People who receive electromechanical-assisted gait training in combination with physiotherapy after stroke are more likely to achieve independent walking than people who receive gait training without these devices. We concluded that seven patients need to be treated to prevent one dependency in walking. Specifically, people in the first three months after stroke and those who are not able to walk seem to benefit most from this type of intervention. The role of the type of device is still not clear. Further research should consist of large definitive pragmatic phase III trials undertaken to address specific questions about the most effective frequency and duration of electromechanical-assisted gait training as well as how long any benefit may last.
Symmetrical and bilateral robotic practice, combined with functional task training, can significantly improve motor function, arm activity, and self-perceived bilateral arm ability in patients late after stroke.
Der schwer betroffene Arm nach Schlaganfall ohne distale Willküraktivität gilt als prognostisch sehr ungünstig. Im Klinikalltag spielt dessen unmittelbare motorische Rehabilitation eher eine untergeordnete Rolle, die Fortschritte sind gering und die Patienten sind frustriert, so dass die Therapeuten sich eher auf die Rehabilitation der ADLs, der Mobilität und das Einhändertraining konzentrieren. Sie sind entscheidend für die angestrebte Rückkehr nach Hause.
The computerized active arm training produced a superior improvement in upper limb motor control and power compared with ES in severely affected stroke patients. This is probably attributable to the greater number of repetitions and the bilateral approach.
Neither anodal nor cathodal transcranial direct current stimulation enhanced the effect of bilateral arm training in this exploratory trial of patients with cortical involvement and severe weakness. Unilateral hand training and upregulation of the nonlesioned hemisphere might also be tried in this population.
Zusammenfassend ist das Armlabor eine interessante Option zur Intensivierung der Rehabilitation der OE nach Schlaganfall. Die Ergebnisse rechtfertigen eine kontrollierte Studie.
The use of the arm studio to intensify upper limb rehabilitation after stroke is promising, and a controlled study is warranted.
«Learning to walk by walking» – the mantra of Prof. Dr. S. Hesse, a pionieer in gait therapy is still valid and scientifically proven with the Gait Trainer GT I. The Gait Trainer GT 11 is based on the principle of the GT I and now taken to the next level with a convenient user interface, a comfortable and easy-to-use electric lifter and offers a modern, yet cost effective gait training based on the end-effector principle which is proven to have a superior impact compared to robotic exoskeleton devices.
Intensive locomotor training plus physiotherapy resulted in a significantly better gait ability and daily living competence in subacute stroke patients compared with physiotherapy alone.