Akifumi Yamaguchi, PT, Yoku Kanazawa, PT, Satoshi Hirano, MD, PhD, Yoichiro Aoyagi, MD, PhD
Jpn J Compr Rehabil Sci 15: 88-93, 2024
Background: Gait training-assist robots and
neuromuscular electrical stimulation devices have
been shown to be useful in gait training for patients
with hemiplegia. However, no case reports have
documented the combined use of a gait training-assist
robot and a neuromuscular electrical stimulator for
gait rehabilitation. In this study, we present the case of
a patient with left hemiplegia who demonstrated
remarkable improvement in walking ability after using
a combination of a gait training-assist robot and a
neuromuscular electrical stimulator for foot drop.
Case Presentation: A 60-year-old man developed
severe left hemiplegia following a stroke in the right
middle cerebral artery region. His lower limb motor
function, as assessed by the Stroke Impairment
Assessment Set (SIAS), was completely impaired
(score of 0), and he was unable to walk by the 57th day
post-onset. By the 66th day, his lower limb motor
function remained unchanged (SIAS score of 0), and
he frequently stumbled on his left foot at the start of
the swing phase during gait training. As a result, robotassisted
gait training combined with neuromuscular
electrical stimulation for foot drop was initiated. By
the 88th day, his lower limb motor function improved
to a score of 1 on the SIAS, and his Functional
Independence Measure (FIM) walk item improved to
a score of 4 with the use of an ankle-foot orthosis and
a cane. On the 89th day, he transitioned to conventional
therapy without the devices. By the 114th day, he was
able to walk with a T-cane without the need for an
orthosis.
Conclusion: The combination of a gait training-assist
robot and a neuromuscular electrical stimulator for
foot drop facilitated dorsiflexion of the ankle during
the swing phase, allowed the patient to practice
walking with minimal assistance. This promoted
active patient-led walking and more efficient motor
learning, ultimately leading to independent walking.
Key words: gait training-assist robot, functional electrical stimulation, motor learning