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  • Feasibility of robot-based perturbed-balance training during treadmill walking in a high-functioning chronic stroke subject [Elektronski vir] : a case-control study
    Matjačić, Zlatko ; Zadravec, Matjaž, 1983- ; Olenšek, Andrej
    Background: For stroke survivors, balance deficits that persist after the completion of the rehabilitation process lead to a significant risk of falls. We have recently developed a balance-assessment ... robot (BAR-TM) that enables assessment of balancing abilities during walking. The purpose of this study was to test feasibility of using the BAR-TM in an experimental perturbed-balance training program with a selected high-functioning stroke survivor. Methods: A control and an individual with right-side chronic hemiparesis post-stroke were studied. The individual post-stroke underwent thirty sessions of balance-perturbed training that involved walking on an instrumented treadmill while the BAR-TM delivered random pushes to the participant's pelvis; these pushes were in various directions, at various speeds, and had various perturbation amplitudes. We assessed kinematics, kinetics, electromyography, and spatio-temporal responses to outward-directed perturbations of amplitude 60 N (before training) and 60 N and 90 N (after training) commencing on contact of either the nonparetic-left foot (LL-NP/L perturbation) or the paretic-right foot (RR-P/R perturbation) while the treadmill was running at a speed of 0.4 m/s. Results: Before training, the individual post-stroke primarily responded to LL-NP/L perturbations with an in-stance response on the non-paretic leg in a similar way to the control participant. After training, the individual post-stroke added adequate stepping by making a cross-step with the paretic leg that enabled successful rejection of the perturbation at lower and higher amplitudes. Before training, the individual post-stroke primarily responded to RR-P/R perturbations with fast cross-stepping using the left, non-paretic leg while in-stance response was entirely missing. After training, the stepping with the non-paretic leg was supplemented by partially recovered ability to exercise in-stance responses on the paretic leg and this enabled successful rejection of the perturbation at lower and higher amplitudes. The assessed kinematics, kinetics, electromyography, and spatio-temporal responses provided insight into the relative share of each balancing strategy that the selected individual post-stroke used to counteract LL-NP/L and RR-P/R perturbations before and after the training. Conclusions: The main finding of this case-control study is that robot-based perturbed-balance training may be a feasible approach. It resulted in an improvement the selected post-stroke participant's ability to counteract outward-directed perturbations.
    Source: Journal of neuroengineering and rehabilitation [Elektronski vir]. - ISSN 1743-0003 (Vol. 15, no. 1, 2018, str. 32-46)
    Type of material - e-article
    Publish date - 2018
    Language - english
    COBISS.SI-ID - 2482537

    Link(s):

    https://link.springer.com/epdf/10.1186/s12984-018-0373-z?author_access_token=1CVPYQjO4UGu4f1T0jC37W_BpE1tBhCbnbw3BuzI2ROp4wXE0dgcvbvarFjD8bwHnQ_2QFzo8iIwxkgEZOTxFRETDMRgvK0o0GxzZgTKQfE9WSBzRSBUlx2loURT4I92mDj80mnDpSqXGRtUjo49Kw%3D%3D
    DOI

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