Robot-assisted Gait Training in Patients With Parkinson's Disease
Robot-assisted Gait Training in Patients With Parkinson's Disease
Robot-assisted gait training can improve gait ability of patients with Parkinson's disease by
 repeating a normal gait pattern with high intensity. This study is a randomized controlled
 trial to investigate the effect of robot-assisted gait training on walking ability and
 functional connectivity of brain in patients with Parkinson's disease using an exo-skeletal
 robot.
Parkinson's disease is a disease caused by dopamine deficiency in the striatum resulting from
 the loss of dopaminergic neuronal cells in the cerebral substantia. It is a progressive
 neurodegenerative disease characterized by motor symptoms including gait disturbance and
 balance instability. In the early stages of Parkinson's disease, dysfunction of the
 sensorimotor area of the basal ganglia typically occurs, leading to habitual control hurdles.
 Accordingly, cognitive efforts are required to perform habitual tasks such as walking, and
 the automaticity of walking is reduced. Walking performance in a dual-task condition has been
 used to assess gait automaticity in patients with Parkinson's disease.

 Patients with Parkinson's disease are known to exhibit changes in functional connectivity of
 the brain from an early stage. In addition, a number of studies have reported that patients
 with Parkinson's disease with gait freezing have a change in resting brain activity and
 functional connectivity of the brain. However, no studies have examined the functional
 connectivity of the brain in patients with Parkinson's disease before and after
 rehabilitation.

 Robot-assisted gait training is a method of rehabilitation that repeats normal gait patterns
 at high intensity. Recent meta-analysis has shown that robot-assisted gait training improved
 the recovery of independent gait after stroke compared with conventional rehabilitation
 therapy. On the other hand, robot-assisted gait training in Parkinson's disease has been
 reported to improve walking speed and walking endurance compared to conventional physical
 therapy, but is not superior to treadmill exercise of the same intensity. In addition, it has
 been reported that in patients with Parkinson's disease with balance impairment,
 robot-assisted gait training can improve balance disorder compared with physical therapy, and
 gait freezing has improved in some small-scale patients. However, studies on the
 effectiveness of robot-assisted gait training in Parkinson's disease are still lacking, and
 the mechanism of the effect has not been elucidated. In particular, the effect on gait
 automaticity, which is a characteristic of Parkinson 's disease, and functional connectivity
 of the brain has not been studied. Therefore, this study is aimed to investigate the effect
 of robot-assisted gait training on walking ability and functional connectivity of brain in
 patients with Parkinson's disease using an exo-skeletal robot.
Inclusion Criteria:

 -  Clinically confirmed patients with idiopathic Parkinson's disease

 -  Hoehn & Yahr stage 2.5 or 3 patients

 -  Patients with a Mini-Mental Status Examination (MMSE) score of 24 or higher

 Exclusion Criteria:

 -  Patients with severe dyskinesia or on-off fluctuations due to medication

 -  Patients who need to change drugs during the study period

 -  Patients with sensory abnormalities of the lower limb

 -  Patients with vestibular disease or paroxismal vertigo

 -  Patients with other neurological or orthopedic disease involving legs, or severe
 cardiovascular diseases