Stroke survivors walk better after human-assisted rehab

Research suggests that, for a patient who has neurological damage from stroke or spinal cord injury, moving the legs in a way that mimics walking on a treadmill can facilitate walking recovery.

Physical therapists often assist stroke patients too weak to walk on their own by fitting them in a harness, putting them on a treadmill and helping them move as they would when walking. But this can be physically demanding on a therapist, and robotic devices have been developed as an alterative to relieve the therapist.

Some research has shown that robotic devices could improve walking ability, but recent animal studies have indicated that providing strict guidance during training could reduce the recovery achieved.

“We wanted to know whether using a robotic device that guides the limb in a symmetrical walking pattern would facilitate greater improvements in walking speed and symmetry than more traditional walking interventions with a physical therapist,” said T. George Hornby, Ph.D., M.P.T., the study’s lead author.

Hornby and colleagues studied 48 stroke survivors who had suffered strokes at least six months earlier and still had moderate to severe trouble walking because of weakness on one side of their bodies. Patients were randomly divided between robotic-assisted locomotor training, or traditional physical therapist-assisted locomotor therapy. During locomotor training, patients are fitted with a harness and suspended from a frame over the treadmill. All patients received 12 30-minute therapy sessions during the four to five weeks of the study.

“We found that stroke patients improved their walking whether they had the robotic device or the therapist helping them,” said Hornby, an assistant professor in the physical therapy department at the University of Illinois in Chicago. “However, the amount of improvement was greater in the therapist-assisted group.”

The researchers noted greater improvements in the therapist-assisted group in walking speed and patients’ amount of time spent on the weak leg during walking. Patients in the therapist-assisted group who had severe walking deficits also perceived that their quality of life improved after therapy because they had fewer physical limitations. The same was not true for the robotic therapy group.

The researchers hypothesize that the greater improvement in the therapist-assisted group was because physical therapists allow for human error, while the robotic device used in this study restricted movement and minimized errors.

“When learning to walk again, if people can make mistakes and realize their errors and change their behavior based on those errors, they may learn better,” Hornby said. “We also think that patients work harder and therefore improve more with therapists because the robotic device moved patients’ legs for them throughout the therapy. Therapists only help as needed.”

The results of the study are limited by the small size and because researchers and patients were aware of which therapy patients received (non-blinded).

The researchers suggest that the effectiveness of robotic devices may be best reserved for acute stroke patients who have no ability to walk on their own, while those who can walk independently — even at very slow speeds — may be better served by human-assisted therapy.

Source: American Heart Association

Occupational therapy gets people with osteoarthritis moving
Physical activity is the cornerstone of any healthy lifestyle – and especially for people with osteoarthritis as exercise helps maintain good joint health, manage their symptoms, and prevent functional decline. Osteoarthritis, however, often makes physical activity, such as exercise, and even performing daily activities, a challenge.
New research shows physical therapy as effective as arthroscopic knee surgery
A new study questioning the usefulness of arthroscopic surgery for osteoarthritis of the knee should encourage patients to consider physical therapy as an effective non-surgical option, according to the American Physical Therapy Association (APTA). The study was published in the September 11 issue of the New England Journal of Medicine (NEJM).
Researchers use virtual reality to study complexities of dizziness
Think back to when you slipped on the ice or in the shower: the ground rushing up, your feet shooting out, terror building even as your mind is working a mile a second to plot a soft landing.
Treadmill exercise retrains brain and body of stroke victims
People who walk on a treadmill even years after stroke damage can significantly improve their health and mobility, changes that reflect actual "rewiring" of their brains, according to research spearheaded at Johns Hopkins.
Alexander technique offers long-term relief for back pain
Alexander technique lessons in combination with an exercise programme offer long-term effective treatment for chronic back pain, according to a study published on BMJ.com today.
Cancer drug may help patients with heart-lung disease
A drug developed to fight cancer is showing early promise as a treatment for pulmonary hypertension, researchers from the University of Chicago Medical Center report May 19 at the American Thoracic Society International Conference in Toronto, Canada.
Exercise plus psychological counseling may benefit depressed heart failure patients
Aerobic exercise combined with cognitive behavioral therapy may improve physical function, reduce depressive symptoms and enhance quality of life in depressed heart failure patients, researchers reported at the American Heart Association’s 9th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.
Occupational Therapists Use Wii for Parkinson's Study
It’s Ingrid Bell’s turn at bat. She steps up to the plate, awaiting the pitch. A 70-mph fastball soars toward her. She swings and connects with the ball. Foul ball! Everyone cheers for her anyway.

Stroke survivors walk better after human-assisted rehab

Related stories:

News discussion: