This paper presents a clinical rehabilitation protocol for stroke patients using a movable trainer, which can automatically execute a neurodevelopmental treatment (NDT) intervention based on key gait events. The trainer consists of gait detection and motor control systems. The gait detection system applied recurrent neural networks (RNNs) to recognize important gait events in real time to trigger the motor control system to repeat the NDT intervention. This paper proposes a modified intervention method that simultaneously improves the user’s gait symmetry and pelvic rotation. We recruited ten healthy subjects and had them wear a rehabilitation gaiter on one knee joint to mimic stroke gaits for verification of the effectiveness of the trainer. We used the RNN model and a modified intervention method to increase the trainer’s effectiveness in improving gait symmetry and pelvic rotation. We then invited ten stroke patients to participate in the experiments, and we found improvement in gait symmetry in 80% and 90% of the patients during and after the training, respectively. Similarly, pelvic rotation improved in 80% of the patients during and after the training. These findings confirmed that the movable NDT trainer could improve gait performance for the rehabilitation of stroke patients.

This paper investigates the clinical efficacy of an automatic mobile trainer for gait training in stroke patients. Neuro-Developmental Treatment (NDT) is a rehabilitation method for stroke patients that enhances motor learning through repeated practice. Despite the proven effectiveness of therapist-assisted NDT, it is labor-intensive and demands health resources. Therefore, we developed automatic trainers based on NDT principles to perform gait training. This paper modifies the mobile trainer’s intervention patterns to improve the subject’s longitudinal gait symmetry, lateral pelvic displacement symmetry, and pelvic rotation. We first invited ten healthy subjects to test the modified trainer and then recruited 26 stroke patients to undergo the same gait training. Longitudinal symmetry, lateral symmetry, and pelvic rotation were assessed before, during, and after the intervention. Most subjects show improvements in longitudinal symmetry, lateral symmetry, and pelvic rotation after using the trainer. These results confirm the trainer’s effectiveness of the modified intervention schemes in helping clinical gait rehabilitation for stroke patients.

We propose a speed-adapted treadmill that can be incorporated into a rehabilitation trainer that applies neurodevelopmental treatment (NDT) for patients with stroke. NDT practice is effective for post-stroke patients, but its requirement for therapists’ participation can limit the patients’ rehabilitation during the golden period of recovery. Previous studies have proposed a trainer that can automatically reiterate therapists’ interventions. However, that trainer employed a constant-speed treadmill, which required the users to frequently adjust their walking speeds during rehabilitation. This paper develops a speed-adapted treadmill that can regulate the treadmill motor to maintain the subject’s position during the training process. First, we derive models of the treadmill and cable motors through experiments. Then, we design robust controls for the two systems and simplify them as proportional-integral-derivative controllers for hardware implementation. Finally, we integrate the system and invite healthy and stroke subjects to participate in clinical experiments. Among ten stroke subjects, all subjects’ walking speeds and nine subjects’ stride lengths were improved, while eight subjects showed improvement in the swing-phase asymmetry and pelvic rotation after receiving the NDT rehabilitation employing the speed-adapted treadmill. Our findings indicate that the NDT trainer effectively enhances users’ gait characteristics, including swing-phase symmetry, pelvic rotation, walking speed, and stride length.

This paper presents control design and implementation for a power-assisted mobile trainer that employs neuro-developmental treatment (NDT) principles. NDT is a gait rehabilitation technique for stroke patients that provides minimum intervention at critical gait events. Traditional NDT rehabilitation is an effective post-stroke treatment but is also time consuming and labor intensive for therapists. Therefore, we designed a mobile NDT trainer to automatically repeat therapists’ intervention patterns, allowing patients to receive sufficient training without increasing therapists’ workloads. Because the trainer was self-propelled, it could cause burdens to stroke patients with limited muscle strength, thereby potentially degrading the rehabilitation effects. Hence, this paper proposes a power-assisted device that can let the mobile trainer follow the user, allowing the subject to focus on the rehabilitation training. We conducted system identification and control design for the power-assisted NDT trainer. We then implemented the designed controllers and tested the trainer. Finally, we invited 10 healthy subjects and 12 stroke patients to conduct clinical experiments. After using the power-assisted NDT trainer, most participants exhibited improvements in swing-phase symmetry, pelvic rotation, and walking speed. Based on the results, the power-assisted device was deemed effective in facilitating stroke rehabilitation.