Treinamento de marcha assistida por robô na reabilitação de AVC: um estudo piloto

Robotic-assisted gait training (RAGT), when combined with conventional physical therapy, improves walking after stroke in terms of gait speed and quality.Two main types of RAGT devices have been investigated: exoskeletons and endeffectors.However, the differences between them have not yet been fully defined.Therefore, it is important to understand the effects of these two types of intervention to plan future comparative studies.To describe the performance of these two devices (Lokomat® and the G-EO System) in terms of their ability to improve functional gait patterns, we performed a retrospective analysis of a cohort of 24 chronic stroke patients who received the robotic training with the two different equipment.The intervention was delivered 3 times per week (36 sessions total).The following tests/scales were employed before and after RAGT: Functional Ambulation Categories (FAC), Timed Up and Go (TUG), 10-Metre Walk Test (10MWT), 6-Minute Walk Test (6MWT), Trunk Impairment Scale (TIS), Dynamic Gait Index (DGI), Berg Balance Scale (BBS) and ability to climb stairs (time to climb six steps of 15cm each; ACS).There were 5 dropouts, all from the G-EO group.At the end, 10 participants in the Lokomat and 9 in the G-EO group completed the intervention.From pre-to post-RAGT, G-EO patients improved on all functional tests/scales, whereas Lokomat patients improved only on the TUG, DGI and BBS.Most patients from both groups showed improvements above the relative smallest real difference (SRD%) in the TUG, 10MWT and 6MWT.Overall, our results show that both end-effectors and exoskeletons improve clinically relevant aspects of walking function, as assessed through the tests/scales TUG, DGI and BBS.Future studies are needed for investigating potential differences in clinical results, side effects, contraindications and cost effectiveness between these two different types of RAGT.