Effects of lower‐extremity exoskeleton robot‐assisted dual‐task training versus walking training on gait and postural control after stroke: A randomized controlled trial

Abstract Background Therapeutic tools are critical for poststroke rehabilitation. The potential benefits of dual‐task training assisted by a lower‐extremity exoskeleton robot to enhance gait and postural control have yet to be studied. Objective To determine the effects of lower‐extremity exoskeleton robot‐assisted dual‐task training on gait and postural control after stroke. Design Single‐blind, randomized controlled trial. Setting Outpatient clinic and ward, Department of Rehabilitation Medicine, Huadong Hospital affiliated with Fudan University. Participants Forty‐four participants in the recovery and sequela phases of stroke with deficits in gait and postural control. Interventions Participants were randomly assigned to two groups: lower‐extremity exoskeleton robot‐assisted walking cognitive dual‐task training (experimental group) or lower‐extremity exoskeleton robot‐assisted walking training (control group). Each participant received 40 minutes per intervention, 1 time per day, 6 times per week for 3 weeks. Main Outcome Measures The primary outcome was gait variability performance. The secondary outcomes included the Timed Up and Go, Berg Balance Scale, Montreal Cognitive Assessment, Fugl‐Meyer assessment of lower extremity, and International Classification of Functioning, Disability and Health‐activities and participation assessment scale. Results Individuals who participated in exoskeleton robot‐assisted walking cognitive dual‐task training improved more than those in the control group in partial gait variability performance analysis, Timed Up and Go test, Berg Balance Scale, and Fugl‐Meyer assessment for the lower extremities ( p < .05). Conclusions Compared to lower‐extremity exoskeleton robot‐assisted walking training, robot‐assisted dual‐task training improves gait and postural control, walking, balance, and lower extremity motor function in survivors of stroke.