Effects of electromechanical assisted gait training with Exowalk® on walking ability of chronic stroke patients: A randomized controlled trial

Abstract

Exowalk® is an exoskeletal walk-robotic device designed for over-ground walking exercise. It is developed for any patients with gait difficulty to do gait training by providing a proper walking pattern. Electromechanical-assisted gait training is known to be effective for acute and sub acute stroke patients by many meta-analysis. This study was conducted to assess the effects of electromechanical-assisted gait training with Exowalk® on gait ability of chronic patients who had suffered from stroke at least for 3 months. We measure the leg muscle power, balance and gait velocity and capacity its effectiveness. Design: Randomized controlled trial. Setting: University rehabilitation hospital. Participants: Individuals with stroke who could stand alone with onset > 3month. Interventions: Participants were randomly assigned into two groups: the experimental group (n = 20) by robot assisted gait training and the control group (n = 21) by physical therapist assisted gait training and receive gait training sessions (30 minutes a day, 5 days a week) with Exowalk® (experimental group) or with physical therapist (control group) for 4 weeks. Main outcome measures: Functional ambulatory category (FAC) before and after gait training. Change of FAC was the primary outcome to evaluate the efficacy of robot assisted gait training. Changes of mobility, walking speed, walking capacity, daily activity and balance were secondary outcomes. No significant difference in baseline (P > .05). Between pre and post-training of 0–2 weeks, the changes of outcome measures such as FAC, 6MWT, 10MWT, BBS, MBI in the experimental group were statistically significant (P < .05). Linear improvement showed in FAC, 10MWT, 6MWT,MI and BBS (0–2–4weeks). We try to analyzed the difference of two group 0–2–4 week. But the small number of patients to achieve 4 weeks (n = 14) and it did not reach statistical significance. To verify comparison the improvement of two groups 0–2–4 week, more number of patients is needed.