LegTutor an Important Boost for People With Stiff-Knee Gait Following Stroke

Dr. James S. Sulzer from the Rehabilitation Institute of Chicago Chicago, Ill; the Departments of Mechanical and Biomedical Engineering, Northwestern University, Evanston, Ill; and the Department of Bioengineering, University of Illinois–Chicago, Chicago, Ill.writing for the American Heart and Stroke Associations made the following study:
Background and Purpose— Stiff-knee gait is defined as reduced knee flexion during the swing phase. It is accompanied by frontal plane compensatory movements (eg, circumduction and hip hiking) typically thought to result from reduced toe clearance. As such, we examined if knee flexion assistance before foot-off would reduce exaggerated frontal plane movements in people with stiff-knee gait after stroke.
Methods— We used a robotic knee orthosis to assist knee flexion torque during the preswing phase in 9 chronic stroke subjects with stiff-knee gait on a treadmill and compared peak knee flexion, hip abduction, and pelvic obliquity angles with 5 nondisabled control subjects.
Results— Maximum knee flexion angle significantly increased in both groups, but instead of reducing gait compensations, hip abduction significantly increased during assistance in stroke subjects by 2.5°, whereas no change was observed in nondisabled control subjects. No change in pelvic obliquity was observed in either group.
Conclusions— Hip abduction increased when stroke subjects received assistive knee flexion torque at foot-off. These findings are in direct contrast to the traditional belief that pelvic obliquity combined with hip abduction is a compensatory mechanism to facilitate foot clearance during swing. Because no evidence suggested a voluntary mechanism for this behavior, we argue that these results were most likely a reflection of an altered motor template occurring after stroke.
The LegTutor has proven to be an important complement in improving functional outcomes in physical rehabilitation for post stroke patients.
The LegTutor provides a safe and comfortable leg brace with position and speed sensors that precisely record three dimensional hip and knee extension, flexion and hip abduction. Rehabilitation games allow the patient to exercise Range of Motion (ROM), speed and accuracy of movement. The LegTutor facilitates evaluation and treatment of the lower extremity including isolated and combined hip and knee movements.
The LegTutor together with its sister devices (HandTutor, ArmTutor and 3DTutor) aim to optimize motor, sensory and cognitive performance to allow the patient to better perform everyday functional tasks through interactive rehabilitation exercises in order to improve quality of life. The Tutors are being successfully used in leading U.S. and foreign hospitals and clinics and are suitable for home use through telerehabilitation. They are available for children as well as adults.