Robot-assisted gait training for Parkinson’s disease

Robot-assisted gait training using the THERA-Trainer lyra with endeffector guided steps vs. treadmill training with visual step guidelines in patients with Parkinson’s disease: A randomised controlled pilot study

Veronika Seidl

Parkinson’s disease is one of the most common neurodegenerative diseases worldwide [1]. Some of the symptoms, such as balance and gait disturbances and risk of falls, respond poorly to pharmacotherapy [2]. Therefore, physiotherapy is an important component in the treatment of patients with Parkinson’s disease [3]. With robotic gait training or treadmill training, it is possible for patients to increase walking distance and step repetitions during therapy [4]. This is important for motor learning and improving walking skills in everyday life.

The aim of this study was to investigate whether robotic gait training using the THERA-Trainer lyra with end-effector guided steps can improve stride length more than treadmill training with visually prescribed steps.

In this randomised controlled trial, 20 patients with Parkinson’s disease (Hoehn & Yahr 1-4) were randomly assigned to 2 groups: a THERA-Trainer lyra group and a treadmill group. Each group received 30 minutes of gait training 3 days per week for 4 weeks. Patients were assessed by a physiotherapist before the procedure, after each treatment and at the end of the procedure. The primary outcome parameter was stride length, measured with the 10-metre walk test. At the beginning of the study, there were no differences between the two groups. After four weeks, both groups had improved their stride length in the primary target value (THERA-Trainer lyra - Group A: mean value 11.50 cm ± 6.33; Treadmill - Group B: mean value 8.30 cm ± 7.45), but no significant differences were found between the two groups (p = 0.58).

The aim of this study was to investigate whether robotic gait training using the THERA-Trainer lyra with end-effector guided steps can improve stride length more than treadmill training with visually prescribed steps.

Secondary outcome measures were walking speed and postural stability during walking, which also improved in both groups without significant difference. The results show a trend towards improvement in gait abilities through training with the THERA-Trainer lyra, but larger studies are needed to further investigate the effectiveness of robotic gait training with the THERA-Trainer lyra in patients with Parkinson’s disease.

Change in both groups	Lyra group, mean value ±SD	Treadmill group, mean value ±SD
10 MWT stride length (cm)	11,50 ± 6,33	8,30 ± 7,45
10 MWT walking speed (km/h)	1,16 ± 0,73	0,84 ± 0,49
FGA (points of max. 28)	5,50 ± 3,24	4,00 ± 5,73

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Veronika Seidl
Physiotherapy, Neurologisches Therapiezentrum Gmundnerberg, Altmünster, Austria

SOURCES:

[1] GBD 2016 Parkinson’s Disease Collaborators, 2018
[2] Ceballos-Baumann & Ebersbach, 2018
[3] Keus et al., 2014