Effects of Robot-Virtual Reality Compared with Robot Alone Training on Gait Kinetics of Individuals Post Stroke

Virtual reality systems have been used to deliver goal directed repetitive training to promote rehabilitation of individuals post-stroke. Lower extremity training of individuals post-stroke who used a robot coupled with virtual environments was shown to transfer to improved over-ground locomotion. To elucidate an underlying mechanism that enabled this functional change we compared the kinetic outcomes of training with the robot-virtual reality (VR) system to the robot alone. Eighteen individuals post-stroke participated in a four-week training protocol. One group trained with the robot-VR system and the other group with the robot alone. Training parameters were comparable for the two groups; however, the improvements in moments and powers generated in the ankle and hip of subjects in the robot-VR group were significantly greater than those in the robot alone group. These findings demonstrate that lower extremity training using virtual environments coupled with a robot produced greater gait related strength gains than training with robot alone.

[1]  S. Olney,et al.  Effects of muscle strengthening and physical conditioning training on temporal, kinematic and kinetic variables during gait in chronic stroke survivors. , 2001, Journal of rehabilitation medicine.

[2]  S. Olney,et al.  Work and power in gait of stroke patients. , 1991, Archives of physical medicine and rehabilitation.

[3]  C. Richards,et al.  Task-related circuit training improves performance of locomotor tasks in chronic stroke: a randomized, controlled pilot trial. , 2000, Archives of physical medicine and rehabilitation.

[4]  J. Eng,et al.  Effects of isokinetic strength training on walking in persons with stroke: a double-blind controlled pilot study. , 2001, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.

[5]  S. Nadeau,et al.  Analysis of the clinical factors determining natural and maximal gait speeds in adults with a stroke. , 1999, American journal of physical medicine & rehabilitation.

[6]  J. Eng,et al.  Magnitude and pattern of 3D kinematic and kinetic gait profiles in persons with stroke: relationship to walking speed. , 2004, Gait & posture.

[7]  S. Adamovich,et al.  Virtual reality-augmented rehabilitation for patients following stroke. , 2002, Physical therapy.

[8]  J E Deutsch,et al.  Virtual Reality-Based Approaches to Enable Walking for People Poststroke , 2007, Topics in stroke rehabilitation.

[9]  R. Brand,et al.  The biomechanics and motor control of human gait: Normal, elderly, and pathological , 1992 .

[10]  J. Whitall,et al.  Repetitive Bilateral Arm Training With Rhythmic Auditory Cueing Improves Motor Function in Chronic Hemiparetic Stroke , 2000, Stroke.

[11]  G.C. Burdea,et al.  Virtual reality-enhanced stroke rehabilitation , 2001, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[12]  R. Teasell,et al.  What’s New in Stroke Rehabilitation , 2004, Stroke.

[13]  J. Perry,et al.  Gait Analysis , 2024 .

[14]  Howard Poizner,et al.  Development and application of virtual reality technology to improve hand use and gait of individuals post-stroke. , 2004, Restorative neurology and neuroscience.

[15]  J. Liepert,et al.  Treatment-induced cortical reorganization after stroke in humans. , 2000, Stroke.

[16]  O. Guntinas-Lichius,et al.  Altered sensory input improves the accuracy of muscle reinnervation. , 2002, Restorative Neurology and Neuroscience.

[17]  A. Lamontagne,et al.  Locomotor rehabilitation in a complex virtual environment , 2004, The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[18]  Francine Malouin,et al.  A Treadmill and Motion Coupled Virtual Reality System for Gait Training Post-Stroke , 2006, Cyberpsychology Behav. Soc. Netw..

[19]  Mark Hallett,et al.  Cortical reorganization and associated functional motor recovery after virtual reality in patients with chronic stroke: an experimenter-blind preliminary study. , 2005, Archives of physical medicine and rehabilitation.

[20]  C. Richards,et al.  The Role of Technology in Task-Oriented Training in Persons with Subacute Stroke: A Randomized Controlled Trial , 2004, Neurorehabilitation and neural repair.

[21]  Judith E. Deutsch,et al.  IMPROVED GAIT AND ELEVATION SPEED OF INDIVIDUALS POST-STROKE AFTER LOWER EXTREMITY TRAINING IN VIRTUAL ENVIRONMENTS. , 2004 .

[22]  E. Roth,et al.  Hemiplegic gait. Relationships between walking speed and other temporal parameters. , 1997, American journal of physical medicine & rehabilitation.

[23]  D. Winter.  Energy generation and absorption at the ankle and knee during fast, natural, and slow cadences. , 1983, Clinical orthopaedics and related research.