Effects of robot-(Morning Walk®) assisted gait training for patients after stroke: a randomized controlled trial

Objective: To investigate the effects of Morning Walk((R))-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((R)), a lower limb rehabilitation robot, plus 1 hour of conventional physiotherapy (Morning Walk((R)) 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((R)) group ( increment mean +/- SD; 19.68 +/- 14.06) showed greater improvement (p = .034) than the control group ( increment mean +/- SD; 11.70 +/- 10.65). And Berg Balance Scale scores improved more (p = .047) in the Morning Walk((R)) group ( increment mean +/- SD; 14.36 +/- 9.01) than the control group ( increment 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((R))-assisted gait training combined with conventional physiotherapy.