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.