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Published in: Journal of NeuroEngineering and Rehabilitation 1/2019

Open Access 01-12-2019 | Stroke | Research

Robot-assisted gait training for balance and lower extremity function in patients with infratentorial stroke: a single-blinded randomized controlled trial

Authors: Ha Yeon Kim, Joon-Ho Shin, Sung Phil Yang, Min A. Shin, Stephanie Hyeyoung Lee

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2019

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Abstract

Background

Balance impairments are common in patients with infratentorial stroke. Although robot-assisted gait training (RAGT) exerts positive effects on balance among patients with stroke, it remains unclear whether such training is superior to conventional physical therapy (CPT). Therefore, we aimed to investigate the effects of RAGT combined with CPT and compared them with the effects of CPT only on balance and lower extremity function among survivors of infratentorial stroke.

Methods

This study was a single-blinded, randomized controlled trial with a crossover design conducted at a single rehabilitation hospital. Patients (n = 19; 16 men, three women; mean age: 47.4 ± 11.6 years) with infratentorial stroke were randomly allocated to either group A (4 weeks of RAGT+CPT, followed by 4 weeks of CPT+CPT) or group B (4 weeks of CPT+CPT followed by 4 weeks of RAGT+CPT). Changes in dynamic and static balance as indicated by Berg Balance Scale scores were regarded as the primary outcome measure. Outcome measures were evaluated for each participant at baseline and after each 4-week intervention period.

Results

No significant differences in outcome-related variables were observed between group A and B at baseline. In addition, no significant time-by-group interactions were observed for any variables, indicating that intervention order had no effect on lower extremity function or balance. Significantly greater improvements in secondary functional outcomes such as lower extremity Fugl-Meyer assessment (FMA-LE) and scale for the assessment and rating of ataxia (SARA) were observed following the RAGT+CPT intervention than following the CPT+CPT intervention.

Conclusion

RAGT produces clinically significant improvements in balance and lower extremity function in individuals with infratentorial stroke. Thus, RAGT may be useful for patients with balance impairments secondary to other pathologies.

Trial registration

ClinicalTrials.gov Identifier NCT02680691. Registered 09 February 2016; retrospectively registered.
Appendix
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Literature
1.
go back to reference Harris JE, Eng JJ, Marigold DS, Tokuno CD, Louis CS. Relationship of balance and mobility to fall incidence in people with chronic stroke. Phys Ther. 2005;85:150–8.PubMed Harris JE, Eng JJ, Marigold DS, Tokuno CD, Louis CS. Relationship of balance and mobility to fall incidence in people with chronic stroke. Phys Ther. 2005;85:150–8.PubMed
2.
go back to reference Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC, et al. Guidelines for adult stroke rehabilitation and recovery. Stroke. 2016;47:e98–e169.CrossRef Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC, et al. Guidelines for adult stroke rehabilitation and recovery. Stroke. 2016;47:e98–e169.CrossRef
3.
go back to reference Diringer MN. Intracerebral hemorrhage: pathophysiology and management. Crit Care Med. 1993;21:1591–603.CrossRef Diringer MN. Intracerebral hemorrhage: pathophysiology and management. Crit Care Med. 1993;21:1591–603.CrossRef
4.
go back to reference van den Bos GA, Smits JP, Westert GP, van Straten A. Socioeconomic variations in the course of stroke: unequal health outcomes, equal care? J Epidemiol Community Health. 2002;56:943–8.CrossRef van den Bos GA, Smits JP, Westert GP, van Straten A. Socioeconomic variations in the course of stroke: unequal health outcomes, equal care? J Epidemiol Community Health. 2002;56:943–8.CrossRef
5.
go back to reference Emsley HC. Posterior circulation stroke: still a Cinderella disease. BMJ. 2013;346:f3552.CrossRef Emsley HC. Posterior circulation stroke: still a Cinderella disease. BMJ. 2013;346:f3552.CrossRef
7.
go back to reference Schmahmann JD, Sherman JC. The cerebellar cognitive affective syndrome. Brain. 1998;121:561–79.CrossRef Schmahmann JD, Sherman JC. The cerebellar cognitive affective syndrome. Brain. 1998;121:561–79.CrossRef
8.
go back to reference Morton SM, Bastian AJ. Cerebellar control of balance and locomotion. Neuroscientist. 2004;10:247–59.CrossRef Morton SM, Bastian AJ. Cerebellar control of balance and locomotion. Neuroscientist. 2004;10:247–59.CrossRef
9.
go back to reference Thach WT, Bastian AJ. Role of the cerebellum in the control and adaptation of gait in health and disease. Prog Brain Res. 2004;143:353–66.CrossRef Thach WT, Bastian AJ. Role of the cerebellum in the control and adaptation of gait in health and disease. Prog Brain Res. 2004;143:353–66.CrossRef
10.
go back to reference Prosperini L, Kouleridou A, Petsas N, Leonardi L, Tona F, Pantano P, et al. The relationship between infratentorial lesions, balance deficit and accidental falls in multiple sclerosis. J Neurol Sci. 2011;304:55–60.CrossRef Prosperini L, Kouleridou A, Petsas N, Leonardi L, Tona F, Pantano P, et al. The relationship between infratentorial lesions, balance deficit and accidental falls in multiple sclerosis. J Neurol Sci. 2011;304:55–60.CrossRef
11.
go back to reference Sale P, Franceschini M, Waldner A, Hesse S. Use of the robot assisted gait therapy in rehabilitation of patients with stroke and spinal cord injury. Eur J Phys Rehabil Med. 2012;48:111–21.PubMed Sale P, Franceschini M, Waldner A, Hesse S. Use of the robot assisted gait therapy in rehabilitation of patients with stroke and spinal cord injury. Eur J Phys Rehabil Med. 2012;48:111–21.PubMed
12.
go back to reference Kleim JA, Jones TA. Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear Res. 2008;51:S225–39.CrossRef Kleim JA, Jones TA. Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear Res. 2008;51:S225–39.CrossRef
13.
go back to reference Mehrholz J, Thomas S, Werner C, Kugler J, Pohl M, Elsner B. Electromechanical-assisted training for walking after stroke. Cochrane Database Syst Rev. 2017;5:CD006185.PubMed Mehrholz J, Thomas S, Werner C, Kugler J, Pohl M, Elsner B. Electromechanical-assisted training for walking after stroke. Cochrane Database Syst Rev. 2017;5:CD006185.PubMed
14.
go back to reference Tong RK, Ng MF, Li LS. Effectiveness of gait training using an electromechanical gait trainer, with and without functional electric stimulation, in subacute stroke: a randomized controlled trial. Arch Phys Med Rehab. 2006;87:1298–304.CrossRef Tong RK, Ng MF, Li LS. Effectiveness of gait training using an electromechanical gait trainer, with and without functional electric stimulation, in subacute stroke: a randomized controlled trial. Arch Phys Med Rehab. 2006;87:1298–304.CrossRef
15.
go back to reference Mayr A, Kofler M, Quirbach E, Matzak H, Fröhlich K, Saltuari L. Prospective, blinded, randomized crossover study of gait rehabilitation in stroke patients using the Lokomat gait orthosis. Neurorehab Neural Repair. 2007;21:307–14.CrossRef Mayr A, Kofler M, Quirbach E, Matzak H, Fröhlich K, Saltuari L. Prospective, blinded, randomized crossover study of gait rehabilitation in stroke patients using the Lokomat gait orthosis. Neurorehab Neural Repair. 2007;21:307–14.CrossRef
16.
go back to reference Pohl M, Werner C, Holzgraefe M, Kroczek G, Wingendorf I, Hoölig G, et al. Repetitive locomotor training and physiotherapy improve walking and basic activities of daily living after stroke: a single-blind, randomized multicentre trial (DEutsche GAngtrainerStudie, DEGAS). Clinical Rehab. 2007;21:17–27.CrossRef Pohl M, Werner C, Holzgraefe M, Kroczek G, Wingendorf I, Hoölig G, et al. Repetitive locomotor training and physiotherapy improve walking and basic activities of daily living after stroke: a single-blind, randomized multicentre trial (DEutsche GAngtrainerStudie, DEGAS). Clinical Rehab. 2007;21:17–27.CrossRef
17.
go back to reference Hornby TG, Campbell DD, Kahn JH, Demott T, Moore JL, Roth HR. Enhanced gait-related improvements after therapist-versus robotic-assisted locomotor training in subjects with chronic stroke. Stroke. 2008;39:1786–92.CrossRef Hornby TG, Campbell DD, Kahn JH, Demott T, Moore JL, Roth HR. Enhanced gait-related improvements after therapist-versus robotic-assisted locomotor training in subjects with chronic stroke. Stroke. 2008;39:1786–92.CrossRef
18.
go back to reference Hidler J, Nichols D, Pelliccio M, Brady K, Campbell DD, Kahn JH, et al. Multicenter randomized clinical trial evaluating the effectiveness of the Lokomat in subacute stroke. Neurorehab Neural Repair. 2009;23:5–13.CrossRef Hidler J, Nichols D, Pelliccio M, Brady K, Campbell DD, Kahn JH, et al. Multicenter randomized clinical trial evaluating the effectiveness of the Lokomat in subacute stroke. Neurorehab Neural Repair. 2009;23:5–13.CrossRef
19.
go back to reference Peurala SH, Airaksinen O, Huuskonen P, Jäkälä P, Juhakoski M, Sandell K, et al. Effects of intensive therapy using gait trainer or floor walking exercises early after stroke. J Rehab Med. 2009;41:166–73.CrossRef Peurala SH, Airaksinen O, Huuskonen P, Jäkälä P, Juhakoski M, Sandell K, et al. Effects of intensive therapy using gait trainer or floor walking exercises early after stroke. J Rehab Med. 2009;41:166–73.CrossRef
20.
go back to reference Hesse S, Bardeleben A, Werner C, Waldner A. Robot-assisted practice of gait and stair climbing in nonambulatory stroke patients. J Rehab Res Devel. 2012;49:613.CrossRef Hesse S, Bardeleben A, Werner C, Waldner A. Robot-assisted practice of gait and stair climbing in nonambulatory stroke patients. J Rehab Res Devel. 2012;49:613.CrossRef
21.
go back to reference Taveggia G, Borboni A, Mulé C, Villafañe JH, Negrini S. Conflicting results of robot-assisted versus usual gait training during postacute rehabilitation of stroke patients: a randomized clinical trial. Int J Rehab Res. 2016;39:29–35.CrossRef Taveggia G, Borboni A, Mulé C, Villafañe JH, Negrini S. Conflicting results of robot-assisted versus usual gait training during postacute rehabilitation of stroke patients: a randomized clinical trial. Int J Rehab Res. 2016;39:29–35.CrossRef
22.
go back to reference Swinnen E, Beckwée D, Meeusen R, Baeyens JP, Kerckhofs E. Does robot-assisted gait rehabilitation improve balance in stroke patients? A systematic review. Topics Stroke Rehab. 2014;21:87–100.CrossRef Swinnen E, Beckwée D, Meeusen R, Baeyens JP, Kerckhofs E. Does robot-assisted gait rehabilitation improve balance in stroke patients? A systematic review. Topics Stroke Rehab. 2014;21:87–100.CrossRef
23.
go back to reference Kim SY, Yang L, Park IJ, Kim EJ, Park MS, You SH, et al. Effects of innovative WALKBOT robotic-assisted locomotor training on balance and gait recovery in hemiparetic stroke: a prospective, randomized, experimenter blinded case control study with a four-week follow-up. IEEE Trans Neural Syst Rehab Eng. 2015;23:636–42.CrossRef Kim SY, Yang L, Park IJ, Kim EJ, Park MS, You SH, et al. Effects of innovative WALKBOT robotic-assisted locomotor training on balance and gait recovery in hemiparetic stroke: a prospective, randomized, experimenter blinded case control study with a four-week follow-up. IEEE Trans Neural Syst Rehab Eng. 2015;23:636–42.CrossRef
24.
go back to reference Bang DH, Shin WS. Effects of robot-assisted gait training on spatiotemporal gait parameters and balance in patients with chronic stroke: a randomized controlled pilot trial. Neurorehabilitation. 2016;38:343–9.CrossRef Bang DH, Shin WS. Effects of robot-assisted gait training on spatiotemporal gait parameters and balance in patients with chronic stroke: a randomized controlled pilot trial. Neurorehabilitation. 2016;38:343–9.CrossRef
25.
go back to reference Cifu DX. Braddom’s physical medicine & rehabilitation, fifth ed. chapter 44 stroke syndromes. Philadelphia: Elsevier; 2016. p. 999–1016. Cifu DX. Braddom’s physical medicine & rehabilitation, fifth ed. chapter 44 stroke syndromes. Philadelphia: Elsevier; 2016. p. 999–1016.
26.
go back to reference Berg KO, Wood-Duaphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992;83(Suppl 2):S7–11.PubMed Berg KO, Wood-Duaphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992;83(Suppl 2):S7–11.PubMed
27.
go back to reference de Oliveira CB, de Medeiros IR, Frota NA, Greters ME, Conforto AB. Balance control in hemiparetic stroke patients: main tools for evaluation. J Rehabil Res Dev. 2008;45:1215–26.CrossRef de Oliveira CB, de Medeiros IR, Frota NA, Greters ME, Conforto AB. Balance control in hemiparetic stroke patients: main tools for evaluation. J Rehabil Res Dev. 2008;45:1215–26.CrossRef
28.
go back to reference Blum L, Korner-Bitensky N. Usefulness of the Berg balance scale in stroke rehabilitation: a systematic review. Phys Ther. 2008;88:559–66.CrossRef Blum L, Korner-Bitensky N. Usefulness of the Berg balance scale in stroke rehabilitation: a systematic review. Phys Ther. 2008;88:559–66.CrossRef
29.
go back to reference Liston RA, Brouwer BJ. Reliability and validity of measures obtained from stroke patients using the balance master. Arch Phys Med Rehabil. 1996;77:425–30.CrossRef Liston RA, Brouwer BJ. Reliability and validity of measures obtained from stroke patients using the balance master. Arch Phys Med Rehabil. 1996;77:425–30.CrossRef
30.
go back to reference Mao HF, Hsueh IP, Tang PF, Sheu CF, Hsieh CL. Analysis and comparison of the psychometric properties of three balance measures for stroke patients. Stroke. 2002;33:1022–7.CrossRef Mao HF, Hsueh IP, Tang PF, Sheu CF, Hsieh CL. Analysis and comparison of the psychometric properties of three balance measures for stroke patients. Stroke. 2002;33:1022–7.CrossRef
32.
go back to reference Verheyden G, Nieuwboer A, Mertin J, Preger R, Kiekens C, de Weerdt W. The trunk impairment scale: a new tool to measure motor impairment of the trunk after stroke. Clin Rehabil. 2004;18:326–34.CrossRef Verheyden G, Nieuwboer A, Mertin J, Preger R, Kiekens C, de Weerdt W. The trunk impairment scale: a new tool to measure motor impairment of the trunk after stroke. Clin Rehabil. 2004;18:326–34.CrossRef
33.
go back to reference Verheyden G, Vereeck L, Truijen S, Troch M, Herregodts I, Lafosse C, et al. Trunk performance after stroke and the relationship with balance, gait and functional ability. Clin Rehabil. 2006;20:451–8.CrossRef Verheyden G, Vereeck L, Truijen S, Troch M, Herregodts I, Lafosse C, et al. Trunk performance after stroke and the relationship with balance, gait and functional ability. Clin Rehabil. 2006;20:451–8.CrossRef
34.
go back to reference Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Stegline S. The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance. Scand J Rehabil Med. 1975;7:13–31.PubMed Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Stegline S. The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance. Scand J Rehabil Med. 1975;7:13–31.PubMed
35.
go back to reference Mehrholz J, Wagner K, Rutte K, Meissner D, Pohl M. Predictive validity and responsiveness of the functional ambulation category in hemiparetic patients after stroke. Arch Phys Med Rehabil. 2007;88:1314–9.CrossRef Mehrholz J, Wagner K, Rutte K, Meissner D, Pohl M. Predictive validity and responsiveness of the functional ambulation category in hemiparetic patients after stroke. Arch Phys Med Rehabil. 2007;88:1314–9.CrossRef
36.
go back to reference Kim SJ, Lee HJ, Hwang SW, Pyo H, Yang SP, Lim MH, et al. Clinical characteristics of proper robot-assisted gait training group in non-ambulatory subacute stroke patients. Ann Rehab Med. 2016;40:183–9.CrossRef Kim SJ, Lee HJ, Hwang SW, Pyo H, Yang SP, Lim MH, et al. Clinical characteristics of proper robot-assisted gait training group in non-ambulatory subacute stroke patients. Ann Rehab Med. 2016;40:183–9.CrossRef
37.
go back to reference Ng SS, Ng PC, Lee CY, Ng ES, Tong MH. Walkway lengths for measuring walking speed in stroke rehabilitation. J Rehabil Med. 2012;44:43–6.CrossRef Ng SS, Ng PC, Lee CY, Ng ES, Tong MH. Walkway lengths for measuring walking speed in stroke rehabilitation. J Rehabil Med. 2012;44:43–6.CrossRef
38.
go back to reference Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. J Gerontol. 1990;45:239–43.CrossRef Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. J Gerontol. 1990;45:239–43.CrossRef
39.
go back to reference Schmitz-Hubsch T, du Montcel ST, Baliko L, Berciano J, Boesch S, Depondt C, Giunti P, Globas C, Infante J, Kang JS, et al. Scale for the assessment and rating of ataxia: development of a new clinical scale. Neurology. 2006;66:1717–20.CrossRef Schmitz-Hubsch T, du Montcel ST, Baliko L, Berciano J, Boesch S, Depondt C, Giunti P, Globas C, Infante J, Kang JS, et al. Scale for the assessment and rating of ataxia: development of a new clinical scale. Neurology. 2006;66:1717–20.CrossRef
40.
go back to reference Stevenson TJ. Detecting change in patients with stroke using the Berg balance scale. Aus J Physiother. 2001;47:29–38.CrossRef Stevenson TJ. Detecting change in patients with stroke using the Berg balance scale. Aus J Physiother. 2001;47:29–38.CrossRef
41.
go back to reference Yoshimoto T, Shimizu I, Hiroi Y, Kawaki M, Sato D, Nagasawa M. Feasibility and efficacy of high-speed gait training with a voluntary driven exoskeleton robot for gait and balance dysfunction in patients with chronic stroke: nonrandomized pilot study with concurrent control. Int J Rehab Res. 2015;38:338–43.CrossRef Yoshimoto T, Shimizu I, Hiroi Y, Kawaki M, Sato D, Nagasawa M. Feasibility and efficacy of high-speed gait training with a voluntary driven exoskeleton robot for gait and balance dysfunction in patients with chronic stroke: nonrandomized pilot study with concurrent control. Int J Rehab Res. 2015;38:338–43.CrossRef
42.
go back to reference Pandian S, Arya KN, Kumar D. Minimal clinically important difference of the lower-extremity Fugl-Meyer assessment in chronic-stroke. Top Stroke Rehabil. 2016;68:233–9.CrossRef Pandian S, Arya KN, Kumar D. Minimal clinically important difference of the lower-extremity Fugl-Meyer assessment in chronic-stroke. Top Stroke Rehabil. 2016;68:233–9.CrossRef
43.
go back to reference Banala SK, Kim SH, Agrawal SK, Scholz JP. Robot assisted gait training with active leg exoskeleton (ALEX). IEEE Trans Neural Syst Rehab Eng. 2009;17:2–8.CrossRef Banala SK, Kim SH, Agrawal SK, Scholz JP. Robot assisted gait training with active leg exoskeleton (ALEX). IEEE Trans Neural Syst Rehab Eng. 2009;17:2–8.CrossRef
44.
go back to reference Robinovitch SN, Feldman F, Yang Y, Schonnop R, Leung PM, Sarraf J, et al. Video capture of the circumstances of falls in elderly people residing in long-term care: an observational study. Lancet. 2013;381:47–54.CrossRef Robinovitch SN, Feldman F, Yang Y, Schonnop R, Leung PM, Sarraf J, et al. Video capture of the circumstances of falls in elderly people residing in long-term care: an observational study. Lancet. 2013;381:47–54.CrossRef
45.
go back to reference Pizzigalli L, Miceheletti Cremasco M, Mulasso A, Rainoldi A. The contribution of postural balance analysis in older adult fallers: a narrative review. J Bodyw Mov Ther. 2016;20:409–17.CrossRef Pizzigalli L, Miceheletti Cremasco M, Mulasso A, Rainoldi A. The contribution of postural balance analysis in older adult fallers: a narrative review. J Bodyw Mov Ther. 2016;20:409–17.CrossRef
46.
go back to reference Finch L, Barbeau H, Arsenault. Influence of body weight support on normal human gait: development of a gait retraining strategy. Phys Ther. 1991;71:842–55.CrossRef Finch L, Barbeau H, Arsenault. Influence of body weight support on normal human gait: development of a gait retraining strategy. Phys Ther. 1991;71:842–55.CrossRef
47.
go back to reference Klarner T, Chan HK, Wakeling JM, andLam T. Patterns of muscle coordination vary with stride frequency during weight assisted treadmill walking. Gait Posture. 2010;31:360–5.CrossRef Klarner T, Chan HK, Wakeling JM, andLam T. Patterns of muscle coordination vary with stride frequency during weight assisted treadmill walking. Gait Posture. 2010;31:360–5.CrossRef
48.
go back to reference Chisari C, Bertolucci F, Monaco V, Venturi M, Simonella C, Micera S, et al. Robot-assisted gait training improves motor performances and modifies motor unit firing in poststroke patients. Eur J Phys Rehabil Med. 2015;51:59–69.PubMed Chisari C, Bertolucci F, Monaco V, Venturi M, Simonella C, Micera S, et al. Robot-assisted gait training improves motor performances and modifies motor unit firing in poststroke patients. Eur J Phys Rehabil Med. 2015;51:59–69.PubMed
49.
go back to reference Mudge S, Rochester L, Recordon A. The effect of treadmill training on gait, balance and trunk control in a hemiplegic subject: a single system design. Disability Rehab. 2003;25:1000–7.CrossRef Mudge S, Rochester L, Recordon A. The effect of treadmill training on gait, balance and trunk control in a hemiplegic subject: a single system design. Disability Rehab. 2003;25:1000–7.CrossRef
50.
go back to reference Combs SA, Dugan EL, Passmore M, Riesner C, Whipker D, Yingling E, et al. Balance, balance confidence, and health-related quality of life in persons with chronic stroke after body weight–supported treadmill training. Arch Phys Med Rehab. 2010;91:1914–9.CrossRef Combs SA, Dugan EL, Passmore M, Riesner C, Whipker D, Yingling E, et al. Balance, balance confidence, and health-related quality of life in persons with chronic stroke after body weight–supported treadmill training. Arch Phys Med Rehab. 2010;91:1914–9.CrossRef
51.
go back to reference Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatric Society. 2008;56:2234–43.CrossRef Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatric Society. 2008;56:2234–43.CrossRef
52.
go back to reference Winstein CJ, Gardner ER, McNeal DR, Barto PS, Nicholson D. Standing balance training: effect on balance and locomotion in hemiparetic adults. Arch Phys Med Rehabil. 1989;70:755–62.PubMed Winstein CJ, Gardner ER, McNeal DR, Barto PS, Nicholson D. Standing balance training: effect on balance and locomotion in hemiparetic adults. Arch Phys Med Rehabil. 1989;70:755–62.PubMed
53.
go back to reference Dean CM, Shepherd RB. Task-related training improves performance of seated reaching tasks after stroke. Stroke. 1997;28:722–8.CrossRef Dean CM, Shepherd RB. Task-related training improves performance of seated reaching tasks after stroke. Stroke. 1997;28:722–8.CrossRef
54.
go back to reference Bultmann U, Pierscianek D, Gizewski ER, Schoch B, Fritsche N, Timmann D, et al. Functional recovery and rehabilitation of postural impairment and gait ataxia in patients with acute cerebellar stroke. Gait Posture. 2014;39:563–9.CrossRef Bultmann U, Pierscianek D, Gizewski ER, Schoch B, Fritsche N, Timmann D, et al. Functional recovery and rehabilitation of postural impairment and gait ataxia in patients with acute cerebellar stroke. Gait Posture. 2014;39:563–9.CrossRef
Metadata
Title
Robot-assisted gait training for balance and lower extremity function in patients with infratentorial stroke: a single-blinded randomized controlled trial
Authors
Ha Yeon Kim
Joon-Ho Shin
Sung Phil Yang
Min A. Shin
Stephanie Hyeyoung Lee
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of NeuroEngineering and Rehabilitation / Issue 1/2019
Electronic ISSN: 1743-0003
DOI
https://doi.org/10.1186/s12984-019-0553-5

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