Structural and functional improvements due to robot-assisted gait training in the stroke-injured brain. (10th January 2017)

• Record Type: Journal Article
• Authors: Yang, Hea Eun; Kyeong, Sunghyon; Lee, Seung Hwa; Lee, Won-Jae; Ha, Sang Won; Kim, Seung Min; Kang, Hyunkoo; Lee, Won Min; Kang, Chang Soon; Kim, Dae Hyun
• Is Part Of: Neuroscience letters. Volume 637(2017)
• Page Start: 114
• Page End: 119
• Publication Date: 2017-01-10
• Subjects: RAGT robot-assisted gait training -- DTI diffusion tensor imaging -- FA fractional anisotropy -- FAC functional ambulation category -- FMLE Fugl-Meyer motor assessment of the lower extremity -- MI motricity index of the lower extremity -- TCT trunk control test -- SMA supplementary motor area -- PPN pedunculopontine nucleus -- CR corona radiata -- PCC posterior cingulate cortex -- MCA middle cerebral artery -- unaffected unaffected hemisphere -- affected affected hemisphere -- MNI Montreal neurological institute -- R right -- L left -- Days days poststroke -- T0 before training -- T1 after 10 sessions -- T2 after 20 sessions -- T3 1-month follow-up -- UH unaffected hemisphere -- AH affected hemisphere; Stroke -- Gait -- Robotic-assisted therapy -- Rehabilitation -- Plasticity -- Functional recovery; Neurology -- Periodicals; Neurology -- Periodicals; Research -- Periodicals; Neurologie -- Périodiques; Neuroanatomie -- Périodiques; Neuropharmacologie -- Périodiques; Neurophysiologie -- Périodiques; Neurology; Periodicals; Electronic journals; 617.48
• DOI: 10.1016/j.neulet.2016.11.039
• Languages: English
• ISSNs: 0304-3940

Abstract

Highlights: Robot-assisted gait training may be promising for post-stroke rehabilitation. The supplementary motor area of the unaffected hemisphere had increased FA. Intact supplementary motor areas may be facilitated by robot-assisted gait training. Abstract: Robot-assisted gait training (RAGT) can improve walking ability after stroke. Because the underlying mechanisms are still unknown, we analyzed changes in post-stroke injured brains after RAGT. Ten non-ambulatory patients receiving inpatient rehabilitation were examined within 3 months of stroke onset. RAGT consisted of 45 min of training, 3 days per week. We acquired diffusion tensor imaging (DTI) data before and after 20 sessions of RAGT. Fractional anisotropy (FA) maps were then used to determine neural changes after RAGT. Fugl-Meyer motor assessment of the lower extremity, motricity index of the lower extremity, functional ambulation category, and trunk control tests were also conducted before training, after 10 and 20 RAGT sessions, and at the 1-month follow-up. After RAGT, the supplementary motor area of the unaffected hemisphere showed increased FA, but the internal capsule, substantia nigra, and pedunculopontine nucleus of the affected hemisphere showed decreased FA. All clinical outcome measures improved after 20 sessions of RAGT. Our findings indicate that RAGT can facilitate plasticity in the intact supplementary motor area, but not the injured motor-related areas, in the affected hemisphere.