A Rehabilitation Program of Exoskeleton-assisted Body Weight-Supported Treadmill Training with Non-immersive Virtual Reality for Stroke Patients

Summary

The efficacy of combining exoskeleton-assisted, body weight-supported treadmill training with game-based virtual reality on dual-task capability in stroke survivors has yet to be studied. Therefore, this rehabilitation program aims to investigate the potential functions and advantages of this combination in enhancing walking capability during stroke recovery.

Abstract

Stroke is a cerebrovascular event that significantly affects patients' mobility and independence. Restoring gait patterns is a critical goal of stroke rehabilitation, and technology-based therapies have shown promising results. Lower limb exoskeleton therapy, body weight-supported treadmill training (BWSTT), and game-based virtual reality (VR) training are innovative approaches that have improved muscle strength, balance, and walking capability in stroke patients. Integrating these therapies into a comprehensive rehabilitation program may enhance motor recovery and functional outcomes for stroke survivors. This study investigates the potential advantages of combining exoskeleton-assisted BWSTT with game-based VR in enhancing dual-task capability during stroke recovery. Berg Balance Scale (BBS) demonstrated significant improvement after training (p = 0.03), but no statistical differences were observed in the Timed Up-and-Go Test (TUG, p = 0.15) and Functional Independence Measure (FIM, p = 0.38). In summary, this treatment has led to improvements in patient balance. The use of advanced technological devices in this rehabilitation protocol during the acute phase following a stroke is promising and warrants further investigation through a randomized controlled trial.

Introduction

In 2020, the approximate rates for stroke in mainland China were as follows: a prevalence rate of 2.6%, an incidence rate of 505.2 per 100,000 individuals annually, and a mortality rate of 343.4 per 1,00,000 individuals annually¹. This debilitating condition causes functional disability, motor impairment, and dependence in 70%-80% of patients². As walking is an essential component of human movement, it plays a crucial role in independent transfer, physiological well-being, and overall physical activity³. Therefore, restoring gait patterns in stroke patients is a critical goal of rehabilitation, as....

Protocol

This research was a retrospective case series of inpatients recruited after stroke at Peking Union Medical College Hospital. This rehabilitation program was approved by the Institutional Review Board of Peking Union Medical College Hospital. Written informed consent was obtained from all patients prior to participation. The details of the equipment and software used in this study are listed in the Table of Materials.

1. Participant recruitment

1. Enroll patients in the study following a rigorous screening process based on specific inclusion criteria. Organize the basic data of patients (see

Results

After completing a 4-week treatment without experiencing any adverse effects, the patient's progress was assessed, and the results were summarized in Table 3. The BBS score⁶ increased from 43.88 ± 3.80 to 48.38 ± 3.66, indicating a positive response. Both the TUG and FIM scores also showed improvement, with the TUG decreasing from 21.88 ± 5.62 to 17.63 ± 5.42 and the FIM increasing from 92.75 ± 12.80 to 98.75 ± 13.38.

The data (see .......

Discussion

In this proposed intervention, a comprehensive treatment approach is presented that integrates a body weight support system and exoskeleton therapy supplemented by VR technology to facilitate dual-task training for individuals with stroke-related lower limb impairments. Treadmill training, when combined with other interventions, has been identified as having the greatest impact, particularly when applied before overground gait training, maximizing the training effect¹⁴. Robotic-assisted rehabilita.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
GraphPad Prism	https://www.graphpad.com/features
SPSS	IBP	version 18.0
ZEPU Gait Training and Assessment System Software	Shandong ZEPU Medical Technology Co., Ltd.	V.1.0.1.2	The ZEPU Gait Training and Assessment System Software is designed to not only assess but also facilitate targeted gait rehabilitation, offering tailored therapeutic programs to improve mobility and functional outcomes for patients.
ZP-AIGen Gait Training System	Shandong ZEPU Medical Technology Co., Ltd.	ZEPU-AI1	Using neuroplasticity principles, the device simulates natural walking patterns, guiding patients through repetitive gait training to restore normal walking. The AI learns gait patterns, offering personalized treatment options. It monitors and records patient progress, helping to create customized treatment plans.