Project Details
Abstract
Ambulation is an important part of neurorehabilitation. Walking after stroke is characterized by slow gait
speed, poor endurance, and a reduced ability to adapt to the task and the environmental constraints.
Positive features of stroke that include hyperreflexia, spasticity, dystonia and enhanced sensitivity to nociceptive
input. Chemodenervation with botulinum toxin type A(BTX-A)have been shown to be effective at reducing
post-stroke foot and ankle spasticity, while improving the motor control capability.Robotic-assisted gait
training(RAGT) have shown positive effects on post-stroke gait pattern. Therefore, the aim of this study is to
investigate if combined use of BTX-A and RAGT can improve the outcome of walking ability in stroke patients
with hemiplegic gait.
In this study we are going to test three hypotheses:
1. The patients who received BTX-A and robotic gait training will get better outcome than those who received
BTX-A and conventional gait training.
2. The patients who received BTX-A and CIMT mode RAGT will get better gait symmetricity than those who
received regular robotic gait training.
3. The patients who received BTX-A and active RAGT with PCRCT will have better gait performance than those
who received full guidance mode(robotic gait training)RAGT
The BTX-A was performed under echo-guided and electrical stimulation guided injection. Lokomat will be
applied for robotic gait training. Totally 4 weeks training will be given to each tested subject. The training
frequency was 3 times per week and 30 minutes per session.
A battery of test including 10 meter walking test, lower extremity Fugl-Meyer assessment and
polyelectromyography during walking will be examined before intervention and at 4 weeks, 8 weeks and 12 weeks
after intervention.
This three year project will be conducted in Linkou and Taoyuan Chang Gung Memorial Hospital. Forty stroke
patients with Functional Ambulation classification grade 3 or more than grade 3 will be recruited each year. They
will be devided into two groups. In group A, FAC grade 3 and grade 4 (dependent walking) will be enrolled. FAC
grade 5 and grade 6 (independent walking) will be enrolled into group B.
In the first year, BTX-A and traditional gait training for the control group will be given and the experimental
group will receive BTX-A and RAGT.
In the second year, the control group will receive RAGT in Constraint-Induced Movement Therapy(CIMT)
mode. The experimental group will receive RAGT in CIMT mode and BTX-A therapy.
In the third year, BTX-A will be given to both control and experimental groups. In the control group, robotic
training with full guidance force while the experimental group will receive robotic training with patient-cooperative
robotic control training(PCRCT). In PCRCT the guidance force will be decreased according to patient’s active
participation.
Project IDs
Project ID:PC10408-1273
External Project ID:MOST104-2314-B182-006-MY3
External Project ID:MOST104-2314-B182-006-MY3
Status | Finished |
---|---|
Effective start/end date | 01/08/15 → 31/07/16 |
Keywords
- Stroke rehabilitation
- Botulinum toxin A
- Robotic-Assisted Training
- motor control
- Constraint-Induced
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