• Physical Therapy Rehabilitation Science
• /
• v.11 no.4
• /
• pp.471-477
• /
• 2022

Objective: The greatest motor impairment after stroke is a decreased ability to walk. Most stroke patients achieve independent gait, but approximately 70% do not reach normal speed, making it difficult to reach a standard of daily living. Therefore, a wearable exoskeleton is recommended for optimal independent gait because different residual disorders hinder motor function after stroke. This review synthesized the effect on gait speed in randomized controlled trials (RCTs) in which gait training using a wearable exoskeleton was performed on post-stroke patients for qualitative and quantitative analysis. Design: A systematic review and meta-analysis of a randomized controlled trials Methods: RCTs using wearable exoskeletons in robotic rehabilitation of post-stroke patients were extracted from an international electronic database. For quality assessment and quantitative analysis, RevMan 5.4 was used. Quantitative analysis was calculated as the standardized mean difference (SMD) and presented as a random effect model. Results: Five studies involving 197 post-stroke patients were included in this review. As a result of the analysis using a random effect model, gait training using a wearable exoskeleton in post-stroke patients showed a significant improvement in gait speed compared to the non-wearing exoskeleton (SMD=1.15, 95% confidence interval: 0.52 to 1.78). Conclusions: This study concluded that a wearable exoskeleton was more effective than conventional gait training in improving the gait speed in post-stroke patients.

• Physical Therapy Rehabilitation Science
• /
• v.9 no.2
• /
• pp.105-112
• /
• 2020

Objective: To investigate the effects of training using a trunk control robot (TCR) system combined with conventional therapy (CT) on balance and gait abilities in persons with chronic stroke. Design: Two-group pretest-posttest design. Methods: Thirty-five subjects with chronic stroke were randomly assigned to either the TCR group (n=17) or the trunk extension-training (TET) group (n=18). Both groups performed CT for 30 minutes, after which the TCR group performed TCR training and the TET group performed trunk extension training for 20 minutes. Both groups performed the therapeutic interventions 3 days per week for 6 weeks. Balance ability was evaluated using the Berg Balance Scale (BBS), and the Timed Up-and-Go (TUG) test. Gait ability was measured using the 10 m Walk Test (10MWT) and the NeuroCom Smart Balance Master. Results: TCR group showed significant improvements in static balance (weight bearing) and dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width (p<0.05); step length was not significant. The TET group showed a significant partial improvement of dynamic balance (weight shifting speed, weight shifting direction, BBS, and 10MWT (p<0.05), but the improvements in static balance, TUG, gait speed, and step width and step length was not significant. Additionally, significant differences in static balance, dynamic balance (weight shifting speed, weight shifting direction, BBS, and TUG), 10MWT, gait speed, and step width were detected between groups (p<0.05). Conclusions: TCR training combined with CT is effective in improving static and dynamic balance, as well as gait abilities in persons with chronic stroke.

• Journal of Institute of Control, Robotics and Systems
• /
• v.16 no.10
• /
• pp.939-947
• /
• 2010

With the rising numbers of elderly and disabled people, the demand for welfare services using a robotic system and not involving human effort is likewise increasing. This study deals with a mobile-robot system combined with a BWS (Body Weight Support) system for gait rehabilitation. The BWS system is designed via the kinematic analysis of the robot's body-lifting characteristics and of the walking guide system that controls the total rehabilitation system integrated in the mobile robot. This mobile platform is operated by utilizing the AGV (Autonomous Guided Vehicle) driving algorithm. Especially, the method that integrates geometric path tracking and obstacle avoidance for a nonholonomic mobile robot is applied so that the system can be operated in an area where the elderly users are expected to be situated, such as in a public hospital or a rehabilitation center. The mobile robot follows the path by moving through the turning radius supplied by the pure-pursuit method which is one of the existing geometric path-tracking methods. The effectiveness of the proposed method is verified through the real experiments those are conducted for path tracking with static- and dynamic-obstacle avoidance. Finally, through the EMG (Electromyography) signal measurement of the subject, the performance of the proposed system in a real operation condition is evaluated.

• Journal of the Institute of Convergence Signal Processing
• /
• v.24 no.2
• /
• pp.126-133
• /
• 2023

In this study, electromyography was obtained in the six muscle areas that move the joints of the two legs, and by analyzing it, an exercise robot system capable of gait rehabilitation was proposed in consideration of the individual's muscle state. Through this, the system was constructed to prevent the effect of exercise from decreasing because the patient's will was not reflected when walking exercise was simply provided automatically. As a result of the evaluation of the developed system, it was confirmed that the pedestrian rehabilitation robot system manufactured through this study had performance suitable for the design requirements, and it was also confirmed that the usability evaluation was comprehensively satisfactory. The results of this study are thought to be of great help to patients who are having difficulty in gait rehabilitation, and are believed to be helpful in the development of electromyography signal-based gait robot systems.

• Proceedings of the Korean Society of Precision Engineering Conference
• /
• 2011.06a
• /
• pp.959-960
• /
• 2011

• Physical Therapy Korea
• /
• v.22 no.2
• /
• pp.30-40
• /
• 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 the Korean Society for Precision Engineering
• /
• v.17 no.12
• /
• pp.169-175
• /
• 2000

Stable and comfortable walking supports, which can reduce the body weight load partially, are needed for the recovering patients from neurologic disease and orthopedic procedures. In this paper, the development of a manipulator of rehabilitation robot for the patients with walking disabilities are studied. A force controller using pneumatic actuators is designed and implemented to the human friendly rehabilitation robot considering the safety of patients, reliability of the system, effectiveness of the unloading control and economic maintenance of the system. The mechanism of the unloading manipulator is devised to improve the sensibility for the movement of the patients such as direction and velocity. For the unloading force control, fuzzy control algorithm is adopted to reduce the partial body weight and suppress the unwanted fluctuation of the body weight load to the weak legs due to the unnatural working of the patients with walking disabilities. The effectiveness of the force control is experimentally demonstrated.

• Journal of The Korean Society of Integrative Medicine
• /
• v.10 no.1
• /
• pp.91-99
• /
• 2022

Purpose : The goal of this study is to examine the effect of robot assisted gait training (RAGT) on the kinematic factors (temporospatial gait parameters, gait cycle ratio, and gait line length) of gait in stroke patients. Methods : The subjects of this study were 24 stroke patients selected by inclusion criteria. Participants were randomly allocated to two groups: robot assisted gait training (n=11) and general neurological physical therapy group (n=11). In the robot-assisted gait training group, robot-assisted gait training was mediated for 30 minutes a day in addition to general neurological physical therapy. The general neurological physical therapy group was mediated by general neurological physical therapy for 30 minutes a day in addition to general neurological physical therapy. The number of interventions was 5 times a week for 5 weeks. In order to compare the kinematic factors of walking between the two groups, gait analysis was performed before and after 5 weeks of training using the Zebris gait analysis system. Results : As a result of the gait analysis of the two groups, there were significant differences in temporospatial gait variables (step length, stride length, step width, step time, stride time), gait cycle ratio (swing phase, stance phase) and gait line length. However, there was no significant difference in the cadence (temporospatial gait parameters) in the robot assisted gait training group compared to general neurological physical therapy group. Conclusion : It is considered to be a useful treatment for stroke patients to promote the recovery of gait function in stroke patients. Based on the results of this study, continuous robot assisted gait training treatment is considered to have a positive effect on gait ability, the goal of stroke rehabilitation. In the future, additional studies should be conducted on many subjects of stroke patients, the kinematic factors of the legs according to the severity of stroke and treatment period, and the effect of gait training.

• PNF and Movement
• /
• v.20 no.2
• /
• pp.295-306
• /
• 2022

Purpose: This study aimed to investigate the effect of robot-assisted gait training on the active ranges of motion, gait abilities, and biomechanical characteristics of gait in patients who underwent lower extremity surgery, and to verify the effectiveness and clinical usefulness of robot-assisted gait training. Methods: This study was conducted on 14 subjects who underwent lower extremity surgery. The subjects participated in robot-assisted gait training for 2 weeks. The active ranges of motion of the lower extremities were evaluated, and gait abilities were assessed using 10-m and 2-min walk tests. An STT Systems Inertial Measurement Unit was used to collect data on biomechanical characteristics during gait. Spatiotemporal parameters were used to measure cadence, step length, and velocity, and kinematic parameters were used to measure hip and knee joint movement during gait. Results: Significant improvements in the active ranges of motion of the hip and knee joints (flexion, extension, abduction, and adduction) and in the 10-m and 2-min walk test results were observed after robot-assisted gait training (p < 0.05). In addition, biomechanical characteristics of gait, spatiotemporal factors (cadence, step length, and velocity), and kinematic factors (gait hip flexion-extension, internal rotation-external rotation angle, and knee joint flexion-extension) were also significantly improved (p < 0.05). Conclusion: The results of this study are of clinical importance as they demonstrate that robot-assisted gait training can be used as an effective intervention method for patients who have undergone lower extremity surgery. Furthermore, the findings of this study are clinically meaningful as they expand the scope of robot-assisted gait training, which is currently mainly applied to patients with central nervous system conditions.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.11 no.10
• /
• pp.3658-3665
• /
• 2010

As the population of elderly people and disabled people are increased, various demands for human welfare using robot system are raised. Especially autonomous rehabilitation system using robot could reduce the human effort while maintaining the its intrinsic efficacy. This study deals with mobile gait rehabilitation system which combined with BWS (Body Weight Support) for training of elderly and handicapped people who suffer the muscle force weakness of lower extremity. BWS which is designed by kinematic analysis of body lifting characteristics and walking guide system are integrated with main control system and wheeled platform. This mobile platform is operated by UCS (User Command System) and autonomous trajectory planning algorithm. Finally, through the EMG (Electromyography) signal measuring and its analysis for subject, performance and feasibility of developed system is verified.