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Open Access Highly Accessed Review

Towards more effective robotic gait training for stroke rehabilitation: a review

Andrew Pennycott12*, Dario Wyss12, Heike Vallery12, Verena Klamroth-Marganska12 and Robert Riener12

Author Affiliations

1 Sensory-Motor Systems Lab, ETH Zürich, Zürich, Switzerland

2 University Hospital Balgrist, University of Zürich, Zürich, Switzerland

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Journal of NeuroEngineering and Rehabilitation 2012, 9:65  doi:10.1186/1743-0003-9-65

Published: 7 September 2012

Abstract

Background

Stroke is the most common cause of disability in the developed world and can severely degrade walking function. Robot-driven gait therapy can provide assistance to patients during training and offers a number of advantages over other forms of therapy. These potential benefits do not, however, seem to have been fully realised as of yet in clinical practice.

Objectives

This review determines ways in which robot-driven gait technology could be improved in order to achieve better outcomes in gait rehabilitation.

Methods

The literature on gait impairments caused by stroke is reviewed, followed by research detailing the different pathways to recovery. The outcomes of clinical trials investigating robot-driven gait therapy are then examined. Finally, an analysis of the literature focused on the technical features of the robot-based devices is presented. This review thus combines both clinical and technical aspects in order to determine the routes by which robot-driven gait therapy could be further developed.

Conclusions

Active subject participation in robot-driven gait therapy is vital to many of the potential recovery pathways and is therefore an important feature of gait training. Higher levels of subject participation and challenge could be promoted through designs with a high emphasis on robotic transparency and sufficient degrees of freedom to allow other aspects of gait such as balance to be incorporated.