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Effects of robot-(Morning Walk) assisted gait training for patients after stroke: a randomized controlled trial [with consumer summary]
Kim J, Kim DY, Chun MH, Kim SW, Jeon HR, Hwang CH, Choi JK, Bae S
Clinical Rehabilitation 2019 Mar;33(3):516-523
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To investigate the effects of Morning Walk-assisted gait training for patients with stroke. DESIGN: Prospective randomized controlled trial. SETTING: Three hospital rehabilitation departments (two tertiary and one secondary). PATIENTS: We enrolled 58 patients with hemiparesis following a first-time stroke within the preceding year and with Functional Ambulation Category scores 2. INTERVENTION: The patients were randomly assigned to one of two treatment groups: 30 minutes of training with Morning Walk, a lower limb rehabilitation robot, plus 1 hour of conventional physiotherapy (Morning Walk) group n = 28); or 1.5 hour of conventional physiotherapy (control group n = 30). All received treatment five times per week for three weeks. MAIN OUTCOME MEASUREMENTS: The primary outcomes were walking ability, assessed using the Functional Ambulation Category scale, and lower limb function, assessed using the Motricity Index-Lower. Secondary outcomes included the 10 Meter Walk Test, Modified Barthel Index, Rivermead Mobility Index, and Berg Balance Scale scores. RESULTS: A total of 10 patients were lost to follow-up, leaving a cohort of 48 for the final analyses. After training, all outcome measures significantly improved in both groups. In Motricity Index-Lower of the affected limb, the Morning Walk group (mean +/- SD 19.68 +/- 14.06) showed greater improvement (p = 0.034) than the control group (mean +/- SD; 11.70 +/- 10.65). And Berg Balance Scale scores improved more (p = 0.047) in the Morning Walk) group (mean +/- SD 14.36 +/- 9.01) than the control group (mean +/- SD 9.65 +/- 8.14). CONCLUSION: Compared with conventional physiotherapy alone, our results suggest that voluntary strength and balance of stroke patients with hemiparesis might be improved with Morning Walk-assisted gait training combined with conventional physiotherapy.

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