising results for walking velocity and propulsion. An important result of this study is that recovery of function occurred in both the paretic and the non-paretic leg. Although results showed a trend in favor of the selective support, further research to the effect of impedance controlled gait training is necessary with larger groups.

Item Type:	Thesis (Thesis)
Supervisor name:	Otter, Dr. A.R. den
Supervisor name:	Asseldonk, Dr. E.H.F. van and University of Twente
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:39
Last Modified:	25 Jun 2020 10:39
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/68

Actions (login required)

View Item