초록
Modem concepts of gait rehabilitation after stroke favor a task-specific repetitive approach. In practice, the required physical effort of the therapists limits the realization of this approach. Therefore, a mechanized gait trainer enabling nonambulatory patients to have the repetitive practice of a gait-like movement without overstraining therapists was constructed. In this study, we developed an active gait training system for patients with gait disorder. This system provides joint movements to patients who cannot carry out an independent gait. It provides a normal stance-swing ratio of 60:40 using an eccentric configuration of two gears. Joint motions of the knee and the ankle were evaluated with using the 3D motion analysis system and compared with the results from the multi-body dynamics simulation. In addition, clinical investigations were also performed for low stroke patients during the 6-week gait training. Results from the dynamics simulation showed that joint movements of the knee and the ankle were affected by the gear size, the step length and the length of the foot plate, except the radius of curvature of the foot guide plate. Also, the 6-week gait training revealed relevant improvements of the gait ability in all low subjects. Functional ambulation category levels of subjects after training were 2 in three patients and 1 in a patient. The developed active gait trainer seems feasible as an adjunctive tool in gait rehabilitation after stroke.
