Abstract
Objective: To investigate the efficacy and safety of a novel lower-limb exoskeletal robot, BEAR-H1 (Shenzhen Milebot Robot Technology), in the locomotor function of subacute stroke patients.Methods: The present study was approved by the ethical committee of the First Affiliated Hospital of Nanjing Medical University (No. 2019-MD-43), and registration was recorded on the Chinese Clinical Trial Registry with a unique identifier: ChiCTR2100044475. A total of 130 patients within 6 months of stroke were randomly divided into two groups: the robot group and the control group. The control group received routine training for walking, while in the robot group, BEAR-H1 lower-limb exoskeletal robot was used for locomotor training. Both groups received two sessions daily, 5 days a week for 4 weeks consecutively. Each session lasted 30 min. Before treatment, after treatment for 2 weeks, and 4 weeks, the patients were assessed based on the 6-minute walking test (6MWT), functional ambulation scale (FAC), Fugl-Meyer assessment lower-limb subscale (FMA-LE), and Vicon gait analysis.Results: After a 4-week intervention, the results of 6MWT, FMA-LE, FAC, cadence, and gait cycle in the two groups significantly improved (P < 0.05), but there was no significant difference between the two groups (P > 0.05). The ratio of stance phase to that of swing phase, swing phase symmetry ratio (SPSR), and step length symmetry ratio (SLSR) was not significantly improved after 4 weeks of training in both the groups. Further analyses revealed that the robot group exhibited potential benefits, as the point estimates of 6MWT and Δ6MWT (post-pre) at 4 weeks were higher than those in the control group. Additionally, within-group comparison showed that patients in the robot group had a significant improvement in 6MWT earlier than their counterparts in the control group.Conclusions: The rehabilitation robot in this study could improve the locomotor function of stroke patients; however, its effect was no better than conventional locomotor training.
Highlights
Stroke is the leading cause of long-term disability in adults (GBD 2019 Diseases and Injuries Collaborators, 2020; Virani et al, 2020)
Further analyses revealed that the robot group exhibited potential benefits, as the point estimates of 6-minute walking test (6MWT) and 6MWT at 4 weeks were higher than those in the control group
Within-group comparison showed that patients in the robot group had a significant improvement in 6MWT earlier than their counterparts in the control group
Summary
Stroke is the leading cause of long-term disability in adults (GBD 2019 Diseases and Injuries Collaborators, 2020; Virani et al, 2020). Conventional rehabilitation therapies for post-stroke locomotor training are performed manually by multiple therapists. Previous studies show that stroke registries in mainland China offered approximately 1.43 million physical therapy sessions in 2017; 5.5 million patients are diagnosed with stroke annually and there is a large unmet demand for physical therapy (Wang et al, 2019). To bridge this gap in rehabilitation therapies and ensure training doses for stroke survivors, the development and validation of intelligent rehabilitation robots in clinical settings are of great importance
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