Effects of Robot-Assisted Gait Training on Cardiopulmonary Fitness in Subacute Stroke Patients

Abstract

Background. Robot-assisted gait training has the potential to improve cardiopulmonary fitness after stroke, even for patients who are in the early stages of recovery and not independent ambulators. The authors compared the effects of robot-assisted gait training and conventional physical therapy on cardiopulmonary fitness. Methods. A prospective single-blinded, randomized controlled study of 37 patients receiving inpatient rehabilitation was performed within 1 month after stroke onset. The robot-assisted gait training group (n = 20) received 40 minutes of gait training with Lokomat and 60 minutes of conventional physical therapy each day, whereas the control group (n = 17) received 100 minutes of conventional physical therapy daily. Using a semirecumbent cycle ergometer, changes in cardiopulmonary fitness were investigated using incremental exercise testing. Motor and gait functional recovery was measured according to changes in the lower-extremity score of the Fugl-Meyer Assessment Scale (FMA-L), leg score of the Motricity Index (MI-L), and the Functional Ambulation Category (FAC). Results. Compared with the control group, the robot group showed 12.8% improvement in peak VO2 after training (P < .05). Compared with the control group, the robot group also improved in FMA-L score (P < .05). Conclusion. Patients can be trained to increase their VO2 and lower-extremity strength using a robotic device for stepping during inpatient rehabilitation. This training has the potential to improve cardiopulmonary fitness in patients who are not yet independent ambulators, but that may require more than 2 weeks of continued, progressive training.