Clinical Research Directory

Effectiveness of Robot-Assisted Structured Foot-Ankle Sensorimotor Training in Stroke Patients

Stroke, one of the central nervous system (CNS) disorders, is a global public health problem due to its high mortality rate and level of physical and mental disability. It is the leading cause of death after heart disease and cancer and one of the most important causes of disability worldwide. After a stroke, motor and sensory disorders, activity and participation limitations and various complications related to these are observed in the lower extremities. As a result of these losses, balance, mobility and gait abnormalities lead to a decrease in quality of life and fall problems. In recent years, the use of robot-assisted rehabilitation in physiotherapy has increased significantly with the support of engineering studies. Robotic and technology-supported trainings enable rehabilitation to be carried out at high intensity and repetition, treatment to be adapted according to the needs of the patient, patient exercise performance to be objectively monitored continuously, customized treatment protocols to be implemented and patients to be motivated with virtual reality technology. Platform-based end effector robots used for ankle rehabilitation in the lower extremity after stroke allow active and passive joint range of motion training to be performed. In addition to such motor trainings, adding sensory (vibrotactile) localization and cognitive trainings to the treatment improves sensory-motor-cognitive integration. In this context, with the proposed robot-assisted structured foot-ankle sensorimotor training protocol: 1. Vibration and sensory localization training applied for correct stepping on the sole of the foot (plantar) and correct pressure distribution, 2. Passive range of motion training supported by virtual reality, 3. Position sense training, 4. Active range of motion training supported by virtual reality and the "Assist-as-needed-AAN" control paradigm, 5. Vibration and sensory localization training applied for correct stepping on the sole of the foot (plantar) and correct pressure distribution, a holistic foot-ankle rehabilitation consisting of 5 stages of sensory-motor-cognitive training will be performed. The aim of the project is to investigate the effectiveness of our structured training protocol, which includes sensory, motor and cognitive integration for foot-ankle rehabilitation, which we created with a robot-assisted foot-ankle system, in stroke patients. Our project aims to improve the tone, range of motion, joint position sense, walking performance, static and dynamic balance control, tactile perception levels and quality of life of the ankle movement and muscles (dorsiflexor and plantar flexor muscles) that are impaired after stroke. It is also aimed to bring a robot-assisted structured foot-ankle training protocol to the literature.

The Feasibility and Therapeutic Effect of Hybrid End-effector Robot-assisted Gait Training With an Active-assisted Module in Chronic Stroke Survivors

Walking rehabilitation after stroke is most effective during the first three months of recovery, but even in the chronic phase-beyond six months post-stroke-a significant number of patients still show potential for gait improvement. Robot-assisted rehabilitation is becoming increasingly common in clinical settings, with various design modes available. However, the effectiveness of new products in improving gait or motor function still requires further investigation. This study aims to evaluate the usability and therapeutic effects of a new end-effector exoskeleton robot system, HIWIN MRG-P110, for gait training in chronic stroke patients. The system uses foot pedal mechanisms to drive hip and knee movements for lower-limb training. Unlike its predecessor, this device allows adjustment of the active assistance ratio, encouraging users to engage in voluntary movement. It is designed for gait training in stroke patients and others with neurological impairments, but the usability and efficacy of this new training model remain to be verified. This clinical trial is a randomized, single-blind, prospective study enrolling 60 stroke patients who are 6 months to 3 years post-onset and have a Functional Ambulation Category (FAC) level of 0 to 3. The study will explore how patients with varying degrees of motor weakness learn to adapt to the "active-assistive mode" in terms of speed and perception. Participants will be randomly assigned to either the active-assistive mode group or the fully passive mode group. Both groups will receive 15 treatment sessions over 5 weeks. The study will compare the two groups in terms of: 1. Improvements in gait and balance immediately post-treatment and at 3-month follow-up 2. Changes in brain activity, as measured by functional near-infrared spectroscopy (fNIRS)

Effect Of Robotic Rehabilitation And Vagus Nerve Stimulation In Ischemia Stroke Patients

This study was conducted in patients with ischemic stroke; This study was conducted to examine the effect of robotic rehabilitation and transcutaneous auricular vagal nerve stimulation applied in addition to robotic rehabilitation on the patient's functional level and autonomic nervous system. 40 people over the age of 18 participated in the study. They were randomly divided into two groups: robotic rehabilitation and transcutaneous auricular vagal nerve stimulation applied in addition to robotic rehabilitation. While the robotic rehabilitation group received Lokomat and neurological rehabilitation, the other group received stimulation with the Vagustim device, which is applied non-invasively through the ear, in addition to Lokomat and neurological rehabilitation. Spasticity, autonomic nervous system, walking speed, motor function, quality of life, muscle activity and pain were evaluated in both groups before starting treatment and six weeks after treatment. In the study, significance was evaluated at p\<0.05 level.