Abnormal Synergistic Gait Mitigation after Acute Stroke Using an Innovative Ankle-Knee-Hip Interlimb Humanoid Robot: A Randomized Controlled Trial

Abnormal spasticity and associated synergistic patterns are the most common neuromuscular impairments affecting ankle-knee-hip interlimb coordinated gait kinematics and kinetics in patients with hemiparetic stroke. Although patients with hemiparetic stroke undergo various treatments to improve gait and movement, it remains unknown how spasticity and associated synergistic patterns change after robot-assisted and conventional treatment. We developed an innovative ankle-knee-hip interlimb coordinated humanoid robot (ICT) to mitigate abnormal spasticity and synergistic patterns. Our study aimed to compare the effects of ICT combined conventional physical therapy (ICT-C) and conventional physical therapy and gait training (CPT-G) on abnormal spasticity, synergistic gait patterns, and gait biomechanics in 20 patients with acute hemiparesis. The interventions were provided in 60-min sessions, 7 days/week, for 2 weeks. ICT-C demonstrated superior effects to CPT-G in knee joint kinematics, hip extensor and ankle dorsiflexor spasticity, hip, knee, ankle active force, knee and ankle resistive force, hip, knee, and ankle stiffness. Concurrently, the abnormal gait synergy was reduced in the ICT-C group. Our novel findings provided promising evidence of the ICT benefits as a successful intervention for abnormal spasticity and synergistic gait impairments in patients with acute hemiparetic stroke.Trial Registration: Clinical Trials.gov identifier NCT03554642 (14/01/2020)