The effect of pelvic movements of a gait training system for stroke patients: a single blind, randomized, parallel study

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Background: Aging societies lead to higher demand for gait rehabilitation as age-related neurological disorders
such as stroke and spinal cord injury increase. Since conventional methods for gait rehabilitation are physically and
economically burdensome, robotic gait training systems have been studied and commercialized, many of which provided
movements confined in the sagittal plane. For better outcomes of gait rehabilitation with more natural gait patterns,
however, it is desirable to provide pelvic movements in the transverse plane. In this study, a robotic gait training
system capable of pelvic motions in the transverse plane was used to evaluate the effect of the pelvic motions on
stroke patients.
Method: Healbot T, which is a robotic gait training system and capable of providing pelvic movements in the
transverse plane as well as flexion/extension of the hip and knee joints and adduction/abduction of the hip joints, is
introduced and used to evaluate the effect of the pelvic movement on gait training of stroke patients. Gait trainings in
Healbot T with and without pelvic movements are carried out with stroke patients having hemiparesis.
Experiment: Twenty-four stroke patients with hemiparesis were randomly assigned into two groups and 23 of them
successfully completed the experiment except one subject who had dropped out due to personal reasons. Pelvison
group was provided with pelvic motions whereas no pelvic movement was allowed for pelvis-off group during
10 sessions of gait trainings in Healbot T. Electromyography (EMG) signals and interaction forces as well as the joint
angles of the robot were measured. Gait parameters such as stride length, cadence, and walking speed were measured
while walking on the ground without assistance of Healbot T after gait training on 1st, 5th, and 10th day.
Result: Stride length significantly increased in both groups. Furthermore, cadence and walking speed of the pelvison
group were increased by 10.6% and 11.8%. Although interaction forces of both groups except the thighs showed
no differences, EMG signals from gluteus medius of the pelvis-on group increased by 88.6% during stance phase.
In addition, EMG signals of biceps femoris, gastrocnemius medial, and gastrocnemius lateral of the pelvis-on group
increased whereas EMG signals of the pelvis-off group except gastrocnemius lateral showed no difference after gait
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ExoskeletonGait trainingPelvic movementRhabilitationStroke
Journal of NeuroEngineering and Rehabilitation
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Medicine > Medicine
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