Postural control and gait quality in individuals in the chronic phase of stroke undergoing mobile robotic-assisted training: a pilot randomized clinical trial

Introduction
Stroke is the second leading cause of death worldwide, after ischemic heart disease. The consequences of stroke can be reduced through systematic rehabilitation of patients, including various types of therapeutic exercises that mitigate neurological deficits and stimulate brain plasticity. Among the most common consequences of stroke are disturbances in body balance and gait. In stroke patients, rehabilitation robots may contribute to improvements in motor function, increased muscle strength, and enhanced gait quality. There is therefore a need for further research to determine which rehabilitation robots are most effective at different stages after stroke and for various types of motor deficits.

Aims
The aim of this pilot study was to obtain preliminary evidence on whether and how exercises performed using a mobile rehabilitation robot improve body balance and gait quality in individuals in the chronic phase after stroke.

Material and methods
The study included chronic post-stroke patients (n = 23) randomly divided into two groups. In the experimental group (EG), participants performed gait exercises using a mobile rehabilitation robot for 20–40 minutes once daily, 6 days per week, for 3 weeks (a total of 18 training sessions). In the control group (CG), participants performed traditional ground-based gait exercises for 10–20 minutes once daily, 6 days per week, for 3 weeks. Patients in both groups also underwent conventional post-stroke rehabilitation for 2.5 hours per day, 6 days per week, based on best clinical practice principles.

Results
Eighteen training sessions performed either on a mobile robot in the EG or as groundbased gait training in the CG did not significantly improve patients’ body balance or gait quality in the chronic phase after stroke.

Conclusions
There is no basis to conclude that ground-based gait training has a statistically significantly greater effect on body balance than training using a mobile robot in individuals in the chronic phase after stroke. Further studies are needed to provide a clear answer as to whether and to what extent mobile robot training can improve body balance and gait quality in individuals in the chronic phase after stroke. Future clinical trials should consider implementing training protocols consisting of more than 18 sessions.