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Effect of a Supplemental Robotic Therapeutic Walking Exercise in Acute Stroke Rehabilitation

Alberto Esquenazi, MD, FAAPMR (MossRehab Gait and Motion Analysis Laboratory, Elkins Park, PA, United States); Ning Cao, MD, FAAPMR; Stella Lee

Meeting: AAPM&R Annual Assembly 2019

Session Information

Date: Thursday, November 14, 2019

Session Title: Neurological Rehabilitation Research Report

Session Time: 12:30pm-2:00pm

Location: Research Hub - Kiosk 6

Disclosures: Alberto Esquenazi, MD, FAAPMR: Ipsen: Research Grant or Support

Objective: To determine the benefit of supplemental therapeutic lower limb walking exercise in acute stroke rehabilitation with either a robotic or conventional therapy.

Design: Participants were randomized to receive supplemental therapy of either 30 minutes of conventional or 30 minutes of Lokomat® robotic training up to 5 days per week. Their involvement in the study was dependent on length of stay.

Setting: Acute tertiary rehabilitation hospital

Participants: Acute stroke patients with unilateral hemiparesis ≥ 18 years of age with a MAS ≤3.

Interventions: Patients participated in conventional therapy that assured compliance with health mandates of time and staff (3 hours of one-to-one therapy). Participants were randomized to receive supplemental therapy of either 30 minutes of conventional (control) or 30 minutes of Lokomat® robotic training (intervention) up to 5 days per week aimed at walking. Their overall involvement in the study was dependent on length of stay.

Main Outcome Measures: Number of steps and treatment sessions through the stay; serious/adverse events (S/AEs); Functional Independence Measure (FIM) efficiency and Modified Borg Rating of Perceived Exertion Scale (RPE).

Results: 11 Lokomat and 9 conventional participants have enrolled so far. Participants in the conventional group on average had more training days (10.6) than the Lokomat group (6.0); number of training days was not statistically different (P =.08). Number of steps per day was statistically larger for the Lokomat group (P=.4). FIM efficiency did not yield statistically significant difference between groups (P = .71). Four Lokomat and three participants from the conventional group reported AEs. No SAEs were reported

Conclusions: These preliminary findings provide a proof-of-concept demonstration that an additional lower limb exercise in combination with mandated multi-disciplinary therapies in acute stroke population is tolerable and, when implemented with a robot, can significantly increase the number of steps. Although the training groups did not yet yield statistical significance, FIM efficiency improved.

Level of Evidence: Level I

To cite this abstract in AMA style:

Esquenazi A, Cao N, Lee S. Effect of a Supplemental Robotic Therapeutic Walking Exercise in Acute Stroke Rehabilitation [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/effect-of-a-supplemental-robotic-therapeutic-walking-exercise-in-acute-stroke-rehabilitation/. Accessed June 12, 2025.
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