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Stroke Research and Treatment
Volume 2013 (2013), Article ID 946056, 9 pages
http://dx.doi.org/10.1155/2013/946056
Clinical Study

Early Poststroke Rehabilitation Using a Robotic Tilt-Table Stepper and Functional Electrical Stimulation

1Department of Neurology and Neurosurgery, National Pirogov Centre of Therapy and Surgery, Nignaya Pervomaiskaya Street 70, Moscow 105203, Russia
2Clinical Neurorehabilitation, Department of Neurology, University of Zurich, 8091 Zurich, Switzerland

Received 27 August 2012; Revised 28 January 2013; Accepted 3 March 2013

Academic Editor: Gerlinde Metz

Copyright © 2013 Alexey N. Kuznetsov et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Stroke frequently leaves survivors with hemiparesis. To prevent persistent deficits, rehabilitation may be more effective if started early. Early training is often limited because of orthostatic reactions. Tilt-table stepping robots and functional electrical stimulation (FES) may prevent these reactions. Objective. This controlled convenience sample study compares safety and feasibility of robotic tilt-table training plus FES (ROBO-FES) and robotic tilt-table training (ROBO) against tilt-table training alone (control). A preliminary assessment of efficacy is performed. Methods. Hemiparetic ischemic stroke survivors (age years, days after stroke) were assigned to 30 days of ROBO-FES ( ), ROBO ( ), or control ( ) in addition to conventional physical therapy. Impedance cardiography and transcranial doppler sonography were performed before, during, and after training. Hemiparesis was assessed using the British Medical Research Council (MRC) strength scale. Results. No serious adverse events occurred; 8 patients in the tilt-table group prematurely quit the study because of orthostatic reactions. Blood pressure and CBFV dipped % during robot training. In 52% of controls mean arterial pressure decreased by %. ROBO-FES increased leg strength by points, ROBO by more than control ( , ). CBFV increased in both robotic groups more than in controls ( ). Conclusions. Robotic tilt-table exercise with or without FES is safe and may be more effective in improving leg strength and cerebral blood flow than tilt table alone.