Effects of robot-virtual reality compared with robot alone training on gait kinetics of individuals post stroke

Virtual reality systems have been used to deliver goal directed repetitive training to promote rehabilitation of individuals post-stroke. Lower extremity training of individuals post-stroke who used a robot coupled with virtual environments was shown to transfer to improved over-ground locomotion. To elucidate an underlying mechanism that enabled this functional change we compared the kinetic outcomes of training with the robot-virtual reality (VR) system to the robot alone. Eighteen individuals post-stroke participated in a four-week training protocol. One group trained with the robot-VR system and the other group with the robot alone. Training parameters were comparable for the two groups; however, the improvements in moments and powers generated in the ankle and hip of subjects in the robot-VR group were significantly greater than those in the robot alone group. These findings demonstrate that lower extremity training using virtual environments coupled with a robot produced greater gait related strength gains than training with robot alone.