Machines to support motor rehabilitation after stroke

Abstract

Following the introduction of treadmill training with partial body weight support, our group designed and developed an electromechanical gait trainer (GT) based on movable footplates to relieve the strenuous effort of the therapists, and to intensify the patient’s gait training. Results of a multicentre trial of 155 acute stroke patients showed its effectiveness in promoting gait ability and competence in activities of daily living (ADL). The “HapticWalker” was the next step, a robotic walking simulator with freely programmable footplates, so that patients could, for example, additionally train stair climbing and perturbations. For the severely affected upper extremity, the computerized arm trainer “Bi-Manu-Track” enabled the bilateral practice of a forearm pronation/supination and wrist flexion/extension. Compared to an electrical stimulation of the paretic wrist extensors, acute stroke patients with a severe arm paresis (n=44) gained significantly more upper limb muscle strength and control. The REHA-Slide is a purely mechanical device to train the shoulder, elbow and wrist joints bilaterally. The REHA-Slide was in a RCT compared to EMG-triggered electrical stimulation. Patient who trained with the REHA-Slide were able to transport more cubes in the Box and Block test than the control group.