Effects of Robotic Interactive Gait Training on Cognitive and Locomotor Function in Post-Stroke Dementia

Abstract

<h3>Research Objectives</h3> To compare the effects of RIGT with CPGT on cognitive and sensorimotor functions, trunk balance and coordination, balance, and activities of daily living performance in patients with PSD. <h3>Design</h3> Two groups pre-post experimental design. <h3>Setting</h3> Hospitalized care. <h3>Participants</h3> Forty-eight patients with post-stroke dementia were assigned to either the RIGT (n = 23) or CPGT (n = 25) group. <h3>Interventions</h3> The rehabilitation protocol consisted of eighteen 30-min sessions of robotic interactive gait training (RIGT) and conventional physiotherapy gait training (CPGT) with a frequency of one session of RIGT or CPGT three times per week for 6 weeks. Experts and certified physical therapists delivered both RIGT and CPGT. The RIGT sessions used the Walkbot, an active lower limb exoskeleton with powered hip, knee, and ankle joints. The initial guidance force and body weight support were set at 100% and then progressively reduced by adjusting the settings. Physical therapists could vary the guidance force according to the patients' abilities to maximize the training intensity and maintain motivation during each session through an enjoyable verbal cognitive task interaction. A therapist would always be present during the RIGT sessions to supervise the patient's progress and raise the patient's awareness to correct gait patterns and postures. The CPGT sessions were performed through an intensive program of exercises to strengthen the gluteus and quadriceps muscles, stretch the hip flexor and hamstring muscles, increase static and dynamic balance, increase functional abilities, and improve overground gait and stair climbing. <h3>Main Outcome Measures</h3> Mini-Mental State Examination (MMSE) Fugl-Meyer Assessment (FMA) Trunk Impairment Scale (TIS) Berg Balance Scale (BBS) Modified Barthel Scale (MBI) <h3>Results</h3> ANOVA and ANCOVA showed that RIGT had superior effects compared with MMSE, FMA, and TIS (P < 0.05), but not with BBS and MBI. <h3>Conclusions</h3> Our results provide clinical evidence that RIGT improves cognitive and sensorimotor recovery function as well as trunk balance and coordination in patients with PSD who are unable to perform dual cognitive-locomotor tasks concurrently. <h3>Author(s) Disclosures</h3> None.