Effects of end-effector robot-assisted gait training on gait ability, muscle strength, and balance in patients with spinal cord injury

Article type: Research Article

Authors: Shin, Ji Cheol^{a; 1} | Jeon, Ha Ra^{b; 1} | Kim, Dahn^a | Min, Won Kyu^c | Lee, June Sung^d | Cho, Sung Il^e | Oh, Da Som^f | Yoo, Jeehyun^{g; *}

Affiliations: [a] Research Institute of Rehabilitation Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea | [b] Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital, Goyang, South Korea | [c] Rehabilitation Center, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea | [d] Rehabilitation Center, National Health Insurance Service Ilsan Hospital, Goyang, South Korea | [e] Rehabilitation Center, Inje University Ilsan Paik Hospital, Goyang, South Korea | [f] Inje Industry, Academic Cooperation Foundation, Goyang, South Korea | [g] Department of Rehabilitation Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea

Correspondence: [*] Address for correspondence: Jeehyun Yoo, MD, PhD, Associate Professor, Department of Rehabilitation Medicine, Inje University College of Medicine, Ilsanpaik Hospital, 170 Juhwa-ro, Ilsanseo-gu, Goyang-si, Gyeonggi-do 10380, Republic of Korea. E-mail: [email protected].

Note: [1] These authors contributed equally to this work and share the first authorship.

Abstract: BACKGROUND:There is no randomized controlled study about the effects of end-effector robot-assisted gait training (RAGT) in patients with spinal cord injury (SCI). OBJECTIVE:To examine the effects of end-effector RAGT on gait and balance abilities in SCI. METHODS:Thirty-one patients were randomly assigned to the RAGT (Morning Walk®, Curexo, Seoul, South Korea) or conventional therapy (CT) group. Patients were assessed using the 10-meter walk test (10MWT), 6-minute walk test (6mWT), lower extremity motor score (LEMS) and proprioception, Berg Balance Scale (BBS), Walking Index for Spinal Cord Injury-II (WISCI-II), and mobility category of Spinal Cord Independence Measure-III. RESULTS:All clinical outcome measures significantly improved in both groups. The BBS and WISCI-II were significantly improved in the RAGT group compared to the CT group. In the RAGT group, pre-LEMS and pre-WISCI-II of the 10MWT improved group and pre-BBS of the 6mWT improved group were higher than those of the 10MWT non-improved and 6mWT non-improved group, respectively. CONCLUSION:End-effector RAGT and CT in patients with incomplete SCI could lead to improvements in gait ability, lower extremity muscle strength, balance, proprioception, and mobility. Additionally, end-effector RAGT could improve balance and gait abilities substantially better than CT.

Keywords: Robotics, robot-assisted gait training, spinal cord injuries, proprioception, postural balance

DOI: 10.3233/NRE-230085

Journal: NeuroRehabilitation, vol. 53, no. 3, pp. 335-346, 2023