Post-stroke Hemiplegic Patients Research Articles

Determination of factors associated with gait recovery and the period for achieving independent walking in post-stroke hemiplegic patients

Conclusion(s):This study shows the joint angles required in two conditions of rising-up motion. In both conditions, an approximately 50◦ flexion angle of the trunk and hip joints might be required at the end of the motion. The upper body could maintain an upright position by flexing the trunk and hip joints to the same extent. In the rotating rising condition, a sufficient range of motion (ROM) might be required not only for trunk rotation but also for the internal rotation of the shoulder and flexion of the elbow for a smooth rising-up motion. Implications: The characteristics of joint movement shown in this study might help physical therapists in setting the target levels of ROM in the joints for therapies targeted at achieving the motion of rising from a supine position.

Development of an independent ambulation rating chart for post-stroke hemiplegic patients in the recovery stage: at what level is patients free to walk within rehabilitation ward

Development of an independent ambulation rating chart for post-stroke hemiplegic patients in the recovery stage: at what level is patients free to walk within rehabilitation ward

The effects of gait velocity on the gait characteristics of hemiplegic patients.

[Purpose] The present study investigated the effects of gait speed on temporal and spatial gait characteristics of hemiplegic stroke patients. [Subjects and Methods] Twenty post-stroke hemiplegic patients participated in the present study. To enhance the reliability of the analysis of the gait characteristics, the assessments were conducted three days per week at the same time every day. Each subject walked maintaining a comfortable speed for the first minute, and measurement was conducted for 30 seconds at a treadmill speed of 1 km/hour thereafter. Then, the subjects walked at a treadmill speed of 2 km/hour for 30 seconds after a 30-minute rest. The differences in the measurements were tested for significance using the paired t-test. [Results] The measures of foot rotation, step width, load response, mid stance, pre-swing, swing phase, and double stance phase showed significant difference between the gait velocities. [Conclusion] The present study provides basic data for gait velocity changes for hemiplegic patients.

上下肢痙縮を有する脳卒中後の片麻痺患者を対象としたA型ボツリヌス毒素製剤投与状況の調査

日本人の上下肢痙縮に対してA型ボツリヌス毒素製剤（BoNT／A）を投与する際の指針となるデータを収集すべく，脳卒中に罹患した片麻痺患者を対象として診療録に基づく多施設共同・後方視的研究を実施し，日常診療で痙縮の治療に携わっている医師の診療状況を調査した．調査対象期間（2012年1月1日～2013年11月30日）にBoNT／Aを投与された307例のデータを集計した結果，1回あたりの合計投与量や1筋あたりの投与量・注射部位数，筋同定法，薬液濃度など，BoNT／A投与の結果に影響する多様な因子について情報が得られた．1筋あたりのBoNT／A投与量を左右する因子としては，患者の体格よりも痙縮の重症度が重視されている可能性が示唆された．経験豊富な医師によるノウハウの一端を明らかにした本研究の集計結果は，実地臨床においてBoNT／Aを投与する際の目安となることが期待される．

No. 106 Effect of Anterioposterior Weight Shifting Training With Visual Feedback on Step Length Asymmetry in Post-Stroke Hemiplegic Patients

No. 106 Effect of Anterioposterior Weight Shifting Training With Visual Feedback on Step Length Asymmetry in Post-Stroke Hemiplegic Patients

Efficacy of Trunk Rehabilitation and Balance Training On Trunk Control, Balance and Gait in Post Stroke Hemiplegic Patients: A Randomized Controlled Trial

Background: Stroke is the second most common cause of death and major cause of long term disability worldwide. Several factors affect the functional independence in post stroke period in which trunk control and balance play a significant role. Despite evidence demonstrating the importance of trunk performance and balance after stroke, studies evaluating therapy aimed at improving trunk control, balance and gait are limited. Aim: The aim of this study was to determine the effect of trunk rehabilitation and balance training on trunk control, balance and gait in post stroke patients. Materials and methods: 30 patients based on inclusion and exclusion criteria were selected from the OPD of University College of Physiotherapy, Faridkot. Patients were equally divided into two groups based on randomization Group A (n=15) and Group B (n=15). Patients in Group A (Experimental Group) received trunk rehabilitation, balance training and conventional physiotherapy. Patients in Group B (Control Group) received conventional physiotherapy only. Duration of treatment was 5 weeks with treatment session for 4 days a week. Outcome Measures: were Trunk Impairment Scale, Berg Balance Scale and 10 meters distance walk test. Results: Both the groups showed improvements in trunk control, balance and gait of post stroke hemiplegic patients (p<0.05). Between groups analysis showed that experimental group demonstrated more significant improvements in Trunk Impairment Scale, Berg Balance Scale scoring and the gait parameters i.e. gait speed and cadence post intervention. Conclusion: Thus the study concluded that trunk rehabilitation exercises and balance training are effective in improving trunk control, balance and gait in post stroke hemiplegic patients.

Functional electrical stimulation to ankle dorsiflexor and plantarflexor using single foot switch in patients with hemiplegia from hemorrhagic stroke.

ObjectiveTo evaluate the effects of functional electrical stimulation (FES) to ankle dorsiflexor (DF) and ankle plantarflexor (PF) on kinematic and kinetic parameters of hemiplegic gait.MethodsFourteen post-stroke hemiplegic patients were considered in this study. Electrical stimulation was delivered to ankle DF during the swing phase and ankle PF during the stance phase via single foot switch. Kinematic and kinetic data were collected using a computerized motion analysis system with force plate. Data of no stimulation (NS), DF stimulation only (DS), DF and PF stimulation (DPS) group were compared among each other.ResultsPeak ankle dorsiflexion angle during swing phase is significantly greater in DS group (-1.55°±9.10°) and DPS group (-2.23°±9.64°), compared with NS group (-6.71°±11.73°) (p<0.05), although there was no statistically significant difference between DS and DPS groups. Ankle plantarflexion angle at toe-off did not show significant differences among NS, DS, and DPS groups. Peak knee flexion in DPS group (34.12°±13.77°) during swing phase was significantly greater than that of NS group (30.78°±13.64°), or DS group (32.83°±13.07°) (p<0.05).ConclusionIn addition to the usual FES application stimulating ankle DF during the swing phase, stimulation of ankle PF during stance phase can help to increase peak knee flexion during the swing phase. This study shows the advantages of stimulating the ankle DF and PF using single foot switch for post-stroke gait.

Plantar Pressure Distribution During Robotic-Assisted Gait in Post-stroke Hemiplegic Patients.

ObjectiveTo assess the plantar pressure distribution during the robotic-assisted walking, guided through normal symmetrical hip and knee physiological kinematic trajectories, with unassisted walking in post-stroke hemiplegic patients.MethodsFifteen hemiplegic stroke patients, who were able to walk a minimum of ten meters independently but with asymmetric gait patterns, were enrolled in this study. All the patients performed both the robotic-assisted walking (Lokomat) and the unassisted walking on the treadmill with the same body support in random order. The contact area, contact pressure, trajectory length of center of pressure (COP), temporal data on both limbs and asymmetric index of both limbs were obtained during both walking conditions, using the F-Scan in-shoe pressure measurement system.ResultsThe contact area of midfoot and total foot on the affected side were significantly increased in robotic-assisted walking as compared to unassisted walking (p<0.01). The contact pressure of midfoot and total foot on affected limbs were also significantly increased in robotic-assisted walking (p<0.05). The anteroposterior and mediolateral trajectory length of COP were not significantly different between the two walking conditions, but their trajectory variability of COP was significantly improved (p<0.05). The asymmetric index of area, stance time, and swing time during robotic-assisted walking were statistically improved as compared with unassisted walking (p<0.05).ConclusionThe robotic-assisted walking may be helpful in improving the gait stability and symmetry, but not the physiologic ankle rocker function.

ツイスター装具を使用し，歩行能力が改善した中枢性片麻痺の2例

ツイスター装具を使用し，歩行能力が改善した中枢性片麻痺の2例

A novel functional electrical stimulation-control system for restoring motor function of post-stroke hemiplegic patients.

Hemiparesis is one of the most common consequences of stroke. Advanced rehabilitation techniques are essential for restoring motor function in hemiplegic patients. Functional electrical stimulation applied to the affected limb based on myoelectric signal from the unaffected limb is a promising therapy for hemiplegia. In this study, we developed a prototype system for evaluating this novel functional electrical stimulation-control strategy. Based on surface electromyography and a vector machine model, a self-administered, multi-movement, force-modulation functional electrical stimulation-prototype system for hemiplegia was implemented. This paper discusses the hardware design, the algorithm of the system, and key points of the self-oscillation-prone system. The experimental results demonstrate the feasibility of the prototype system for further clinical trials, which is being conducted to evaluate the efficacy of the proposed rehabilitation technique.

Does the rectus femoris nerve block improve knee recurvatum in adult stroke patients? A kinematic and electromyographic study

Knee recurvatum (KR) during gait is common in hemiplegic patients. Quadriceps spasticity has been postulated as a cause of KR in this population. The aim of this study was to assess the role of rectus femoris spasticity in KR by using selective motor nerve blocks of the rectus femoris nerve in hemiparetic stroke patients. The data from six adult, post-stroke hemiplegic patients who underwent a rectus femoris nerve block for a stiff-knee gait were retrospectively analyzed. An extensive clinical and functional evaluation was performed and gait was assessed by motion analysis (kinematic, kinetic and electromyographic parameters) before and during the block realized using 2% lidocaine injected under a neurostimulation and ultrasonographic targeting procedure. The main outcome measures were the peak knee extension in stance and peak knee extensor moment obtained during gait analysis. No serious adverse effect of the nerve block was observed. The block allowed a reduction of rectus femoris overactivity in all patients. Peak knee extension and extensor moment in stance did not improve in any patient, but peak knee flexion during the swing phase was significantly higher after block (mean: 31.2° post, 26.4 pre, p<0.05). Our results provide arguments against the hypothesis that the spasticity of the rectus femoris contributes to KR.

The effect of mirror therapy on the upper limb function rehabilitation of stroke patients with hemiplegia and their activity of daily living

Objective To explore the possible treatment mechanism of mirror therapy on the upper limb function rehabilitation of stroke patients with hemiplegia.Methods A total of 83 cases of post-stroke hemiplegic patients were randomly divided into the mirror treatment group (n =42,using mirror therapy) and control group (n =41,using conventional rehabilitation),Respectively before treatment and after 4 weeks of treatment,WMFT and FMA were used to evaluate the two groups of patients with upper limb motor function,VAS and modified Asworth spasm Scale were used to assess patients with upper extremity pain,spasticity,BI was used to evaluate the patient's activities of daily life (ADL).Results After 4 weeks of treatment,in two groups,the scores of WMFT,FMA,VAS,BI were significantly higher than before (P ＜0.05) ; Between the two groups,the scores of WMFT (60.17 ± 4.82 vs 47.31 ± 4.57),FMA (58.77 ± 3.79 vs 46.32 ± 3.84) in the mirror treatment group were all higher than those of the control group (P ＜ 0.05) ; but the scores of VAS (1.47 ±0.23 vs 1.53 ± 0.25),BI (79.75 ± 7.94 vs 75.25 ± 7.55) was not significant difference (P ＞ 0.05).The difference of Asworth spasm improvement was not significant before and after treatment and between two groups (P ＞ 0.05).Conclusions Mirror therapy on the upper limb motor function rehabilitation of stroke patients have a certain effect,but there is no obvious effects to improve the patient's activities of daily living,limb spasticity and to alleviate patients with upper extremity pain. Key words: Stroke; Hemiparesis; Mirror therapy; Upper limb function rehabilitation

보폭 비대칭을 보이는 뇌졸중 후 편마비 환자를 위한 체중이동 훈련 시스템 개발

The aim of this study was to develop and verify gait training system for post-stroke hemiplegia patients with step length asymmetry. Most post-stroke hemiplegic patients show gait asymmetry and weight shifting training has been suggested as a useful method for improving the walking ability. However, verbal cue by physical therapist may be not effective. Therefore, our weight shift training system was designed to give a feedback to patients through precise plantar pressure and center of pressure (COP) measurement. This weight shifting biofeedback training system is composed of F-Scan plantar pressure measurement system and software development kit (SDK) for Windows operating system. Two post-stroke patients with step length asymmetry were enrolled in this study. After training for six weeks, the weight shift score and step length ratio of two all patients were improved and approached to them of non-disabled. This system developed in this study may improve the step length asymmetry, and therefore this system is also expected to improve a walking ability in hemiplegic patients.

Animal models of post-ischemic forced use rehabilitation: methods, considerations, and limitations

Many survivors of stroke experience arm impairments, which can severely impact their quality of life. Forcing use of the impaired arm appears to improve functional recovery in post-stroke hemiplegic patients, however the mechanisms underlying improved recovery remain unclear. Animal models of post-stroke rehabilitation could prove critical to investigating such mechanisms, however modeling forced use in animals has proven challenging. Potential problems associated with reported experimental models include variability between stroke methods, rehabilitation paradigms, and reported outcome measures. Herein, we provide an overview of commonly used stroke models, including advantages and disadvantages of each with respect to studying rehabilitation. We then review various forced use rehabilitation paradigms, and highlight potential difficulties and translational problems. Lastly, we discuss the variety of functional outcome measures described by experimental researchers. To conclude, we outline ongoing challenges faced by researchers, and the importance of translational communication. Many stroke patients rely critically on rehabilitation of post-stroke impairments, and continued effort toward progression of rehabilitative techniques is warranted to ensure best possible treatment of the devastating effects of stroke.

Examination of Exercise Guidance for Hemiplegic Patients Based on an Analysis of Energy Consumption While Walking

Purpose: When exercise by post-stroke hemiplegic patients is guided, there is often a lack of specific guidance regarding how much walking the patient should do. The purpose of this study was to examine exercise guidance for hemiplegic patients based on an analysis of energy consumption while walking. The assumption is that an energy consumption of about 300 kcal through daily exercise (equivalent to walking about 10,000 steps) is effective for health maintenance in an able-bodied person. Methods: Seventy-one hemiplegic patients were included in this study; the number of steps, walking distance, and energy consumption were measured while the subjects walked for 12 minutes. Next, the number of steps, walking distance, and walking time equivalent to the target energy consumption (300 kcal/60 kg) were calculated. Results: The number of steps and walking distance equivalent to the target energy consumption were reduced in subjects whose walking speed was slower. Conclusion: We must consider motor functions, such as walking speed, when prescribing the number of steps and walking distance because energy consumption per step and distance is influenced by motor paralysis in hemiplegic patients.

Development of mirror image motion system with sEMG for shoulder rehabilitation of post-stroke hemiplegic patients

A robot-assisted bimanual shoulder flexion rehabilitation system using surface electromyography (sEMG) for post-stroke hemiplegic patients is presented. Impedance compensation of the actuators using a disturbance observer (DOB) was applied for back-drivable operation. The sEMG signal processing was utilized to obtain a desired assistive torque. Four modes of motion (passive, mirror image, shared, and voluntary) were suggested as an appropriate training platform for the various patient statuses and levels of individual recovery. Then the performance of the impedance compensation and assistive operation of the system was verified by experiments with healthy participants. The DOB decreased resistive torque by 99% compared to the open loop performance. The shoulder torque was estimated using the sEMG and linear regression (CORR = 0.960 ± 0.011, NRMSE = 7.31 ± 1.32%) and an artificial neural network (ANN) (CORR = 0.986 ± 0.005, NRMSE = 6.96 ± 1.08%) methods for generating system input based on the user’s motion intention. Every mode had less than a 6% NRMSE motion error in experiments without discomforts or resistance during shoulder flexion motion of mirror the arm.

Acupuncture treatment programs for post-stroke motor rehabilitation in community hospitals: study protocol of a multicenter, randomized, controlled trial

Stroke is responsible for increasingly high rates of mortality and disability worldwide. Approximately two million people suffer from stroke for the first time in China each year. The high incidence (50%) of post-stroke disability brings a heavy burden to patients and their caregivers. Acupuncture has been widely used in the communities for post-stroke rehabilitation in China. The objective of this trial is to apply our acupuncture research achievement to treatment and evaluation of post-stroke hemiplegic patients in community. A multicenter, randomized, controlled trial will be performed in Longhua Hospital and a number of community health service centers in Shanghai. A total of 124 patients (estimated sample size) with post-stroke hemiplegia will be randomly divided into an acupuncture group and a control group. The patients undergoing randomization should be stratified according to National Institutes of Health Stroke Scale score at baseline. Within the acupuncture group, different acupuncture protocols are administered to patients with flaccid paralysis or spastic paralysis based on the Ashworth Scale. Patients in the acupuncture group will also be treated with comprehensive rehabilitation therapy. The control group will be treated with comprehensive rehabilitation therapy only. The primary outcome measures are the Simplified Fugl-Meyer Motor Scale, the Modified Barthel Index, and the Burden of Stroke Scale. Secondary outcome measures are the modified Rankin Scale, the modified Ashworth Scale and the Stroke Scale of Traditional Chinese Medicine. Outcome measures will be performed after 4 and 8 weeks of treatment. The patients will be followed up after 6 months. The results of this study are expected to demonstrate that our standardized acupuncture protocol for treating and evaluating post-stroke hemiplegic patients will improve motor function and lessen the burden of post-stroke patients within the communities. This will provide the evidence to support successful translation of acupuncture therapy for post-stroke hemiplegic patients in community hospital use. This trial was registered in Chinese Clinical Trial Registry with the registration number ChiCTR-TRC-11001347.

Prevalence of Hemiplegic Shoulder Pain in Post-stroke Patients – A Hospital Based Study

Abstract Objectives To study the prevalence of hemiplegic shoulder pain (HSP) and its association with other factors like age, sex, side of paralysis, type of brain lesion, muscle tone, degree of functional recovery in upper limb and glenohumeral subluxation (GHS). Methodology Prospective study based on all the hemiplegic 140 patients admitted in the physical medicine and rehabilitation ward in two consecutive years. Tools Assessment of HSP was done by using a structured questionnaire known as “Shoulder Q”. Modified Ashworth scale (MAS) was used for spasticity assessment and functional independence measure (FIM) to document the severity of disability. Follow-up at intervals of 1, 3 and 6 months from the date of discharge for all cases were attempted and even cases with at least one follow-up around 3 months were also included in the study. Analysis was done on 109 patients as 31 patients lost to follow-up. Results Out of the 109 patients, 61.5% were males with a mean age of 58.9 ± 10.9 years. Cerebral infarct represents 53.2% of patients. HSP was present in 47.7% (n= 52) of patients. The prevalence of HSP on left and right sides was comparable though involvement was more on the left side (58.8%). Glenohumeral subluxation was present in 32.7% (n=17) of 52 cases with HSP and 33.3% (n=19) of 57 cases without HSP. Mean FIM score at admission for patients with HSP was 54.5 ± 17.6 and 56.6 ± 19.5 among cases without HSP. Again, mean FIM scores at last follow-up were 80.0 ± 16.4 and 79.9 ± 18.9 respectively for both cases with HSP and without it. Among the compliers, patients with tone more than MAS=1 were more likely to develop HSP. Conclusion Prevalence rate of HSP among post-stroke hemiplegic patients admitted during two years was 47.7%. There was no association of HSP with factors like age, sex, side of paralysis, type of lesion and GHS. Correlation between HSP and muscle tone or degree of functional recovery was significant.

Mirtazapine Relieves Limb Paralysis of Unknown Etiology: A Three-Year Case Follow-Up

Back to table of contents Previous article Next article LettersFull AccessMirtazapine Relieves Limb Paralysis of Unknown Etiology: A Three-Year Case Follow-UpChien-Han Lai, M.D., M.Sc.Chien-Han LaiSearch for more papers by this author, M.D., M.Sc.Published Online:1 Oct 2011https://doi.org/10.1176/jnp.23.4.jnpe18AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: “Mrs. M” is a housewife who has had bilateral limb paralysis (LP) of her legs for the last 3.3 years; she had no significant brain or lumbar spine findings in MRI of brain or lumbar-spine, biochemistry examination, and substance or toxicity screenings by many departments of internal and surgical medicine. She was transferred to our clinic because there were no pathologic results of medical examinations. No significant psychosocial stressors, depression (Hamilton Rating Scale for Depression [Ham-D]), or anxiety symptoms (Hamilton Rating Scale for Anxiety (Ham-A) were noted, except bilateral LP of legs, with decreased muscle power (MP: score 2), mild anorexia, low back pain (visual analog scale (VAS) score: 5), and insomnia. No other neurologic signs were found except bilateral LP of legs. Mirtazapine (30 mg/day) was used for the above complaints with unknown etiology, and Mrs. M had relief of LP with less pain feelings (VAS: 3), increased mp, better sleep, and appetite within 2 weeks. LP improved progressively in the following 1 month, with MP returning to normal (score: 5), pain relief (VAS: 1), and ability to walk without assistance. She continued mirtazapine use during the last 3 years; however, she complained that LP and pain would relapse with cessation of mirtazapine (MP: 3 and VAS: 4 if she discontinued mirtazapine use for longer than 1 month). She was still under continuous therapy with mirtazapine (30 mg/day) with good control of LP and pain up to the present (MP: 5; VAS: 1). There has been no significant psychopathology of depression (Ham-D: 0–1) or anxiety (Ham-A: 0–2) during these 3 years.DiscussionMirtazapine could enhance firing rates of dopaminergic neurons and adrenergic neurons in frontocortical and corticolimbic areas, such as frontal cortex, striatum, nucleus accumbens, and hippocampus.1 Dopaminergic-enhancing agents, such as L-dopa, has been reported to facilitate motor recovery in hemiplegic stroke patients.2 The precursor of norepinephrine or aromatic amino acid decarboxylase inhibitor could elevate norepinephrine level in cerebral cortex and hippocampus of sensorimotor cortex-ablated rats. The increase in norepinephrine level was correlated with motor-function recovery.3 Serotonin could give a significant number of stroke patients better outcomes of motor function after fluoxetine treatment, above and beyond the depression-treating effects.4Dept. of Psychiatry Buddhist Tzu-Chi General Hospital Taipei Branch Taipei, Taiwan Institute of Brain Science National Yang Ming University Taipei City, Taiwane-mail: [email protected]com.tw.Support: Buddhist Tzu-Chi General Hospital, Taipei Branch hospital project TCRD-TPE-97-02.1. Millan MJ , Gobert A , Rivet JM , et al.: Mirtazapine enhances frontocortical dopaminergic and corticolimbic adrenergic, but not serotonergic, transmission by blockade of alpha2-adrenergic and serotonin2C receptors: a comparison with citalopram. Eur J Neurosci 2000; 12:1079–1095Crossref, Medline, Google Scholar2. Scheidtmann K , Fries W , Muller F , et al.: Effect of levodopa in combination with physiotherapy on functional motor recovery after stroke: a prospective, randomised, double-blind study. Lancet 2001; 358:787–790Crossref, Medline, Google Scholar3. Kikuchi K , Nishino K , Ohyu H : Increasing CNS norepinephrine levels by the precursor L-dopa facilitates beam-walking recovery after sensorimotor cortex ablation in rats. Brain Res 2000; 860:130–135Crossref, Medline, Google Scholar4. Dam M , Tonin P , De Boni A , et al.: Effects of fluoxetine and maprotiline on functional recovery in poststroke hemiplegic patients undergoing rehabilitation therapy. Stroke 1996; 27:1211–1214Crossref, Medline, Google Scholar FiguresReferencesCited byDetailsCited ByNone Volume 23Issue 4 Fall 2011Pages E18-E18 Metrics Support: Buddhist Tzu-Chi General Hospital, Taipei Branch hospital project TCRD-TPE-97-02.PDF download History Published online 1 October 2011 Published in print 1 October 2011

Efficacy of a hybrid assistive limb in post-stroke hemiplegic patients: a preliminary report

BackgroundRobotic devices are expected to be widely used in various applications including support for the independent mobility of the elderly with muscle weakness and people with impaired motor function as well as support for nursing care that involves heavy laborious work. We evaluated the effects of a hybrid assistive limb robot suit on the gait of stroke patients undergoing rehabilitation.MethodsThe study group comprised 16 stroke patients with severe hemiplegia. All patients underwent gait training. Four patients required assistance, and 12 needed supervision while walking. The stride length, walking speed and physiological cost index on wearing the hybrid assistive limb suit and a knee-ankle-foot orthosis were compared.ResultsThe hybrid assistive limb suit increased the stride length and walking speed in 4 of 16 patients. The patients whose walking speed decreased on wearing the hybrid assistive limb suit either had not received sufficient gait training or had an established gait pattern with a knee-ankle-foot orthosis using a quad cane. The physiological cost index increased after wearing the hybrid assistive limb suit in 12 patients, but removal of the suit led to a decrease in the physiological cost index values to equivalent levels prior to the use of the suit.ConclusionsAlthough the hybrid assistive limb suit is not useful for all hemiplegic patients, it may increase the walking speed and affect the walking ability. Further investigation would clarify its indication for the possibility of gait training.