Augmented Effect of Combined Robotic Assisted Gait Training and Proprioceptive Neuromuscular Facilitation-irradiation Technique on Muscle Activation and Ankle Kinematics in Hemiparetic Gait: A Preliminary Study

Background Proprioceptive neuromuscular facilitation (PNF) alone has limited effectiveness in restoring gait, while robotic-assisted gait training (RAGT) improves motor relearning through repetitive, task-specific movements. Combining PNF with robotic gait training (PRGT) may enhance locomotor recovery by promoting proprioceptive awareness and muscle activation alongside repetitive gait retraining in stroke patients. Objective This study compares the immediate effects of PRGT and RAGT on ankle dorsiflexion and muscle activity in chronic hemiparetic stroke patients and healthy controls. Methods Thirty participants, including 15 stroke patients and 15 healthy controls, were randomly assigned to PRGT or RAGT for a single 30-min session. Muscle activity (pectoralis major, external oblique, internal oblique/transverse abdominis, rectus femoris, tibialis anterior) was measured using electromyography, while ankle dorsiflexion angle was assessed using a dual-axis inclinometer. Results PRGT significantly increased muscle activations compared to RAGT in stroke patients ( p < 0.05). Additionally, there was a significant difference in ankle dorsiflexion between RAGT and PRGT in both groups ( p < 0.05). Conclusion PRGT demonstrated superior immediate effects on muscle activation and ankle movement, suggesting that combining PNF with robotic-assisted gait training is beneficial for chronic stroke rehabilitation.