Robotic Training in Stroke Rehabilitation

The debilitating effects of a stroke usually have a devastating impact on an individual’s quality of life by reducing mobility and making it difficult to perform essential daily activities. In the post-stroke recovery process, medication and rehabilitation play an essential role in restoring the patient’s quality of life to the maximum levels as soon as possible. 
A Stroke occurs when the blood supply to the brain is interrupted or reduced, causing damage to part of the brain and disrupting the individual’s ability to function normally. The common symptoms and signs of stroke include weakness and/or numbness of one side of body and limbs. These weakness and/or numbness of the limbs result in inability to use the affected limbs and walk normally.
It is very important for stroke patients to start their rehabilitation as soon as possible in order to have the best chance of resuming their normal activities to the maximum level with the least disability. The principle of the rehabilitation process after a stroke is that the patients need to perform the same movements repetitively and continuously in order to encourage the unaffected brain cells to learn, remember and function in place of the lost brain cells.
Walking, or ambulation, is a vital part of the rehabilitation process after a stroke. This is one activity requiring repetitive body movement which should be performed regularly by stroke recovery patients in order to achieve their maximum rehabilitation goals and regain the ability to perform their essential daily activities as soon as possible. 
Generally, stroke patients perform their ambulation exercises with the professional assistance and supervision of physiotherapists. However, the sheer effort involved means that it is extremely challenging for the patient and therapist to achieve the desired amount of repetitive movement before they tire. Robotic gait training is the latest medical innovation used to enhance the effectiveness of ambulation training in stroke patients.
As part of the stroke rehabilitation process under the guidance of professional physical therapists, robotic gait training offers a number of advantages. 
The main features of the robotic gait are: 
  • An adjustable body weight support reduces the risk of muscle soreness or fatigue due to excessive exercises or wrong movements during training and facilitates a gradual increase in the duration, intensity and specificity of repetitive training.
  • The variety of training programs includes training in single or double leg motions, regular stepping, walking on flat ground, and climbing up and down stairs. A monitor measures the weight bearing of each foot to provide useful feedback for the patients. A functional electrical stimulation is also applied to the weakened muscles in order to replicate the patient’s normal walking pattern  and restore muscle functions during training.
  • The extended duration of repeated training that the robotic gait machine makes possible enables the patient to regain muscle strength and endurance faster and more effectively than with traditional post-stroke rehabilitation therapy, resulting in a tangible improvement in their ability to resume a normal walking pattern over a longer distance with effective energy consumption from a shorter training period.
However, before being approved for robot gait training, the patient must first be evaluated by a doctor. To be considered suitable for robotic gait training, the patient must have fair to good sitting balance, be able to communicate well, not have any uncontrolled bowel or bladder functions, and not have any bleeding tendency. The patient must also not have any open wounds or tubes attached to their abdomen, hip or lower back areas. 
If you are interested in robotic gait training, please contact the department of Physical Medicine and Rehabilitation, Bumrungrad International Hospital.
By Dr. Wannapa Lertprapamongkol, Physiatrist, Department of Physical Medicine and Rehabilitation, Bumrungrad International Hospital
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Posted by Bumrungrad International