Long-term retention of robotic gait training: transference from the laboratory to the real-world

Thursday, November 10, 2022

12:23 PM – 12:28 PM

Location: Station 3

Presenting Author(s)

Sarah M. dos Anjos, PhD

Assistant Professor
University of Alabama at Birmingham
Birmingham, Alabama, United States

Non-presenting Author(s)

AB

Alyssa Brown

Masters in Science - Occupational Therapy Student
University of Alabama at Birmingham, Alabama, United States
AF

Ashlyn Frederick

Masters in Science - Occupational Therapy Student
University of Alabama at Birmingham, Alabama, United States
DB

David Bryson

Physical Therapist
University of Alabama at Birmingham, Alabama, United States
CB

Camille Bryson, PT

Physical Therapist
University of Alabama at Birmingham
Birmingham, Alabama, United States
KH

Katie Holliday

Doctor in Physical Therapy Student
Department of Physical Therapy, University of Alabama at Birmingham
Birmingham, Alabama, United States
DB

David A. Brown, PT, PhD, FAPTA

Sr VP and Dean
School of Health Professions at University of Texas Medical Branch
Galveston, Texas, United States
Carmen E. Capo-Lugo, PT, PhD

Assistant Professor
Department of Physical Therapy, University of Alabama at Birmingham
Birmingham, Alabama, United States

Research Objectives: Investigate the long-term retention of effects on gait and mobility after a robotic treadmill gait training protocol (TT) plus a transfer package (TP).

Design: Preliminary RCT findings of a six-week robotic treadmill training combined with behavioral strategies. Outcomes measured pre-, immediately after (post), and at 3-month follow-up (FU).

Setting: Clinical Research Unit

Participants: 7 participants (>6 months poststroke); walking impairment, can walk ≤10 feet. Randomized to experimental (n=4) or control groups (n=3).

Interventions: All participants receive the same TT protocol. The experimental group (TT+TP) receives TT, and 30 minutes of behavioral strategies (TP) application to enhance motor skill transference outside clinical settings. Controls (TT) receive home exercise handouts plus TT. The 6-week intervention involves three 30-minute TT sessions a week targeting endurance, strength, and speed.

Main Outcome Measures: Lower Extremity Motor Activity Log (LE-MAL), Berg Balance Scale (BBS), 10MWT, 6MWT, Fear of Falling Avoidance Questionnaire (FFABQ).

Results: On average, all participants improved on all post-pre assessments. TT+TP participants showed continuous improvement at FU. LE-MAL (TT post-pre: 0.6 and: -0.6; TT+TP post-pre: 1.0 and FU: 0.2), BBS (TT post-pre: 1.3 and FU: -1.0; TT+TP post-pre: 1.5 and FU: 0.7), 10MWT self-selected speed: TT post-pre: 0.03m/s and FU: -0.15m/s; TT+TP post-pre: 0.01m/s and FU: 0.04 m/s, 10MWT fast speed: TT post-pre: 0.02 m/s and FU: 0.0.3 m/s; TT+TP post-pre: -0.01 m/s and FU: 0.08 m/s, 6MWT TT post-pre: 22.2 m and FU: 10.7 m/s; TT+TP post-pre: 13.8 m and FU: 17.4 m, and FFABQ (lower scores mean lower avoidance behavior), TT post-pre: -5 and FU: 0.7; TT+TP post-pre: -3.3 and FU: -3.25.

Conclusions: This preliminary analysis suggests the TT+TP group retains TT improvements. Adding behavioral strategies to robotic gait training may induce long-term retention of improvements in TT, endurance, balance, and confidence.

Author(s) Disclosures: DB has a potential conflict of interest, please refer to author disclosure of information for details. The other authors have no conflict of interest to declare.

Learning Objectives:

Upon completion, participant will be able to identify changes in the paretic lower extremity use, balance, endurance, walking speed and confidence post and 3 months after a robotic treadmill protocol
Upon completion, participant will be able to explore the potential effect of the addition of a set of behavioral components to a robotic treadmill gait training
Upon completion, participant will be able to reproduce similar protocols and use behavioral components combined to motor training with individuals with stroke.