Open AccessIs robot-assisted gait training intensity a determinant of functional recovery early after stroke? A pragmatic observational study of clinical care
Author(s) -
Luc Oscar Lissom,
Nicola Lamberti,
Susanna Lavezzi,
Nino Basaglia,
Fabio Manfredini,
Sofía Straudi
Publication year - 2022
Publication title -
international journal of rehabilitation research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.452
H-Index - 52
eISSN - 1473-5660
pISSN - 0342-5282
DOI - 10.1097/mrr.0000000000000518
Subject(s) - medicine , rehabilitation , observational study , gait training , stroke (engine) , functional independence measure , physical therapy , physical medicine and rehabilitation , gait , mechanical engineering , engineering
Gait rehabilitation is a critical factor in functional recovery after a stroke. The aim of this pragmatic observational study was to identify the optimal dose and timing of robot-assisted gait training (RAGT) that can lead to a favourable outcome in a sample of subacute stroke survivors. Subacute patients with stroke who underwent a RAGT within a multidisciplinary rehabilitation program were enrolled. A set of clinical (i.e. age, type of stroke and time since stroke) and rehabilitation stay outcomes (length of stay and RAGT number of sessions) were recorded to evaluate their impact on functional outcome measures by functional independence measure (FIM) or functional ambulation category (FAC). We included 236 patients (62.73 ± 11.82 year old); 38.44% were females, and 59.32% were ischaemic stroke patients. Patients that received at least 14 RAGT sessions, had 15.83% more chance to be responders compared to those that receive less sessions (P = 0.006). Similarly, younger patients (≤60 years) were more prone to be responders (+15.1%). Lastly, an early rehabilitation (<6 weeks) was found to be more efficient (+21.09%) in determining responsiveness (P < 0.001). Becoming newly independent for gait, that refers to a FAC score ≥4, was related with age and RAGT sessions (P = 0.001). In conclusion, a younger age (≤60 years), an early rehabilitation (<6 weeks since stroke) and a higher RAGT dose (at least 14 sessions) were related to a favourable outcome in patients with subacute stroke.