Can Lowering the Guidance Force of Robot-Assisted Gait Training Induce a Sufficient Metabolic Demand in Subacute Dependent Ambulatory Patients With Stroke?

Arch Phys Med Rehabil. 2017 Apr;98(4):695-700. doi: 10.1016/j.apmr.2016.10.021. Epub 2016 Nov 30.

Abstract

Objective: To assess the effects of guidance force (GF) and gait speed (GS) on cardiorespiratory responses and energy cost in subacute dependent ambulatory patients with stroke.

Design: Cross-sectional study.

Setting: University rehabilitation hospital.

Participants: Patients with subacute stroke (N=10; mean age, 64.50±19.20y) who were dependent ambulators (functional ambulation category ≤2).

Interventions: Patients participated in cardiorespiratory tests during robot-assisted gait training. Subjects walked at a fixed percentage (50%) of body weight support and various percentages of GF (100%, 80%, and 60%) and GS (1.4 and 1.8km/h). The therapist encouraged patients to maximize their locomotor ability.

Main outcome measures: During the cardiorespiratory tests, oxygen consumption (V˙o2), heart rate, and respiratory exchange ratio were measured continuously to assess cardiometabolic demands.

Results: There were no significant differences in cardiometabolic demands according to GS (1.4 vs 1.8km/h). There were no significant differences in cardiometabolic demands according to GF at a GS of 1.4km/h. However, lowering GF decreased V˙o2 when comparing GFs of 100% (6.89±2.38mL/kg/min), 80% (6.46±1.73mL/kg/min), and 60% (5.77±1.71mL/kg/min) at a GS of 1.8km/h (P=.03).

Conclusions: Lowering the GF of robot-assisted gait training at a higher GS cannot induce a sufficient cardiometabolic demand for subacute dependent ambulatory patients with stroke. This implies that it is important to take the patient's functional ability into consideration when choosing training protocols.

Keywords: Energy metabolism; Oxygen consumption; Rehabilitation; Robotics; Stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Dependent Ambulation
  • Energy Metabolism / physiology*
  • Exercise Test / methods*
  • Female
  • Gait Disorders, Neurologic / metabolism*
  • Gait Disorders, Neurologic / rehabilitation*
  • Heart Rate / physiology
  • Humans
  • Male
  • Middle Aged
  • Oxygen Consumption / physiology
  • Physical Fitness / physiology*
  • Robotics / methods*
  • Stroke / metabolism*
  • Stroke / physiopathology*
  • Stroke Rehabilitation / methods*