Ann Rehabil Med.  2016 Apr;40(2):183-189. 10.5535/arm.2016.40.2.183.

Clinical Characteristics of Proper Robot-Assisted Gait Training Group in Non-ambulatory Subacute Stroke Patients

• Kim SJ
• Lee HJ
• Hwang SW
• Pyo H
• Yang SP
• Lim MH
• Park GL
• Kim EJ

• KMID: 2309915
• DOI: http://doi.org/10.5535/arm.2016.40.2.183

Abstract

OBJECTIVE
To identify the clinical characteristics of proper robot-assisted gait training group using exoskeletal locomotor devices in non-ambulatory subacute stroke patients.
METHODS
A total of 38 stroke patients were enrolled in a 4-week robotic training protocol (2 sessions/day, 5 times/week). All subjects were evaluated for their general characteristics, Functional Ambulatory Classification (FAC), Fugl-Meyer Scale (FMS), Berg Balance Scale (BBS), Modified Rankin Scale (MRS), Modified Barthel Index (MBI), and Mini-Mental Status Examination (MMSE) at 0, 2, and 4 weeks. Statistical analysis were performed to determine significant clinical characteristics for improvement of gait function after robot-assisted gait training.
RESULTS
Paired t-test showed that all functional parameters except MMSE were improved significantly (p<0.05). The duration of disease and baseline BBS score were significantly (p<0.05) correlated with FAC score in multiple regression models. Receiver operating characteristic (ROC) curve showed that a baseline BBS score of '9' was a cutoff value (AUC, 0.966; sensitivity, 91%-100%; specificity, 85%). By repeated-measures ANOVA, the differences in improved walking ability according to time were significant between group of patients who had baseline BBS score of '9' and those who did not have baseline BBS score of '9'
CONCLUSION
Our results showed that a baseline BBS score above '9' and a short duration of disease were highly correlated with improved walking ability after robot-assisted gait training. Therefore, baseline BBS and duration of disease should be considered clinically for gaining walking ability in robot-assisted training group.

Keyword

Stroke; Rehabilitation; Gait; Physical therapy modalities; Neurologic gait disorders

MeSH Terms

Classification
Gait Disorders, Neurologic
Gait*
Humans
Physical Therapy Modalities
Rehabilitation
ROC Curve
Sensitivity and Specificity
Stroke*
Walking

Figure

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  Fig. 1 Study flow chart. FAC, Functional Ambulatory Classification.

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  Fig. 2 Patients were stratified into group A (a baseline BBS of ≤9) or group B (a baseline BBS of >9) for repeated-measures ANOVA. Differences in changed BBS score according to time were significant (p=0.019) between the two groups. BBS: Berg Balance Scale. *Denotes significant difference in changes of BBS score according to time between the two groups by repeated-measures ANOVA (p<0.05).

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