Comprehensive Summary
This multicenter randomized controlled trial evaluated treatments for lateropulsion, also known as pusher syndrome, in post-stroke patients. Lateropulsion interferes with balance and gait, as standard care in Japan often involves gait training with a knee-ankle-foot orthosis (KAFO). The study compared KAFO-based therapy to a gait exercise assist robot (GEAR) for effectiveness. Thirty-six patients were randomized into two groups that received 50-minute therapy sessions daily for two weeks. Both groups demonstrated significant improvement on the Burke Lateropulsion Scale (BLS) and the Scale for Contraversive Pushing (SCP). While the GEAR group achieved greater walking distances and step counts, the severity of lateropulsion improved similarly in both groups with no significant differences.
Outcomes and Implications
This study is important because it suggests that both traditional orthosis-assisted therapy and robotic-assisted gait training can effectively reduce lateropulsion after stroke, a condition that prolongs rehabilitation and limits independence. While the findings highlight that robotic devices may enhance gait efficiency, they don't appear to accelerate recovery from lateropulsion beyond conventional methods. Clinically, this means healthcare providers may use either approach depending on resource availability and patient needs. KAFO-based therapy remains a reliable and accessible standard of care, but for broader implementation, robotic devices could offer value in rehabilitation centers aiming to optimize walking outcomes.