Motor and psychosocial impact of robot-assisted gait training in a real-world rehabilitation setting: A pilot study

<div><p>In the last decade robotic devices have been applied in rehabilitation to overcome walking disability in neurologic diseases with promising results. Robot assisted gait training (RAGT) using the Lokomat seems not only to improve gait parameters but also the perception of well-being. Data on the psychosocial patient-robot impact are limited, in particular in the real-world of RAGT, in the rehabilitation setting. During rehabilitation training, the Lokomat can be considered an “assistive device for movement”. This allowed the use of the Psychosocial Impact of Assistive Device Scale- PIADS to describe patient interaction with the Lokomat. The primary aim of this pilot study was to evaluate the psychosocial impact of the Lokomat in an in-patient rehabilitation setting using the PIADS; secondary aims were to assess whether the psychosocial impact of RAGT is different between pathological sub-groups and if the Lokomat influenced functional variables (Functional Independence Measure scale–FIM and parameters provided by the Lokomat itself). Thirty-nine consecutive patients (69% males, 54.0±18.0 years) eligible for Lokomat training, with etiologically heterogeneous walking disabilities (Parkinson’s Disease, n = 10; Spinal Cord Injury, n = 21; Ictus Event, n = 8) were enrolled. Patients were assessed with the FIM before and after rehabilitation with Lokomat, and the PIADS was administered after the rehabilitative period with Lokomat. Overall the PIADS score was positive (35.8±21.6), as well as the three sub-scales, pertaining to “ability”, “adaptability” and “self-esteem” (17.2±10.4, 8.9±5.5 and 10.1±6.6 respectively) with no between-group differences. All patients significantly improved in gait measure and motor FIM scale (difference after—before treatment values: 11.7±9.8 and 11.2±10.3 respectively), increased treadmill speed (0.4 ± 0.2m/s), reduced body weight support (-14.0±9.5%) and guidance force (-13.1 ± 10.7%). This pilot study indicates that Lokomat, in a real-world in-patient setting, may have a generalised approval, independent of disease, underlining the importance of the psycho-social framework for patients training with assistive robotic-devices.</p></div

Flow diagram of the research outline.

<p>Flow diagram of the research outline.</p

Demographic and baseline clinical data for all patients and for the three different groups of patients.

<p>Demographic and baseline clinical data for all patients and for the three different groups of patients.</p

PIADS total and subscale scores for walking/not walking patients.

<p>PIADS total and subscale scores for walking/not walking patients.</p

Changes (values after RAGT-values before RAGT) in variables for all patients and for the three different groups of patients.

<p>Changes (values after RAGT-values before RAGT) in variables for all patients and for the three different groups of patients.</p

Chlorine Para-Substitution of 1‑Phenylethanol: Resonant Photoionization Spectroscopy and Quantum Chemical Calculations of Hydrated and Diastereomeric Complexes

The conformational landscape of (<i>S</i>)-1-(4-chlorophenyl)­ethanol, its monohydrated complex, and its diastereomeric adducts with <i>R</i>- and <i>S</i>-butan-2-ol, have been investigated by resonant two-photon ionization (R2PI) spectroscopy coupled with time-of-flight mass spectrometry. Theoretical calculations at the D-B3LYP/6-31++G** level of theory have been performed to assist in the interpretation of the spectra and in the assignment of the structures. The R2PI spectra and the predicted structures have been compared with those obtained on the analogous non-halogenated and fluorinated systems, i.e., (<i>R</i>)-1-phenylethanol and (<i>S</i>)-1-(4-fluorophenyl)­ethanol, respectively. It appears that the presence of chlorine atom in the para position of the aromatic ring does not influence the overall geometry of bare molecule and its complexes with respect to the non-halogenated analogous systems. Anyway, it affects the electron density in the π system, and in turn the strength of OH···π and CH···π interactions. A spectral chiral discrimination is evident from the R2PI spectra of the diastereomeric adducts of (<i>S</i>)-1-(4-chlorophenyl)­ethanol with the two enantiomers of butan-2-ol

Contingency table comparing rate of MCI diagnosis assessed by ENB-2 (gold standard) vs. MoCA.

<p>Contingency table comparing rate of MCI diagnosis assessed by ENB-2 (gold standard) vs. MoCA.</p

Scores on ENB-2 neuropsychological tests: comparison with normative data, and number (% frequency) of impaired scores.

<p>Scores on ENB-2 neuropsychological tests: comparison with normative data, and number (% frequency) of impaired scores.</p

Psychological and neuropsychological data of patients (n = 65) from the different screening tests.

<p>Psychological and neuropsychological data of patients (n = 65) from the different screening tests.</p