Robot-Assisted Gait Training for Achieving Gait Symmetry in a Subacute Stroke Patient: A Case Report

Gait asymmetry in post-stroke patients is an important gait characteristic that is associated with their balance control, inefficiency, and risks of musculoskeletal injury to the non-paretic lower limb and falling. Unfortunately, most stroke patients retain an asymmetrical gait pattern, even though their gait independence and gait speed improve. We describe the clinical course of a subacute stroke patient who achieved a symmetrical gait at discharge after undergoing both gait training with orthoses and robot-assisted gait training from the early intervention phase. A Korean woman in her 50s developed a right frontal subcortical hemorrhage. She had severe left upper- and lower-extremity motor paralysis and was unable to walk independently. Her gait pattern was also observed to have a knee extension thrust pattern and a resulting asymmetric gait pattern. The gait interventions consisted of gait training with a knee-ankle-foot orthosis (KAFO) and an ankle-foot orthosis (AFO), in addition to robot-assisted gait training from the early onset. The control of the knee joint's movement was obtained by the attachment of the knee-ankle-foot robot to the paretic lower limb. Following these interventions, the patient was able to walk independently and had a symmetrical gait pattern at the time of discharge. The combination of robot-assisted gait training and gait training with orthoses for subacute stroke patients, as is widely used in general populations, may prevent the patients' mislearning of gait movements and contribute to the acquisition of a symmetrical gait pattern.