Robot-assisted end-effector-based gait training in chronic stroke patients: A multicentric uncontrolled observational retrospective clinical study

BACKGROUND: Until now studies report inconclusive results as regards the effectiveness of exclusive use of robot-assisted training and clinical indications in stroke patients. OBJECTIVE: To evaluate if the only robot-assisted end-effector-based gait training can be feasible in chronic stroke subjects in terms of gait recovery. METHODS: Five rehabilitation centers participated and one hundred chronic post-stroke patients were recruited. Patients underwent a robot-assisted end-effector-based gait training as only rehabilitation treatment. 6 Minute Walk Test, 10 Meter Walk Test, Timed Up and Go test, Modified Ashworth Scale, Motricity Index, Functional Ambulation Classification (FAC) and Walking Handicap Scale were used as outcome clinical measure. Patients were divided into two groups: those assessed as FAC <3 (Group 1) and as FAC ≥ 3 (Group 2). RESULTS: Statistically significant changes were observed in each clinical outcome measure. Significant changes were observed in Group 1 and in Group 2. Significant percentages of patients achieved Minimally Clinically Important Difference in 6 Minute Walk Test in Group 2 and Timed Up and Go test in Group 1. CONCLUSIONS: Chronic stroke patients exposed to only robot-assisted end-effector-based gait training showed significant improvements in global motor performances, gait endurance, balance and coordination, lower limbs strength and even spasticity.