NEW YORK (Reuters Health) – Six months after a stroke, survivors who are able to walk but still have moderate-to-severe difficulty in doing so, make better progress in their walking ability through physical therapist-assisted training than training provided by a robotic device, according to report published in the medical journal Stroke.

“We wanted to know whether using a robotic device that guides the limb in a symmetrical walking pattern would facilitate greater improvements in walking speed and symmetry than more traditional walking interventions with a physical therapist,” lead author Dr. T. George Hornby said in an American Heart Association news release.

Hornby and colleagues at the Rehabilitation Institute of Chicago evaluated 48 stroke patients who had been partially paralyzed on one side of the body for more than 6 months. All of the patients participated in 12 sessions of 30-minute therapy on a treadmill while wearing a harness to support their body weight.

Half of the patients were randomly assigned to robotic-assisted training, which provided continuous symmetrical stepping assistance, while the other half was trained by a physical therapist, who assisted the patients only as needed to ensure continuous walking.

The increase in walking speed at the end of treatment was two-times higher in the group that worked with the physical therapist than in the group that worked with the robot, the team reports. In addition, the time that patients were able to stand on one leg — a measure of progress — improved significantly only in the group treated by the physical therapist.

Patient reports of improved physical functioning were received only by those with severe deficits in mobility who received therapist-assisted training.

Changes were maintained for up to 6 months, the investigators report.

These study results suggest that stroke patients with chronic partial paralysis, but who are able to walk independently, even at very slow speed, make better progress working with a physical therapist rather than a robotic device to improve their walking skills,” Hornby and his colleagues conclude.

On the other hand, they suggest that physical therapy with a robotic device might be more effective for stroke survivors who can’t walk.

SOURCE: Stroke, June 2008.

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