Ann Rehabil Med.  2023 Apr;47(2):108-117. 10.5535/arm.23017.

Feasibility and Usability of a Robot-Assisted Complex Upper and Lower Limb Rehabilitation System in Patients with Stroke: A Pilot Study

• Kim KT
• Choi Y
• Cho JH
• Lee S

• KMID: 2541844
• DOI: http://doi.org/10.5535/arm.23017

Abstract

Objective
To evaluate the feasibility and usability of cost-effective complex upper and lower limb robot-assisted gait training in patients with stroke using the GTR-A, a foot-plate based end-effector type robotic device.
Methods
Patients with subacute stroke (n=9) were included in this study. The enrolled patients received 30-minute robot-assisted gait training thrice a week for 2 weeks (6 sessions). The hand grip strength, functional ambulation categories, modified Barthel index, muscle strength test sum score, Berg Balance Scale, Timed Up and Go Test, and Short Physical Performance Battery were used as functional assessments. The heart rate was measured to evaluate cardiorespiratory fitness. A structured questionnaire was used to evaluate the usability of robot-assisted gait training. All the parameters were evaluated before and after the robot-assisted gait training program.
Results
Eight patients completed robot-assisted gait training, and all parameters of functional assessment significantly improved between baseline and posttraining, except for hand grip strength and muscle strength test score. The mean scores for each domain of the questionnaire were as follows: safety, 4.40±0.35; effects, 4.23±0.31; efficiency, 4.22±0.77; and satisfaction, 4.41±0.25.
Conclusion
Thus, the GTR-A is a feasible and safe robotic device for patients with gait impairment after stroke, resulting in improvement of ambulatory function and performance of activities of daily living with endurance training. Further research including various diseases and larger sample groups is necessary to verify the utility of this device.

Keyword

Gait, Locomotion, Rehabilitation, Robotics, Stroke

Figure

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  Fig. 1. GTR-A (HUCASYSTEM, Sejong, Korea), a complex upper and lower limb rehabilitation system. (A) Gross image of the robotic device. (B) Four-bar linkage mechanism with implemented gait trajectory. (C) Interconnection of the upper and lower extremity drive system using a timing belt.

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  Fig. 2. The mean percent of maximal heart rate (%HRmax) for each robot-assisted gait training session in 4 participants. The gray scale reveals the range of exercise intensity. %HRmax=HRmax (during exercise)/age predicted HRmax.

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  Fig. 3. The mean scores of the usability questionnaire in 4 subdomains (safety, effect, efficiency, satisfaction) on a 5-point Likert scale.

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