human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives To assess the influence of RAGT on balance , coordination , and functional independence in activities of daily living of chronic stroke survivors with ataxia at least one year of injury . Methods It was a r and omized controlled trial . The patients were allocated to either therapist-assisted gait training ( TAGT ) or robotic-assisted gait training ( RAGT ) . Both groups received 3 weekly sessions of physiotherapy with an estimated duration of 60 minutes each and prescribed home exercises . The following outcome measures were evaluated prior to and after the completion of the 5-month protocol treatment : BBS , TUG test , FIM , and SARA . For intragroup comparisons , the Wilcoxon test was used , and the Mann – Whitney test was used for between-group comparison . Results Nineteen stroke survivors with ataxia sequel after one year of injury were recruited . Both groups showed statistically significant improvement ( P < 0.05 ) in balance , functional independencein , and general ataxia symptoms . There were no statistically significant differences ( P < 0.05 ) for between-group comparisons both at baseline and after completion of the protocol . Conclusions Chronic stroke patients with ataxia had significant improvements in balance and independence in activities of daily living after RAGT along with conventional therapy and home exercises . This trial was registered with trial registration number 39862414.6.0000.5505 Robot gait training has the potential to increase the effectiveness of walking therapy . Clinical outcomes after robotic training are often not superior to conventional therapy . We evaluated the effectiveness of a robot training compared with a usual gait training physiotherapy during a st and ardized rehabilitation protocol in inpatient participants with poststroke hemiparesis . This was a r and omized double-blind clinical trial in a postacute physical and rehabilitation medicine hospital . Twenty-eight patients , 39.3 % women ( 72±6 years ) , with hemiparesis ( < 6 months after stroke ) receiving a conventional treatment according to the Bobath approach were assigned r and omly to an experimental or a control intervention of robot gait training to improve walking ( five sessions a week for 5 weeks ) . Outcome measures included the 6-min walk test , the 10 m walk test , Functional Independence Measure , SF-36 physical functioning and the Tinetti scale . Outcomes were collected at baseline , immediately following the intervention period and 3 months following the end of the intervention . The experimental group showed a significant increase in functional independence and gait speed ( 10 m walk test ) at the end of the treatment and follow-up , higher than the minimal detectable change . The control group showed a significant increase in the gait endurance ( 6-min walk test ) at the follow-up , higher than the minimal detectable change . Both treatments were effective in the improvement of gait performances , although the statistical analysis of functional independence showed a significant improvement in the experimental group , indicating possible advantages during generic activities of daily living compared with overground treatment Background and Purpose — The success of gait rehabilitation after stroke depends on active walking exercises . However , the disabling after-effects of stroke often make such exercises impossible at the onset of therapy . To facilitate treadmill training of paraparetic patients , a robot-driven gait orthosis ( Lokomat ) was developed . We investigated the effects of the Lokomat when used with hemiparetic patients . Methods — The authors conducted a r and omized , controlled pilot study of 30 acute stroke survivors . The treatment group received 30 minutes of robotic training daily and the control group 30 minutes of conventional physiotherapy daily in addition to 30 minutes of conventional physiotherapy for each group . Outcome measures were independence of gait , gait speed , gait parameters , and body tissue composition . Results — After 4 weeks of therapy , the walking ability of the Lokomat group and the control group expressed as the functional ambulation classification was significantly improved . The functional ambulation category ( median± interquartile range ) was at baseline 0±0 in control and 0±1 in the therapy group and increased after therapy to 1±3 in both groups significantly ( P=0.01 ) . There was no significant difference in gain of these parameters between the groups . The Lokomat group had a significantly longer single stance phase ( sec ; mean±SEM ) on the paretic leg when walking on the floor . At baseline , it was 0.19±0.17 and after therapy 0.49±0.07 ( P=0.014 ) . The control group had increased their body weight approximately 1.33±1.40 kg ( mean±SEM ; P=0.046 ) , mostly as fat mass , whereas the Lokomat group had lost fat mass approximately −2.9±1.0 kg ( mean±SEM ; P=0.016 ) and increased their muscle mass approximately 3.36±1.4 kg ( mean± SEM ; P=0.031 ) . Conclusions — This pilot study indicates that Lokomat therapy is a promising intervention for gait rehabilitation . Although there was no difference between groups in gain of functional scores , the Lokomat group showed an advantage of robotic training over conventional physiotherapy in improvement of gait abnormality and body tissue composition BACKGROUND This study was a prospect i ve , r and omized , open , blinded-endpoint trial with the aim of examining whether gait training with a gait-assistance robot ( GAR ) improves gait disturbances in subacute non-ambulatory hemiplegic stroke patients more than overground conventional gait training . The GAR adopts a robot arm control system with full weight bearing and foot pressure visual biofeedback . METHODS Twenty-six hemiplegic patients were r and omly assigned to either the  GAR-assisted gait training ( GAGT ) group or the  overground conventional gait training ( OCGT ) group . Both groups underwent 60 min of st and ard physical therapy and 20 min of GAGT or OCGT 5 days a week for 4 weeks . The primary outcome measure was the Functional Ambulation Classification ( FAC ) . The secondary outcome measures were the peak torque of the extensor muscles in the lower extremities and a 10-m walking test . The lower extremity function was evaluated using the Fugl-Meyer Assessment , and activities of daily living were assessed using the Functional Independence Measure . RESULTS The GAGT group demonstrated significantly greater improvements in FAC and peak torque on the unaffected side ( p=0.02 ) than the OCGT group . Additionally , gait speed tended to be faster ( p=0.07 ) in the GAGT group . CONCLUSIONS GAGT combined with st and ard physical therapy in subacute non-ambulatory hemiplegic patients led to significant improvements in gait and peak torque on the unaffected side compared to OCGT Background and Purpose — Gait velocity is a powerful indicator of function and prognosis after stroke . Gait velocity can be stratified into clinical ly meaningful functional ambulation classes , such as household ambulation ( < 0.4 m/s ) , limited community ambulation ( 0.4 to 0.8 m/s ) , and full community ambulation ( > 0.8 m/s ) . The purpose of the current study was to determine whether changes in velocity-based community ambulation classification were related to clinical ly meaningful changes in stroke-related function and quality of life . Methods — In subacute stroke survivors with mild to moderate deficits who participated in a r and omized clinical trial of stroke rehabilitation and had a baseline gait velocity of 0.8 m/s or less , we assessed the effect of success versus failure to achieve a transition to the next class on function and quality of life according to domains of the Stroke Impact Scale ( SIS ) . Results — Of 64 eligible participants , 19 were initially household ambulators , and 12 of them ( 68 % ) transitioned to limited community ambulation , whereas of 45 initially limited community ambulators , 17 ( 38 % ) became full community ambulators . Function and quality -of-life SIS scores after treatment were significantly higher among survivors who achieved a favorable transition compared with those who did not . Among household ambulators , those who transitioned to limited or full community ambulation had significantly better SIS scores in mobility ( P=0.0299 ) and participation ( P=0.0277 ) . Among limited community ambulators , those who achieved the transition to full community ambulatory status had significantly better scores in SIS participation ( P=0.0085 ) . Conclusions — A gait velocity gain that results in a transition to a higher class of ambulation results in better function and quality of life , especially for household ambulators . Household ambulators possibly had more severe stroke deficits , reducing the risk of “ ceiling ” effects in SIS-measured activities of daily living and instrumental activities of daily living . Outcome assessment based on transitions within a mobility classification scheme that is rooted in gait velocity yields potentially meaningful indicators of clinical benefit . Outcomes should be selected that are clinical ly meaningful for all levels of severity Objective . To compare the efficacy of robotic-assisted gait training with the Lokomat to conventional gait training in individuals with subacute stroke . Methods . A total of 63 participants < 6 months poststroke with an initial walking speed between 0.1 to 0.6 m/s completed the multicenter , r and omized clinical trial . All participants received twenty-four 1-hour sessions of either Lokomat or conventional gait training . Outcome measures were evaluated prior to training , after 12 and 24 sessions , and at a 3-month follow-up exam . Self-selected overground walking speed and distance walked in 6 minutes were the primary outcome measures , whereas secondary outcome measures included balance , mobility and function , cadence and symmetry , level of disability , and quality of life measures . Results . Participants who received conventional gait training experienced significantly greater gains in walking speed ( P = .002 ) and distance ( P = .03 ) than those trained on the Lokomat . These differences were maintained at the 3-month follow-up evaluation . Secondary measures were not different between the 2 groups , although a 2-fold greater improvement in cadence was observed in the conventional versus Lokomat group . Conclusions . For subacute stroke participants with moderate to severe gait impairments , the diversity of conventional gait training interventions appears to be more effective than robotic-assisted gait training for facilitating returns in walking ability Background While manually-assisted body-weight supported treadmill training ( BWSTT ) has revealed improved locomotor function in persons with post-stroke hemiparesis , outcomes are inconsistent and it is very labor intensive . Thus an alternate treatment approach is desirable . Objectives of this pilot study were to : 1 ) compare the efficacy of body-weight supported treadmill training ( BWSTT ) combined with the Lokomat robotic gait orthosis versus manually-assisted BWSTT for locomotor training post-stroke , and 2 ) assess effects of fast versus slow treadmill training speed . Methods Sixteen volunteers with chronic hemiparetic gait ( 0.62 ± 0.30 m/s ) post-stroke were r and omly allocated to Lokomat ( n = 8) or manual-BWSTT ( n = 8) 3 × /wk for 4 weeks . Groups were also stratified by fast ( mean 0.92 ± 0.15 m/s ) or slow ( 0.58 ± 0.12 m/s ) training speeds . The primary outcomes were self-selected overground walking speed and paretic step length ratio . Secondary outcomes included : fast overground walking speed , 6-minute walk test , and a battery of clinical measures . Results No significant differences in primary outcomes were revealed between Lokomat and manual groups as a result of training . However , within the Lokomat group , self-selected walk speed , paretic step length ratio , and four of the six secondary measures improved ( p = 0.04–0.05 , effect sizes = 0.19–0.60 ) . Within the manual group , only balance scores improved ( p = 0.02 , effect size = 0.57 ) . Group differences between fast and slow training groups were not revealed ( p ≥ 0.28 ) . Conclusion Results suggest that Lokomat training may have advantages over manual-BWSTT following a modest intervention dose in chronic hemiparetic persons and further , that our training speeds produce similar gait improvements . Suggestions for a larger r and omized controlled trial with optimal study parameters are provided Objective . Treadmill training with partial body weight support has been suggested as a useful strategy for gait rehabilitation after stroke . This prospect i ve , blinded , r and omized controlled study of gait retraining tested the feasibility and potential efficacy of using an electromechanical-driven gait orthosis ( Lokomat ) for treadmill training . Methods . Sixteen stroke patients , mostly within 3 months after onset , were r and omized into 2 treatment groups , ABA or BAB ( A = 3 weeks of Lokomat training , B = 3 weeks of conventional physical therapy ) for 9 weeks of treatment . The outcome measures were the EU-Walking Scale , Rivermead Motor Assessment Scale , 10-m timed walking speed , 6-minute timed walking distance , Motricity Index , Medical Research Council Scale of strength , and Ashworth Scale of tone . Results . The EU-Walking Scale , Rivermead Motor Assessment Scale , 6-minute timed walking distance , Medical Research Council Scale , and Ashworth Scale demonstrated significantly more improvement during the Lokomat training phase than during the conventional physical therapy phase within each 3-week interval . Conclusions . Despite the small number of patients , the present data suggest that the Lokomat robotic assistive device provides innovative possibilities for gait training in stroke rehabilitation while eliminating prolonged repetitive movements in a nonergonomic position on the part of the physical therapist Background . Robotic-assisted walking training after stroke aims to enable highly impaired patients to walk independently , but results have been mixed . Objective . The authors aim ed to identify the characteristics of patients who may be most likely to benefit . Methods . A total of 48 participants with motor and gait dysfunction following subacute stroke were stratified by the motricity index into high ( < 29 ) and low ( ≥29 ) motor impairment groups . Each arm was r and omized to a robotic or 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives To assess the influence of RAGT on balance , coordination , and functional independence in activities of daily living of chronic stroke survivors with ataxia at least one year of injury . Methods It was a r and omized controlled trial . The patients were allocated to either therapist-assisted gait training ( TAGT ) or robotic-assisted gait training ( RAGT ) . Both groups received 3 weekly sessions of physiotherapy with an estimated duration of 60 minutes each and prescribed home exercises . The following outcome measures were evaluated prior to and after the completion of the 5-month protocol treatment : BBS , TUG test , FIM , and SARA . For intragroup comparisons , the Wilcoxon test was used , and the Mann – Whitney test was used for between-group comparison . Results Nineteen stroke survivors with ataxia sequel after one year of injury were recruited . Both groups showed statistically significant improvement ( P < 0.05 ) in balance , functional independencein , and general ataxia symptoms . There were no statistically significant differences ( P < 0.05 ) for between-group comparisons both at baseline and after completion of the protocol . Conclusions Chronic stroke patients with ataxia had significant improvements in balance and independence in activities of daily living after RAGT along with conventional therapy and home exercises . This trial was registered with trial registration number 39862414.6.0000.5505 Robot gait training has the potential to increase the effectiveness of walking therapy . Clinical outcomes after robotic training are often not superior to conventional therapy . We evaluated the effectiveness of a robot training compared with a usual gait training physiotherapy during a st and ardized rehabilitation protocol in inpatient participants with poststroke hemiparesis . This was a r and omized double-blind clinical trial in a postacute physical and rehabilitation medicine hospital . Twenty-eight patients , 39.3 % women ( 72±6 years ) , with hemiparesis ( < 6 months after stroke ) receiving a conventional treatment according to the Bobath approach were assigned r and omly to an experimental or a control intervention of robot gait training to improve walking ( five sessions a week for 5 weeks ) . Outcome measures included the 6-min walk test , the 10 m walk test , Functional Independence Measure , SF-36 physical functioning and the Tinetti scale . Outcomes were collected at baseline , immediately following the intervention period and 3 months following the end of the intervention . The experimental group showed a significant increase in functional independence and gait speed ( 10 m walk test ) at the end of the treatment and follow-up , higher than the minimal detectable change . The control group showed a significant increase in the gait endurance ( 6-min walk test ) at the follow-up , higher than the minimal detectable change . Both treatments were effective in the improvement of gait performances , although the statistical analysis of functional independence showed a significant improvement in the experimental group , indicating possible advantages during generic activities of daily living compared with overground treatment Background and Purpose — The success of gait rehabilitation after stroke depends on active walking exercises . However , the disabling after-effects of stroke often make such exercises impossible at the onset of therapy . To facilitate treadmill training of paraparetic patients , a robot-driven gait orthosis ( Lokomat ) was developed . We investigated the effects of the Lokomat when used with hemiparetic patients . Methods — The authors conducted a r and omized , controlled pilot study of 30 acute stroke survivors . The treatment group received 30 minutes of robotic training daily and the control group 30 minutes of conventional physiotherapy daily in addition to 30 minutes of conventional physiotherapy for each group . Outcome measures were independence of gait , gait speed , gait parameters , and body tissue composition . Results — After 4 weeks of therapy , the walking ability of the Lokomat group and the control group expressed as the functional ambulation classification was significantly improved . The functional ambulation category ( median± interquartile range ) was at baseline 0±0 in control and 0±1 in the therapy group and increased after therapy to 1±3 in both groups significantly ( P=0.01 ) . There was no significant difference in gain of these parameters between the groups . The Lokomat group had a significantly longer single stance phase ( sec ; mean±SEM ) on the paretic leg when walking on the floor . At baseline , it was 0.19±0.17 and after therapy 0.49±0.07 ( P=0.014 ) . The control group had increased their body weight approximately 1.33±1.40 kg ( mean±SEM ; P=0.046 ) , mostly as fat mass , whereas the Lokomat group had lost fat mass approximately −2.9±1.0 kg ( mean±SEM ; P=0.016 ) and increased their muscle mass approximately 3.36±1.4 kg ( mean± SEM ; P=0.031 ) . Conclusions — This pilot study indicates that Lokomat therapy is a promising intervention for gait rehabilitation . Although there was no difference between groups in gain of functional scores , the Lokomat group showed an advantage of robotic training over conventional physiotherapy in improvement of gait abnormality and body tissue composition BACKGROUND This study was a prospect i ve , r and omized , open , blinded-endpoint trial with the aim of examining whether gait training with a gait-assistance robot ( GAR ) improves gait disturbances in subacute non-ambulatory hemiplegic stroke patients more than overground conventional gait training . The GAR adopts a robot arm control system with full weight bearing and foot pressure visual biofeedback . METHODS Twenty-six hemiplegic patients were r and omly assigned to either the  GAR-assisted gait training ( GAGT ) group or the  overground conventional gait training ( OCGT ) group . Both groups underwent 60 min of st and ard physical therapy and 20 min of GAGT or OCGT 5 days a week for 4 weeks . The primary outcome measure was the Functional Ambulation Classification ( FAC ) . The secondary outcome measures were the peak torque of the extensor muscles in the lower extremities and a 10-m walking test . The lower extremity function was evaluated using the Fugl-Meyer Assessment , and activities of daily living were assessed using the Functional Independence Measure . RESULTS The GAGT group demonstrated significantly greater improvements in FAC and peak torque on the unaffected side ( p=0.02 ) than the OCGT group . Additionally , gait speed tended to be faster ( p=0.07 ) in the GAGT group . CONCLUSIONS GAGT combined with st and ard physical therapy in subacute non-ambulatory hemiplegic patients led to significant improvements in gait and peak torque on the unaffected side compared to OCGT Background and Purpose — Gait velocity is a powerful indicator of function and prognosis after stroke . Gait velocity can be stratified into clinical ly meaningful functional ambulation classes , such as household ambulation ( < 0.4 m/s ) , limited community ambulation ( 0.4 to 0.8 m/s ) , and full community ambulation ( > 0.8 m/s ) . The purpose of the current study was to determine whether changes in velocity-based community ambulation classification were related to clinical ly meaningful changes in stroke-related function and quality of life . Methods — In subacute stroke survivors with mild to moderate deficits who participated in a r and omized clinical trial of stroke rehabilitation and had a baseline gait velocity of 0.8 m/s or less , we assessed the effect of success versus failure to achieve a transition to the next class on function and quality of life according to domains of the Stroke Impact Scale ( SIS ) . Results — Of 64 eligible participants , 19 were initially household ambulators , and 12 of them ( 68 % ) transitioned to limited community ambulation , whereas of 45 initially limited community ambulators , 17 ( 38 % ) became full community ambulators . Function and quality -of-life SIS scores after treatment were significantly higher among survivors who achieved a favorable transition compared with those who did not . Among household ambulators , those who transitioned to limited or full community ambulation had significantly better SIS scores in mobility ( P=0.0299 ) and participation ( P=0.0277 ) . Among limited community ambulators , those who achieved the transition to full community ambulatory status had significantly better scores in SIS participation ( P=0.0085 ) . Conclusions — A gait velocity gain that results in a transition to a higher class of ambulation results in better function and quality of life , especially for household ambulators . Household ambulators possibly had more severe stroke deficits , reducing the risk of “ ceiling ” effects in SIS-measured activities of daily living and instrumental activities of daily living . Outcome assessment based on transitions within a mobility classification scheme that is rooted in gait velocity yields potentially meaningful indicators of clinical benefit . Outcomes should be selected that are clinical ly meaningful for all levels of severity Objective . To compare the efficacy of robotic-assisted gait training with the Lokomat to conventional gait training in individuals with subacute stroke . Methods . A total of 63 participants < 6 months poststroke with an initial walking speed between 0.1 to 0.6 m/s completed the multicenter , r and omized clinical trial . All participants received twenty-four 1-hour sessions of either Lokomat or conventional gait training . Outcome measures were evaluated prior to training , after 12 and 24 sessions , and at a 3-month follow-up exam . Self-selected overground walking speed and distance walked in 6 minutes were the primary outcome measures , whereas secondary outcome measures included balance , mobility and function , cadence and symmetry , level of disability , and quality of life measures . Results . Participants who received conventional gait training experienced significantly greater gains in walking speed ( P = .002 ) and distance ( P = .03 ) than those trained on the Lokomat . These differences were maintained at the 3-month follow-up evaluation . Secondary measures were not different between the 2 groups , although a 2-fold greater improvement in cadence was observed in the conventional versus Lokomat group . Conclusions . For subacute stroke participants with moderate to severe gait impairments , the diversity of conventional gait training interventions appears to be more effective than robotic-assisted gait training for facilitating returns in walking ability Background While manually-assisted body-weight supported treadmill training ( BWSTT ) has revealed improved locomotor function in persons with post-stroke hemiparesis , outcomes are inconsistent and it is very labor intensive . Thus an alternate treatment approach is desirable . Objectives of this pilot study were to : 1 ) compare the efficacy of body-weight supported treadmill training ( BWSTT ) combined with the Lokomat robotic gait orthosis versus manually-assisted BWSTT for locomotor training post-stroke , and 2 ) assess effects of fast versus slow treadmill training speed . Methods Sixteen volunteers with chronic hemiparetic gait ( 0.62 ± 0.30 m/s ) post-stroke were r and omly allocated to Lokomat ( n = 8) or manual-BWSTT ( n = 8) 3 × /wk for 4 weeks . Groups were also stratified by fast ( mean 0.92 ± 0.15 m/s ) or slow ( 0.58 ± 0.12 m/s ) training speeds . The primary outcomes were self-selected overground walking speed and paretic step length ratio . Secondary outcomes included : fast overground walking speed , 6-minute walk test , and a battery of clinical measures . Results No significant differences in primary outcomes were revealed between Lokomat and manual groups as a result of training . However , within the Lokomat group , self-selected walk speed , paretic step length ratio , and four of the six secondary measures improved ( p = 0.04–0.05 , effect sizes = 0.19–0.60 ) . Within the manual group , only balance scores improved ( p = 0.02 , effect size = 0.57 ) . Group differences between fast and slow training groups were not revealed ( p ≥ 0.28 ) . Conclusion Results suggest that Lokomat training may have advantages over manual-BWSTT following a modest intervention dose in chronic hemiparetic persons and further , that our training speeds produce similar gait improvements . Suggestions for a larger r and omized controlled trial with optimal study parameters are provided Objective . Treadmill training with partial body weight support has been suggested as a useful strategy for gait rehabilitation after stroke . This prospect i ve , blinded , r and omized controlled study of gait retraining tested the feasibility and potential efficacy of using an electromechanical-driven gait orthosis ( Lokomat ) for treadmill training . Methods . Sixteen stroke patients , mostly within 3 months after onset , were r and omized into 2 treatment groups , ABA or BAB ( A = 3 weeks of Lokomat training , B = 3 weeks of conventional physical therapy ) for 9 weeks of treatment . The outcome measures were the EU-Walking Scale , Rivermead Motor Assessment Scale , 10-m timed walking speed , 6-minute timed walking distance , Motricity Index , Medical Research Council Scale of strength , and Ashworth Scale of tone . Results . The EU-Walking Scale , Rivermead Motor Assessment Scale , 6-minute timed walking distance , Medical Research Council Scale , and Ashworth Scale demonstrated significantly more improvement during the Lokomat training phase than during the conventional physical therapy phase within each 3-week interval . Conclusions . Despite the small number of patients , the present data suggest that the Lokomat robotic assistive device provides innovative possibilities for gait training in stroke rehabilitation while eliminating prolonged repetitive movements in a nonergonomic position on the part of the physical therapist Background . Robotic-assisted walking training after stroke aims to enable highly impaired patients to walk independently , but results have been mixed . Objective . The authors aim ed to identify the characteristics of patients who may be most likely to benefit . Methods . A total of 48 participants with motor and gait dysfunction following subacute stroke were stratified by the motricity index into high ( < 29 ) and low ( ≥29 ) motor impairment groups . Each arm was r and omized to a robotic or 
    Output:
    