Reduction of Gait Asymmetry Using the Tethered Pelvic Assist Device (TPAD) in In

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Reduction of Gait Asymmetry Using the Tethered Pelvic Assist Device (TPAD) in Individuals Chronically Post-Stroke

Asymmetrical gait is common in individuals after stroke due to the hemiparetic nature of the disease. Traditional care models, treadmill based training, and robotic training have all worked to reduce asymmetry in this population; however, despite efforts, individuals remain with motor deficits that limit community participation. The tethered pelvic assist device (TPAD) has been developed by Dr. Sunil Agrawal (Dept. of Mechanical Engineering, Columbia University). This is a novel robotic device that uses an arrangement of force tethers attached to a pelvic belt to manipulate load forces on the pelvis during treadmill-based gait training. In this non-randomized pilot study of feasibility, we used the TPAD to maintain a prescribed force, guiding the pelvis to increase loading onto the paretic limb while the user freely controls the spatiotemporal aspects of limb movement during gait. On completion of the daily TPAD treadmill training, participants also received additional overground gait training that reinforced skills learned with the TPAD. The purpose of this study was to evaluate the overall feasibility in terms of safety, adherence and treatment tolerance as well as establish preliminary efficacy of implementing this five-day TPAD and overground training paradigm to reduce asymmetry in individuals with chronic stroke.

This study was conducted primarily in the Department of Rehabilitation & Regenerative Medicine at Columbia University Medical Center in collaboration with Dr. Joel Stein, and was led by TC student Lauri Bishop, Phd, PT, DPT.

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