Robotized Knee-Ankle-Foot Orthosis-Assisted Gait Training on Genu Recurvatum during Gait in Patients with Chronic Stroke: A Feasibility Study and Case Report

Yoko Takahashi, Kohsuke Okada, Tomoyuki Noda, Tatsuya Teramae, Takuya Nakamura, Koshiro Haruyama, Kohei Okuyama, Kengo Tsujimoto, Katsuhiro Mizuno, Jun Morimoto, Michiyuki Kawakami

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Genu recurvatum (knee hyperextension) is a common problem after stroke. It is important to promote the coordination between knee and ankle movements during gait; however, no study has investigated how multi-joint assistance affects genu recurvatum. We are developing a gait training technique that uses robotized knee-ankle-foot orthosis (KAFO) to assists the knee and ankle joints simultaneously. This report aimed to investigate the safety of robotized KAFO-assisted gait training (Experiment 1) and a clinical trial to treat genu recurvatum in a patient with stroke (Experiment 2). Six healthy participants and eight patients with chronic stroke participated in Experiment 1. They received robotized KAFO-assisted gait training for one or 10 sessions. One patient with chronic stroke participated in Experiment 2 to investigate the effect of robotized KAFO-assisted gait training on genu recurvatum. The patient received the training for 30 min/day for nine days. The robot consisted of KAFO and an attached actuator of four pneumatic artificial muscles. The assistance parameters were adjusted by therapists to prevent genu recurvatum during gait. In Experiment 2, we evaluated the knee joint angle during overground gait, Fugl-Meyer Assessment of lower extremity (FMA-LE), modified Ashworth scale (MAS), Gait Assessment and Intervention Tool (G.A.I.T.), 10-m gait speed test, and 6-min walk test (6MWT) before and after the intervention without the robot. All participants completed the training in both experiments safely. In Experiment 2, genu recurvatum, FMA-LE, MAS, G.A.I.T., and 6MWT improved after robotized KAFO-assisted gait training. The results indicated that the multi-joint assistance robot may be effective for genu recurvatum after stroke.

Original languageEnglish
Article number415
JournalJournal of Clinical Medicine
Volume12
Issue number2
DOIs
Publication statusPublished - 2023 Jan

Keywords

  • hemiplegia
  • knee hyperextension
  • lower extremity
  • pneumatic artificial muscles
  • rehabilitation
  • walking

ASJC Scopus subject areas

  • General Medicine

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