Mobility training using a bionic knee orthosis in patients in a post-stroke chronic state: a case seriesReport as inadecuate

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Journal of Medical Case Reports

, 6:216

First Online: 23 July 2012Received: 28 December 2011Accepted: 23 July 2012DOI: 10.1186-1752-1947-6-216

Cite this article as: Byl, N.N. J Med Case Reports 2012 6: 216. doi:10.1186-1752-1947-6-216


IntroductionAn emerging area of neurorehabilitation is the use of robotic devices to enhance the efficiency and effectiveness of lower extremity physical therapy post-stroke. Many of the robotic devices currently available rely on computer-driven locomotive algorithms combined with partial bodyweight-supported treadmill training that drive reflex stepping with minimal patient intention during therapy. In this case series, we examined the effect of task-oriented mobility training in patients in a post-stroke chronic state using a novel, wearable, mobile, intention-based robotic leg orthosis.

Case presentationThree individuals, all of whom had reached a plateau with conventional bodyweight-supported treadmill training, participated in task-oriented mobility therapy 1.5 hours, two to four times per week for four weeks with a robotic leg orthosis under supervision by a physical therapist. Participant 1 was a 59-year-old Caucasian man, who had an ischemic left stroke six years previously with resultant right hemiparesis. Participant 2 was a 42-year-old Caucasian woman with left hemiparesis after a right stroke 15 months previously. Participant 3 was a 62-year-old Caucasian woman with a history of a right middle cerebral artery aneurysm with third degree sub-arachnoid hemorrhage 10 years ago.

Immediately after training, all participants demonstrated improved gait speed 10 meter walk, stride length and walking endurance 6 minute walk compared with baseline measurements. Improvements were maintained one month after training. Timed up and go and five times sit-to-stand were maintained for all three participants, with only one individual remaining outside the safety performance norm.

ConclusionsLower extremity training integrating an intention-based robotic leg orthosis may improve gait speed, endurance and community levels of participation in select patients in a post-stroke chronic state after plateauing within a bodyweight-supported treadmill training program. The wearable, mobile assistive robotic device safely supplemented supervised physical therapy including mobility and balance skill training.

AbbreviationsBWSTTbodyweight-supported treadmill training

FTSTSfive times sit-to-stand

RLOrobotic leg orthosis

TUGtimed up and go.

Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-6-216 contains supplementary material, which is available to authorized users.

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Author: Nancy N Byl


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