Immediate after-effects of robot-assisted gait with pelvic support or pelvic constraint on overground walking in healthy subjects.
J F Alingh, V Weerdesteyn, B Nienhuis and 3 others
PMID 30876445WHAT IT FOUND
After robot walking with the pelvis constrained, healthy people took the first overground trial with less side-to-side pelvic movement and a narrower step width than after pelvic support.
The change did not persist into later trials.
Key findings
01In the first overground trial, side-to-side pelvic movement was lower after pelvic constraint (32.3 mm) than after pelvic support (40.1 mm).
02In the first overground trial, step width was smaller after pelvic constraint (0.17 m) than after pelvic support (0.20 m) or baseline (0.19 m).
03The after-effect did not persist into trials 2 to 5.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was done in healthy young adults, so it does not show what happens in people with stroke, spinal cord injury, or cerebral palsy. 13 of 14 recruited adults were analysed, and a participant was excluded because the pelvic constraint condition could not be completed due to technical problems. The after-effect was measured only immediately after a 20-minute robot session, not over repeated sessions or longer follow-up. The pelvic constraint and pelvic support conditions also used different levels of guidance force, so the carryover cannot be attributed only to pelvic constraint. The robot speed was slower than the overground walking speed, which may have reduced the carryover. The paper does not report how the order of the robot conditions was assigned.
The easy way to misread this
Do not conclude that robot gait training with pelvic constraint harms patients with stroke, spinal cord injury, or cerebral palsy. The study was done in healthy adults, the carryover was small and lasted only the first overground trial, and the settings differed in guidance force, so the effect cannot be attributed only to pelvic constraint.