Changes in Balance, Gait and Electroencephalography Oscillations after Robot-Assisted Gait Training: An Exploratory Study in People with Chronic Stroke

Hoon-Ming Heng,Nai-Hsin Meng,Hui-Chun Huang,Ming-Kuei Lu,Jui-Cheng Chen,Li-Wei Chou,Chon-Haw Tsai,Masashi Hamada

doi:10.3390/brainsci10110821

Abstract

Robot-assisted gait training (RAGT) systems offer the advantages of standard rehabilitation and provide precise and quantifiable control of therapy. We examined the clinical outcome of RAGT and analyzed the correlations between gait analysis data and event-related desynchronization (ERD) and event-related synchronization (ERS) in patients with chronic stroke. We applied the Berg balance scale (BBS) and analyzed gait parameters and the ERD and ERS of self-paced voluntary leg movements performed by patients with chronic stroke before and after undergoing RAGT. A significant change was observed in BBS (p = 0.011). We also showed preliminary outcomes of changes in gait cycle duration (p = 0.015) and in ipsilesional ERS in the low-beta (p = 0.033) and high-beta (p = 0.034) frequency bands before and after RAGT. In addition, correlations were observed between BBS and ipsilesional ERS in the alpha and low-beta bands (r = −0.52, p = 0.039; r = −0.52, p = 0.040). The study demonstrated that RAGT can improve balance and provided an idea of the possible role of brain oscillation and clinical outcomes in affecting stroke rehabilitation.

Highlights

Motor function recovery after stroke is related to changes in the plasticity of the motor cortex and related motor areas
Berg balance scale (BBS) scores and their correlation with gait parameters in the present study reveal consistent improvements resulting from Robot-assisted gait training (RAGT) rehabilitation among patients with stroke
event-related desynchronization (ERD), event-related synchronization (ERS), and gait measurements in the present study demonstrated the benefit of RAGT, and we expect that the results would have indicated a more distinct improvement if our research had not been limited by a small sample size and strictness of measurement criteria

Summary

Introduction

Motor function recovery after stroke is related to changes in the plasticity of the motor cortex and related motor areas. These altered activation patterns can revert to their original state, with normalization of reduced excitability and increase in the size of the cortical representation of motor function. The Berg balance scale (BBS) is an assessment of balance with high inter-rater and interrater reliability, especially for people who have had a stroke [9]. It has strong validity for inpatients with stroke [10]. Gait analysis has been suggested for use in assessing and improving walking ability in patients with stroke [11]

Methods

Discussion

Conclusion