• Journal of Biomedical Engineering Research
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• v.31 no.5
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• pp.344-350
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• 2010

The aim of this study was to investigate the characteristics of the flexion withdrawal reflex modulated during Lokomat treadmill walking in people with spinal cord injury. The influence of the limb position and movement were tested in 5 subjects with chronic spinal cord injury. EMG activities from tibialis anterior and moments of the hip joint elicited by the foot stimulation were examined during Lokomat treadmill walking. To trigger the flexion withdrawal reflex during Lokomat treadmill walking, a train of 10 stimulus pulses was applied at the skin of the medial arch. The TA EMG activity was modulated during gait phase and the largest TA reflex was obtained after heel-off and initial swing phase. During swing phase, TA EMG was 40.9% greater for the extended hip position (phase 6), compared with flexed hip position (phase 8). The measured reflex moment of the hip joint was also modulated during gait phase. In order to characterize the neural contribution of flexion reflex at the hip joint, we compared estimated moments consisted of the static and dynamic components with measured moment of the hip joint. The mean static gains of reflex hip moments for swing and stance phase are -0.1, -0.8, respectively. The mean dynamic gains of reflex hip moments are 0.25 for swing, 0.75 for stance phase. From this study, we postulate that the joint moment and muscle response of flexion withdrawal reflex have the phase-dependent modulation and linear relationship with hip angle and angular velocity for swing phase during Lokomat treadmill walking.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.10
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• pp.562-568
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• 2016

This study to investigated the therapeutic effect of robot-assisted rehabilitation (Lokomat) with virtual reality (VR) on Pusher syndrome (PS) after stroke. A total of 10 patients presented with PS after stroke were recruited. The participants were divided into two groups: Lokomat (n=5) and control groups (n=5). Lokomat and conventional physical therapy (CPT) were performed together in the experimental group, and the patients in the control group were treated with CPT only twice a day. One session of intervention was carried out for 30 minutes five times per week for 4 weeks. Scale for contraversive pushing (SCP), Berg balance scale (BBS), falling index (FI), and Timed up and go test (TUG) were measured before and after the intervention. The Lokomat group produced significantly better outcomes in SCP (p=0.046), BBS (p=0.046), FI (p=0.038), and TUG (p=0.038) compared with the control group after 4 weeks of intervention. In addition, there were significant correlations between SCP and BBS (p=0.024), FI (p=0.039), and TUG (p=0.030). In conclusion, Lokomat with VR more effectively aided recovery from PS after stroke, and restoration of PS symptoms was related with improvement of balance and gait function.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.7
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• pp.459-466
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• 2016

This study examined the effects of robot-assisted therapy on the motor and functional recovery of the lower limbs in 53 subacute stroke patients. Robot-assisted therapy was performed using Lokomat? (Hocoma AG, Zurich, Switzerland) for thirty minutes per day, five times a week for four weeks. The outcome measures used were the Fugl-Meyer assessment, Motricity index(MI), Functional ambulation category(FAC), Berg balance scale(BBS) for gait function and balance ability, 10m walking test, K-Modified Barthel Index(K-MBI) for the activities of daily living and Mini mental state examination (MMSE), and Beck's depression inventory(BDI) for depression. All patients recruited underwent these evaluations before and after the four week robot-assisted therapy. For the evaluation, the somatosensory evoked potentials were used to assess the functional recovery. Robot-assisted therapy on the lower limb after subacute stroke showed improvement in motor strength, gait function, and the activities of daily living. All changes in terms of MI, FAC, BBS, and K-MBI exhibited a statistically significant difference after the four weeks robot-assisted therapy. The somatosensory evoked potential result showed a correlation with the MI and K-MBI. Robot-assisted therapy is believed to facilitate the motor and functional recovery of the lower limb in subacute stroke patients.

• Physical Therapy Korea
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• v.22 no.2
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• pp.30-40
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• 2015

Robot-assisted rehabilitation therapy has been used to increase physical function in post-stroke patients. The aim of this meta-analysis was to identify whether robot-assisted gait training can improve patients' functional abilities. A comprehensive search was performed of PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), Academic Search Premier (ASP), ScienceDirect, Korean Studies Information Service System (KISS), Research Information Sharing Service (RISS), Korea National Library, and the Korean Medical Database up to April, 2014. Fifteen eligible studies researched the effects of robot-assisted gait training to a control group. All outcome measures were classified by International Classification of Functioning, Disability, and Health (ICF) domains (body function and structures, activity, and participation) and were pooled for calculating the effect size. The overall effect size of the robot-assisted gait training was .356 [95% confidence interval (CI): .186~.526]. When the effect was compared by the type of electromechanical robot, Gait Trainer (GT) (.471, 95% CI: .320~.621) showed more effective than Lokomat (.169, 95% CI: .063~.275). In addition, acute stroke patients showed more improvement than others. Although robot-assisted gait training may improve function, but there is no scientific evidence about the appropriate treatment time for one session or the appropriate duration of treatment. Additional researchers are needed to include more well-designed trials in order to resolve these uncertainties.

• Journal of International Academy of Physical Therapy Research
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• v.2 no.1
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• pp.207-213
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• 2011

In this case report, we investigated the effects of robot-assisted gait therapy in a chronic stroke patient using motor assessment and gait analysis. A patient who suffered from the right hemiparesis following the left corona radiata and basal ganglia infarction received 30 minutes of robot-assisted gait therapy, 3 times a week for 4 weeks. Outcome was measured using Motoricity index(MI), Fugl-Meyer assessment(FMA), modified motor assessment scale(MMAS), isometric torque, body tissue composition, 10-meter gait speed and gait analysis. After robot-assisted gait therapy, the patient showed improvement in motor functions measured by MI, FMA, MMAS, isometric torque, skeletal muscle mass, 10-meter gait speed. In gait analysis, cadence, single support time, double support time, step length, walking speed improvement in after robot-assisted gait therapy. The results of this study showed that robot-assisted gait therapy is considered to facilitate locomotor recovery of the chronic hemiparetic stroke patient.

• PNF and Movement
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• v.21 no.1
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• pp.1-10
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• 2023

Purpose: This systematic review aims to determine whether robot-assisted training is more effective in gait training for persons with subacute hemiparetic stroke. Methods: This study adopted a systematic review study design focused on subacute hemiparetic stroke, and four core academic databases were searched until June 11, 2021, for relevant studies, including PubMed, Embase, the Cochrane Library, and ProQuest Central. The review included randomized controlled trials (RCTs) evaluating the effects of robotic-assisted training on gait performance in persons with a diagnosis of subacute hemiparetic stroke. The selected RCT studies were qualitatively synthesized based on the population, intervention, comparison, outcome, settings, and study design (PICOS-SD). Results: The study selected five RCTs involving 253 subacute hemiparetic stroke patients and performing robotic-assisted gait training using the following devices: the Lokomat, Morning Walk, Walkbot, ProStep Plus, or Gait Trainer II. Five RCTs were eligible for the meta-analysis after quantitative synthesis, and the results showed that the robot-assisted gait training group had a greater gait performance than the control group based on the 10-meter walk test, Berg balance scale, Rivermed mobility index, functional ambulation category, and modified Barthel index. Conclusion: The results of this study showed that the gait performance of subacute hemiparetic stroke patients changes throughout robot-assisted gait training, but there were no indications that any of the clinically relevant effects of robot-assisted training are greater than those of conventional gait training. Further, the small sample size and different therapeutic intensities indicate that definitive conclusions could not be made.