r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2022-27-1-16-25r-n-j-262Research ArticleОБЗОРЫREVIEWSВосстановление навыков ходьбы у пациентов, перенесших мозговой инсультWalking skills recovery for patients suffered a strokehttps://orcid.org/0000-0001-9719-6772БеловаА. Н.BelovaA. N.

Нижний Новгород

Nizhny Novgorod

anbelova@mail.ruhttps://orcid.org/0000-0003-2346-7810СушинВ. О.SushinV. O.

Сушин Вильям Олегович — ассистент кафедры медицинской реабилитации

Нижний Новгород

Sushin Viliyam — Assistant of Departments of Medical Rehabilitation

Nizhny Novgorod

sushin.nn@mail.ruhttps://orcid.org/0000-0002-6978-139XЛитвиноваН. Ю.LitvinovaN. Y.

Нижний Новгород

Nizhny Novgorod

ny7171@mail.ruhttps://orcid.org/0000-0002-8160-1208ШабановаМ. А.ShabanovaM. A.

Нижний Новгород

Nizhny Novgorod

bilberry47@mail.ruhttps://orcid.org/0000-0001-6478-8077РезеноваА. М.RezenovaM. A.

Нижний Новгород

Nizhny Novgorod

seule1993@gmail.comФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава РоссииРоссияFederal State Budgetary Educational Institution of Higher Education «Privolzhsky Research Medical University» of the Ministry of Health of the Russian FederationRussian Federation2022070320222711625Copyright © Белова А.Н., Сушин В.О., Литвинова Н.Ю., Шабанова М.А., Резенова А.М., 20222022Белова А.Н., Сушин В.О., Литвинова Н.Ю., Шабанова М.А., Резенова А.М.Belova A.N., Sushin V.O., Litvinova N.Y., Shabanova M.A., Rezenova M.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/262

Восстановление ходьбы является одной из приоритетных задач медицинской реабилитации пациентов, перенесших мозговой инсульт. Локомоторным тренировкам должно предшествовать обследование, направленное на идентификацию патологических характеристик походки и включающее ряд функциональных тестов. Арсенал методов восстановления навыков ходьбы достаточно широк и включает конвенционные тренировки, тренировки на беговой дорожке без поддержки массы тела и с поддержкой массы тела, занятия с применением электромеханических и роботизированных устройств, дополнительное использование биологически обратной связи, виртуальной реальности, ортезирования, электростимуляции мышц, силовых тренировок и тренировок равновесия. В обзоре дается краткая характеристика этих методов реабилитации с позиций доказательной медицины. Индивидуальная программа реабилитации зависит от выраженности, давности и характера двигательных нарушений, предпочтений самого пациента и ограничений, связанных с его сопутствующими заболеваниями.

Recovering the walking ability is one of the major goals in rehabilitation of poststroke patients. Locomotor training should be preceded by identifying pathological gait characteristics and functional gait assessment. The spectrum of rehabilitation methods for restoration of walking skills is quite wide and includes conventional training, training on a treadmill without body weight support and with body weight support, using of electromechanical and robotic devices, additional use of biofeedback, virtual reality, orthoses, electrical muscle stimulation, strength training and balance training. The review provides a brief description of these rehabilitation methods in view of evidence-based medicine. The individual choice of procedures depends on the severity, duration and characteristics of walking defiits, the patient’s preferences and limitations associated with his concomitant diseases.

инсультходьбареабилитацияstrokegaitrehabilitationРабота выполнена в рамках программы стратегического академического лидерства «Приоритет-2030»ReferencesBeyaert C., Vasa R., Frykberg G. Gait post-stroke: Pathophysiology and rehabilitation strategies. Neurophysiologie Clinique/ Clinical Neurophysiology. 2015;45(4–5):335–355. https://doi.org/10.1016/j.neucli.2015.09.005Beyaert C., Vasa R., Frykberg G. Gait post-stroke: Pathophysiology and rehabilitation strategies. Neurophysiologie Clinique/ Clinical Neurophysiology. 2015;45(4–5):335–355. https://doi.org/10.1016/j.neucli.2015.09.005Hornby T., Reisman D., Ward I., Scheets P., Miller A., Haddad D. et al. Clinical Practice Guideline to Improve Locomotor Function Following Chronic Stroke, Incomplete Spinal Cord Injury, and Brain Injury. Journal of Neurologic Physical Therapy. 2020;44(1):49–100. https://doi.org/10.1097/NPT.0000000000000303Hornby T., Reisman D., Ward I., Scheets P., Miller A., Haddad D. et al. Clinical Practice Guideline to Improve Locomotor Function Following Chronic Stroke, Incomplete Spinal Cord Injury, and Brain Injury. Journal of Neurologic Physical Therapy. 2020;44(1):49–100. https://doi.org/10.1097/NPT.0000000000000303Hesse S. Treadmill training with partial body weight support after stroke: A review. NeuroRehabilitation. 2008;23(1):55–65. https://doi.org/10.3233/NRE-2008-23106Hesse S. Treadmill training with partial body weight support after stroke: A review. NeuroRehabilitation. 2008;23(1):55–65. https://doi.org/10.3233/NRE-2008-23106Скворцов Д.В. Диагностика двигательной патологии инструментальными методами: анализ походки, стабилометрия. М.: Т.М. Андреева. 2007:640 с.Skvortsov D.V. Diagnosis of motor pathology by instrumental methods: gait analysis, stabilometry. M.: T.M. Andreeva. 2007:640 p. (In Russian).Lewek M., Bradley C., Wutzke C., Zinder, S. The Relationship Between Spatiotemporal Gait Asymmetry and Balance in Individuals With Chronic Stroke. Journal of Applied Biomechanics. 2014;30(1):31–36. https://doi.org/10.1123/jab.2012-0208Lewek M., Bradley C., Wutzke C., Zinder, S. The Relationship Between Spatiotemporal Gait Asymmetry and Balance in Individuals With Chronic Stroke. Journal of Applied Biomechanics. 2014;30(1):31–36. https://doi.org/10.1123/jab.2012-0208Хатькова C.Е., Костенко Е.В., Акулов М.А., Дягилева В.П., Николаев Е.А., Орлова А.С. Современные аспекты патофизиологии нарушений ходьбы у пациентов после инсульта и особенности их реабилитации. Журнал неврологии и психиатрии им. С.С. Корсакова. 2020;119(12):43–50. https://doi.org/10.17116/jnevro201911911243. [Khat’kova C.E., Kostenko E.V., Akulov M.A., Dyagileva V.P., Nikolaev E.A., Orlova A.S. Modern aspects of the pathophysiology of walking disorders and their rehabilitation in post-stroke patients. S.S. Korsakov Journal of Neurology and Psychiatry (Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova). 2020;119(12):43–50. (In Russian).] https://doi.org/10.17116/jnevro201911911243Khat’kova C.E., Kostenko E.V., Akulov M.A., Dyagileva V.P., Nikolaev E.A., Orlova A.S. Modern aspects of the pathophysiology of walking disorders and their rehabilitation in post-stroke patients. S.S. Korsakov Journal of Neurology and Psychiatry (Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova). 2020;119(12):43–50. (In Russian). https://doi.org/10.17116/jnevro201911911243Moore J., Potter K., Blankshain K., Kaplan S., O’Dwyer L., Sullivan J. A Core Set of Outcome Measures for Adults With Neurologic Conditions Undergoing Rehabilitation. Journal of Neurologic Physical Therapy. 2018;42(3):174–220. https://doi.org/10.1097/NPT.0000000000000229Moore J., Potter K., Blankshain K., Kaplan S., O’Dwyer L., Sullivan J. A Core Set of Outcome Measures for Adults With Neurologic Conditions Undergoing Rehabilitation. Journal of Neurologic Physical Therapy. 2018;42(3):174–220. https://doi.org/10.1097/NPT.0000000000000229Middleton A., Fritz S., Lusardi M. Walking Speed: The Functional Vital Sign. Journal of Aging and Physical Activity. 2015;23(2):314–322. https://doi.org/10.1123/japa.2013-0236Middleton A., Fritz S., Lusardi M. Walking Speed: The Functional Vital Sign. Journal of Aging and Physical Activity. 2015;23(2):314–322. https://doi.org/10.1123/japa.2013-0236Danks K., Pohlig R., Roos M., Wright T., Reisman D. Relationship Between Walking Capacity, Biopsychosocial Factors, Selfefficacy, and Walking Activity in Persons Poststroke. Journal of Neurologic Physical Therapy. 2016;40(4):232–238. https://doi.org/10.1097/NPT.0000000000000143Danks K., Pohlig R., Roos M., Wright T., Reisman D. Relationship Between Walking Capacity, Biopsychosocial Factors, Selfefficacy, and Walking Activity in Persons Poststroke. Journal of Neurologic Physical Therapy. 2016;40(4):232–238. https://doi.org/10.1097/NPT.0000000000000143Fulk G., Echternach J., Nof L., O’Sullivan S. Clinometric properties of the six-minute walk test in individuals undergoing rehabilitation poststroke. Physiotherapy Theory and Practice, 2008; 4(3):195–204. https://doi.org/10.1080/09593980701588284Fulk G., Echternach J., Nof L., O’Sullivan S. Clinometric properties of the six-minute walk test in individuals undergoing rehabilitation poststroke. Physiotherapy Theory and Practice, 2008; 4(3):195–204. https://doi.org/10.1080/09593980701588284Mathias S., Nayak U.S., Isaacs B. Balance in elderly patients: the “get-up and go” test. Archives of Physical Medicine and Rehabilitation. 1986;67(6):387–389.Mathias S., Nayak U.S., Isaacs B. Balance in elderly patients: the “get-up and go” test. Archives of Physical Medicine and Rehabilitation. 1986;67(6):387–389.Herman T., Inbar-Borovsky N., Brozgol M., Giladi N., Hausdorff J. The Dynamic Gait Index in healthy older adults: The role of stair climbing, fear of falling and gender. Gait & Posture. 2009;29(2):237–241. https://doi.org/10.1016/j.gaitpost.2008.08.013Herman T., Inbar-Borovsky N., Brozgol M., Giladi N., Hausdorff J. The Dynamic Gait Index in healthy older adults: The role of stair climbing, fear of falling and gender. Gait & Posture. 2009;29(2):237–241. https://doi.org/10.1016/j.gaitpost.2008.08.013Wrisley D., Kumar N. Functional Gait Assessment: Concurrent, Discriminative, and Predictive Validity in Community-Dwelling Older Adults. Physical Therapy. 2010;90(5):761–773. https://doi.org/10.2522/ptj.20090069Wrisley D., Kumar N. Functional Gait Assessment: Concurrent, Discriminative, and Predictive Validity in Community-Dwelling Older Adults. Physical Therapy. 2010;90(5):761–773. https://doi.org/10.2522/ptj.20090069Jackson A., Carnel C., Ditunno J., Read M., Boninger M., Schmeler M. et al. Outcome Measures for Gait and Ambulation in the Spinal Cord Injury Population. The Journal Of Spinal Cord Medicine. 2008;31(5):487–499. https://doi.org/10.1080/10790268.2008.11753644Jackson A., Carnel C., Ditunno J., Read M., Boninger M., Schmeler M. et al. Outcome Measures for Gait and Ambulation in the Spinal Cord Injury Population. The Journal Of Spinal Cord Medicine. 2008;31(5):487–499. https://doi.org/10.1080/10790268.2008.11753644Kitago T., Liang J., Huang V.S., Hayes S., Simon P., Tenteromano L. et al. Improvement after constraint-induced movement therapy: recovery of normal motor control or task-specific compensation? Neurorehabil Neural Repair. 2013;27(2):99–109. https://doi.org/10.1177/1545968312452631Kitago T., Liang J., Huang V.S., Hayes S., Simon P., Tenteromano L. et al. Improvement after constraint-induced movement therapy: recovery of normal motor control or task-specific compensation? Neurorehabil Neural Repair. 2013;27(2):99–109. https://doi.org/10.1177/1545968312452631Kleim J., Jones, T. Principles of Experience-Dependent Neural Plasticity: Implications for Rehabilitation After Brain Damage. Journal of Speech, Language, and Hearing Research. 2008;51(1):225–239. https://doi.org/10.1044/1092-4388(2008/018)Kleim J., Jones, T. Principles of Experience-Dependent Neural Plasticity: Implications for Rehabilitation After Brain Damage. Journal of Speech, Language, and Hearing Research. 2008;51(1):225–239. https://doi.org/10.1044/1092-4388(2008/018)Mikolajczyk T., Ciobanu I., Badea D.I., Iliescu A., Pizzamiglio S., Schauer T. et al. Design and evaluation of the LOPES exoskeleton robot for interactive gait rehabilitation. Transactions on Neural Systems and Rehabilitation Engineering. Published in: IEEE. 2007;15(3):379–386. https://doi.org/10.1109/TNSRE.2007.903919Mikolajczyk T., Ciobanu I., Badea D.I., Iliescu A., Pizzamiglio S., Schauer T. et al. Design and evaluation of the LOPES exoskeleton robot for interactive gait rehabilitation. Transactions on Neural Systems and Rehabilitation Engineering. Published in: IEEE. 2007;15(3):379–386. https://doi.org/10.1109/TNSRE.2007.903919O’Sullivan S.B., Schmitz T.J. Improving functional outcomes in physical rehabilitation. 2nd ed. Philadelphia: F.A. Davis Company. 2016:448 p. ISBN 9780803646124O’Sullivan S.B., Schmitz T.J. Improving functional outcomes in physical rehabilitation. 2nd ed. Philadelphia: F.A. Davis Company. 2016:448 p. ISBN 9780803646124White J., Bartley E., Janssen H., Jordan L., Spratt N. Exploring stroke survivor experience of participation in an enriched environment: a qualitative study. Disability And Rehabilitation. 2015;37(7):593–600. https://doi.org/10.3109/09638288.2014.935876White J., Bartley E., Janssen H., Jordan L., Spratt N. Exploring stroke survivor experience of participation in an enriched environment: a qualitative study. Disability And Rehabilitation. 2015;37(7):593–600. https://doi.org/10.3109/09638288.2014.935876Laver K., Lange B., George S., Deutsch J., Saposnik G., Crotty M. Virtual reality for stroke rehabilitation. Cochrane Database Of Systematic Reviews. 2017;11(11):CD008349. https://doi.org/10.1002/14651858.CD008349.pub4Laver K., Lange B., George S., Deutsch J., Saposnik G., Crotty M. Virtual reality for stroke rehabilitation. Cochrane Database Of Systematic Reviews. 2017;11(11):CD008349. https://doi.org/10.1002/14651858.CD008349.pub4Harkema S., Behrman P.T., Barbeau H. Locomotor Training: principles and practice. New York, NY: Oxford University Press. 2011:200 p. https://doi.org/10.1093/acprof:oso/9780195342086.001.0001Harkema S., Behrman P.T., Barbeau H. Locomotor Training: principles and practice. New York, NY: Oxford University Press. 2011:200 p. https://doi.org/10.1093/acprof:oso/9780195342086.001.0001George Hornby T., Straube D.S., Kinnaird C.R., Holleran C.L., Echauz A.J., Rodriguez K.S. et al. Importance of Specificity, Amount, and Intensity of Locomotor Training to Improve Ambulatory Function in Patients Poststroke. Topics In Stroke Rehabilitation. 2011;18(4):293–307. https://doi.org/10.1310/tsr1804-293George Hornby T., Straube D.S., Kinnaird C.R., Holleran C.L., Echauz A.J., Rodriguez K.S. et al. Importance of Specificity, Amount, and Intensity of Locomotor Training to Improve Ambulatory Function in Patients Poststroke. Topics In Stroke Rehabilitation. 2011;18(4):293–307. https://doi.org/10.1310/tsr1804-293Perez M., Lungholt B., Nyborg K., Nielsen J. Motor skill training induces changes in the excitability of the leg cortical area in healthy humans. Experimental Brain Research. 2004;159(2):197–205. https://doi.org/10.1007/s00221-004-1947-5Perez M., Lungholt B., Nyborg K., Nielsen J. Motor skill training induces changes in the excitability of the leg cortical area in healthy humans. Experimental Brain Research. 2004;159(2):197–205. https://doi.org/10.1007/s00221-004-1947-5States R.A., Pappas E., Salem Y. Overground physical therapy gait training for chronic stroke patients with mobility deficits. Stroke. 2009;40(11):627–628. https://doi.org/10.1002/14651858.CD006075.pub2States R.A., Pappas E., Salem Y. Overground physical therapy gait training for chronic stroke patients with mobility deficits. Stroke. 2009;40(11):627–628. https://doi.org/10.1002/14651858.CD006075.pub2Tyson S., Sadeghi-Demneh E., Nester C. A systematic review and meta-analysis of the effect of an ankle-foot orthosis on gait biomechanics after stroke. Clinical Rehabilitation. 2013;27(10):879–891. https://doi.org/10.1177/0269215513486497Tyson S., Sadeghi-Demneh E., Nester C. A systematic review and meta-analysis of the effect of an ankle-foot orthosis on gait biomechanics after stroke. Clinical Rehabilitation. 2013;27(10):879–891. https://doi.org/10.1177/0269215513486497Mehrholz J., Thomas S., Elsner B. Treadmill training and body weight support for walking after stroke (Review). Cochrane Database of Systematic Reviews. 2017;8(8):CD002840). https://doi.org/10.1002/14651858.CD002840.pub4Mehrholz J., Thomas S., Elsner B. Treadmill training and body weight support for walking after stroke (Review). Cochrane Database of Systematic Reviews. 2017;8(8):CD002840). https://doi.org/10.1002/14651858.CD002840.pub4Boyne P., Dunning K., Carl D., Gerson M., Khoury J., Rockwell B. et al. High-Intensity Interval Training and Moderate-Intensity Continuous Training in Ambulatory Chronic Stroke: Feasibility Study. Physical Therapy. 2016;96(10):1533–1544. https://doi.org/10.2522/ptj.20150277Boyne P., Dunning K., Carl D., Gerson M., Khoury J., Rockwell B. et al. High-Intensity Interval Training and Moderate-Intensity Continuous Training in Ambulatory Chronic Stroke: Feasibility Study. Physical Therapy. 2016;96(10):1533–1544. https://doi.org/10.2522/ptj.20150277Holleran C., Rodriguez K., Echauz A., Leech K., Hornby T. Potential Contributions of Training Intensity on Locomotor Performance in Individuals With Chronic Stroke. Journal of Neurologic Physical Therapy. 2015;39(2):95–102. https://doi.org/10.1097/NPT.0000000000000077Holleran C., Rodriguez K., Echauz A., Leech K., Hornby T. Potential Contributions of Training Intensity on Locomotor Performance in Individuals With Chronic Stroke. Journal of Neurologic Physical Therapy. 2015;39(2):95–102. https://doi.org/10.1097/NPT.0000000000000077Mao Y., Lo W., Lin Q., Li L., Xiao X., Raghavan P., Huang D. The Effect of Body Weight Support Treadmill Training on Gait Recovery, Proximal Lower Limb Motor Pattern, and Balance in Patients with Subacute Stroke. BioMed Research International. 2015;2015:175719. https://doi.org/10.1155/2015/175719Mao Y., Lo W., Lin Q., Li L., Xiao X., Raghavan P., Huang D. The Effect of Body Weight Support Treadmill Training on Gait Recovery, Proximal Lower Limb Motor Pattern, and Balance in Patients with Subacute Stroke. BioMed Research International. 2015;2015:175719. https://doi.org/10.1155/2015/175719Cho K., Lee W. Effect of treadmill training based real-world video recording on balance and gait in chronic stroke patients: A randomized controlled trial. Gait & Posture. 2014;39(1):523–528. https://doi.org/10.1016/j.gaitpost.2013.09.003Cho K., Lee W. Effect of treadmill training based real-world video recording on balance and gait in chronic stroke patients: A randomized controlled trial. Gait & Posture. 2014;39(1):523–528. https://doi.org/10.1016/j.gaitpost.2013.09.003Sullivan K., Knowlton B., Dobkin B. Step training with body weight support: Effect of treadmill speed and practice paradigms on poststroke locomotor recovery. Archives of Physical Medicine and Rehabilitation. 2002;83(5):683–691. https://doi.org/10.1053/apmr.2002.32488Sullivan K., Knowlton B., Dobkin B. Step training with body weight support: Effect of treadmill speed and practice paradigms on poststroke locomotor recovery. Archives of Physical Medicine and Rehabilitation. 2002;83(5):683–691. https://doi.org/10.1053/apmr.2002.32488Takao T., Tanaka N., Iizuka N., Saitou H., Tamaoka A., Yanagi H. Improvement of gait ability with a short-term intensive gait rehabilitation program using body weight support treadmill training in community dwelling chronic poststroke survivors. Journal of Physical Therapy Science. 2015;27(1):159–163. https://doi.org/10.1589/jpts.27.159Takao T., Tanaka N., Iizuka N., Saitou H., Tamaoka A., Yanagi H. Improvement of gait ability with a short-term intensive gait rehabilitation program using body weight support treadmill training in community dwelling chronic poststroke survivors. Journal of Physical Therapy Science. 2015;27(1):159–163. https://doi.org/10.1589/jpts.27.159Yen C., Wang R., Liao K., Huang C., Yang Y. Gait TrainingInduced Change in Corticomotor Excitability in Patients With Chronic Stroke. Neurorehabilitation and Neural Repair. 2007;22(1):22–30. https://doi.org/10.1177/1545968307301875Yen C., Wang R., Liao K., Huang C., Yang Y. Gait TrainingInduced Change in Corticomotor Excitability in Patients With Chronic Stroke. Neurorehabilitation and Neural Repair. 2007;22(1):22–30. https://doi.org/10.1177/1545968307301875Combs-Miller S., Kalpathi Parameswaran A., Colburn D., Ertel T., Harmeyer A., Tucker L., Schmid A. Body weight-supported treadmill training vs. overground walking training for persons with chronic stroke: a pilot randomized controlled trial. Clinical Rehabilitation. 2014;28(9):873–884. https://doi.org/10.1177/0269215514520773Combs-Miller S., Kalpathi Parameswaran A., Colburn D., Ertel T., Harmeyer A., Tucker L., Schmid A. Body weight-supported treadmill training vs. overground walking training for persons with chronic stroke: a pilot randomized controlled trial. Clinical Rehabilitation. 2014;28(9):873–884. https://doi.org/10.1177/0269215514520773Mehrholz J., Thomas S., Kugler J., Pohl M., Elsner B. Electromechanical-assisted training for walking after stroke. Cochrane Database of Systematic Reviews. 2020;10(CD006185):751. https://doi.org/10.1002/14651858.CD006185.pub5Mehrholz J., Thomas S., Kugler J., Pohl M., Elsner B. Electromechanical-assisted training for walking after stroke. Cochrane Database of Systematic Reviews. 2020;10(CD006185):751. https://doi.org/10.1002/14651858.CD006185.pub5Kim H., You J. A Review of Robot-Assisted Gait Training in Stroke Patients. Brain & Neurorehabilitation. 2017;10(2). https://doi.org/10.12786/bn.2017.10.e9Kim H., You J. A Review of Robot-Assisted Gait Training in Stroke Patients. Brain & Neurorehabilitation. 2017;10(2). https://doi.org/10.12786/bn.2017.10.e9Iosa M., Morone G., Cherubini A., Paolucci S. The Three Laws of Neurorobotics: A Review on What Neurorehabilitation Robots Should Do for Patients and Clinicians. Journal of Medical and Biological Engineering. 2016;36(1):1–11. https://doi.org/10.1007/s40846-016-0115-2Iosa M., Morone G., Cherubini A., Paolucci S. The Three Laws of Neurorobotics: A Review on What Neurorehabilitation Robots Should Do for Patients and Clinicians. Journal of Medical and Biological Engineering. 2016;36(1):1–11. https://doi.org/10.1007/s40846-016-0115-2Bessler J., Prange-Lasonder G., Schulte R., Schaake L., Prinsen E., Buurke J. Occurrence and Type of Adverse Events During the Use of Stationary Gait Robots — A Systematic Literature Review. Frontiers in Robotics and AI, 2020;7:557–606. https://doi.org/10.3389/frobt.2020.557606Bessler J., Prange-Lasonder G., Schulte R., Schaake L., Prinsen E., Buurke J. Occurrence and Type of Adverse Events During the Use of Stationary Gait Robots — A Systematic Literature Review. Frontiers in Robotics and AI, 2020;7:557–606. https://doi.org/10.3389/frobt.2020.557606Morone G., Paolucci S., Cherubini A., De Angelis D., Venturiero V., Coiro P., Iosa M. Robot-assisted gait training for stroke patients: current state of the art and perspectives of robotics. Neuropsychiatric Disease and Treatment. 2017;13:1303–1311. https://doi.org/10.2147/NDT.S114102Morone G., Paolucci S., Cherubini A., De Angelis D., Venturiero V., Coiro P., Iosa M. Robot-assisted gait training for stroke patients: current state of the art and perspectives of robotics. Neuropsychiatric Disease and Treatment. 2017;13:1303–1311. https://doi.org/10.2147/NDT.S114102Zhang X., Yue Z., Wang J. Robotics in Lower-Limb Rehabilitation after Stroke. Behavioural Neurology. 2017;article ID3731802:1–13. https://doi.org/10.1155/2017/3731802Zhang X., Yue Z., Wang J. Robotics in Lower-Limb Rehabilitation after Stroke. Behavioural Neurology. 2017;article ID3731802:1–13. https://doi.org/10.1155/2017/3731802Berger A., Horst F., Müller S., Steinberg F., Doppelmayr M. Current State and Future Prospects of EEG and fNIRS in RobotAssisted Gait Rehabilitation: A Brief Review. Frontiers in Human Neuroscience. 2019;13(13):1–24. https://doi.org/10.3389/fnhum.2019.00172Berger A., Horst F., Müller S., Steinberg F., Doppelmayr M. Current State and Future Prospects of EEG and fNIRS in RobotAssisted Gait Rehabilitation: A Brief Review. Frontiers in Human Neuroscience. 2019;13(13):1–24. https://doi.org/10.3389/fnhum.2019.00172Bang D., Shin W. Effects of robot-assisted gait training on spatiotemporal gait parameters and balance in patients with chronic stroke: A randomized controlled pilot trial. Neurorehabilitation. 2016;38(4):343–349. https://doi.org/10.3233/NRE-161325Bang D., Shin W. Effects of robot-assisted gait training on spatiotemporal gait parameters and balance in patients with chronic stroke: A randomized controlled pilot trial. Neurorehabilitation. 2016;38(4):343–349. https://doi.org/10.3233/NRE-161325Buesing C., Fisch G., O’Donnell M., Shahidi I., Thomas L., Mummidisetty C. et al. Effects of a wearable exoskeleton stride management assist system (SMA®) on spatiotemporal gait characteristics in individuals after stroke: a randomized controlled trial. Journal of Neuroengineering And Rehabilitation. 2015;12:69. https://doi.org/10.1186/s12984-015-0062-0Buesing C., Fisch G., O’Donnell M., Shahidi I., Thomas L., Mummidisetty C. et al. Effects of a wearable exoskeleton stride management assist system (SMA®) on spatiotemporal gait characteristics in individuals after stroke: a randomized controlled trial. Journal of Neuroengineering And Rehabilitation. 2015;12:69. https://doi.org/10.1186/s12984-015-0062-0Forrester L., Roy A., Hafer-Macko C., Krebs H., Macko R. Taskspecific ankle robotics gait training after stroke: a randomized pilot study. Journal of Neuroengineering and Rehabilitation. 2016;13(1):1–6. https://doi.org/10.1186/s12984-016-0158-1Forrester L., Roy A., Hafer-Macko C., Krebs H., Macko R. Taskspecific ankle robotics gait training after stroke: a randomized pilot study. Journal of Neuroengineering and Rehabilitation. 2016;13(1):1–6. https://doi.org/10.1186/s12984-016-0158-1Giggins O., Persson U., Caulfield B. Biofeedback in rehabilitation. Journal of Neuroengineering and Rehabilitation. 2013;10(60):1–11. https://doi.org/10.1186/1743-0003-10-60Giggins O., Persson U., Caulfield B. Biofeedback in rehabilitation. Journal of Neuroengineering and Rehabilitation. 2013;10(60):1–11. https://doi.org/10.1186/1743-0003-10-60Schenck C., Kesar T. Effects of unilateral real-time biofeedback on propulsive forces during gait. Journal of Neuroengineering and Rehabilitation. 2017;14(1):52. https://doi.org/10.1186/s12984-017-0252-zSchenck C., Kesar T. Effects of unilateral real-time biofeedback on propulsive forces during gait. Journal of Neuroengineering and Rehabilitation. 2017;14(1):52. https://doi.org/10.1186/s12984-017-0252-zStanton R., Ada L., Dean C.M., Preston E. Biofeedback improves performance in lower limb activities more than usual therapy in people following stroke: a systematic review. Journal of Physiotherapy. 2016;63(1):11–16. https://doi.org/10.1016/j.jphys.2016.11.006Stanton R., Ada L., Dean C.M., Preston E. Biofeedback improves performance in lower limb activities more than usual therapy in people following stroke: a systematic review. Journal of Physiotherapy. 2016;63(1):11–16. https://doi.org/10.1016/j.jphys.2016.11.006Holden M. Virtual Environments for Motor Rehabilitation: Review. Cyberpsychology & Behavior. 2005;8(3):187–211. https://doi.org/10.1089/cpb.2005.8.187Holden M. Virtual Environments for Motor Rehabilitation: Review. Cyberpsychology & Behavior. 2005;8(3):187–211. https://doi.org/10.1089/cpb.2005.8.187Fu M., Knutson J., Chae J. Stroke rehabilitation using virtual environments. Phys. Med. Rehabil. Clin. N. Am. 2015;26(4):747–757. https://doi.org/10.1016/j.pmr.2015.06.001Fu M., Knutson J., Chae J. Stroke rehabilitation using virtual environments. Phys. Med. Rehabil. Clin. N. Am. 2015;26(4):747–757. https://doi.org/10.1016/j.pmr.2015.06.001Keshner E.A., Fung J. The quest to apply VR technology to rehabilitation: tribulations and treasures. Journal of Vestibular Research. 2017;27:1–5. https://doi.org/10.3233/VES-170610Keshner E.A., Fung J. The quest to apply VR technology to rehabilitation: tribulations and treasures. Journal of Vestibular Research. 2017;27:1–5. https://doi.org/10.3233/VES-170610Calabro S., Naro A., Russo M., Leo A., Luca R., Balletta T. et al. The role of virtual reality in improving motor performance as revealed by EEG: a randomized trial. J. Neuroeng. Rehabil. 2017;14:53. https://doi.org/10.1186/s12984-017-0268-4Calabro S., Naro A., Russo M., Leo A., Luca R., Balletta T. et al. The role of virtual reality in improving motor performance as revealed by EEG: a randomized trial. J. Neuroeng. Rehabil. 2017;14:53. https://doi.org/10.1186/s12984-017-0268-4Jaffe D.L., Brown D.A., Pierson-Carey C.D., Buckley E.L., Lew H.L. Stepping over obstacles to improve walking in individuals with poststroke hemiplegia. Journal of Rehabilitation Research & Development. 2004;41(3):283–292Jaffe D.L., Brown D.A., Pierson-Carey C.D., Buckley E.L., Lew H.L. Stepping over obstacles to improve walking in individuals with poststroke hemiplegia. Journal of Rehabilitation Research & Development. 2004;41(3):283–292Johansson B.B. Current trends in stroke rehabilitation. A review with focus on brain plasticity. Acta Neurol. Scand. 2011;123(3):147–159. https://doi.org/10.1111/j.1600-0404.2010.01417.xJohansson B.B. Current trends in stroke rehabilitation. A review with focus on brain plasticity. Acta Neurol. Scand. 2011;123(3):147–159. https://doi.org/10.1111/j.1600-0404.2010.01417.xMalouin F., Richards C. Mental Practice for Relearning Locomotor Skills. Physical Therapy. 2010;90(2):240–251. https://doi.org/10.2522/ptj.20090029Malouin F., Richards C. Mental Practice for Relearning Locomotor Skills. Physical Therapy. 2010;90(2):240–251. https://doi.org/10.2522/ptj.20090029Dunsky A., Dickstein R., Marcovitz E., Levy S., Deutsch J. Home-Based Motor Imagery Training for Gait Rehabilitation of People With Chronic Poststroke Hemiparesis. Archives of Physical Medicine and Rehabilitation. 2008;89(8):1580–1588. https://doi.org/10.1016/j.apmr.2007.12.039Dunsky A., Dickstein R., Marcovitz E., Levy S., Deutsch J. Home-Based Motor Imagery Training for Gait Rehabilitation of People With Chronic Poststroke Hemiparesis. Archives of Physical Medicine and Rehabilitation. 2008;89(8):1580–1588. https://doi.org/10.1016/j.apmr.2007.12.039Sacheli L.M., Zapparoli L., De Santis C., Preti M., Pelosi C., Ursino N. et al. Mental steps: Differential activation of internal pacemakers in motor imagery and in mental imitation of gait. Human Brain Mapping. 2017;38(10):5195–5216. https://doi.org/10.1002/hbm.23725Sacheli L.M., Zapparoli L., De Santis C., Preti M., Pelosi C., Ursino N. et al. Mental steps: Differential activation of internal pacemakers in motor imagery and in mental imitation of gait. Human Brain Mapping. 2017;38(10):5195–5216. https://doi.org/10.1002/hbm.23725Signal N. Strength training after stroke: rationale, evidence and potential implementation barriers for physiotherapists. New Zealand Journal of Physiotherapy. 2014;42(2):101–107.Signal N. Strength training after stroke: rationale, evidence and potential implementation barriers for physiotherapists. New Zealand Journal of Physiotherapy. 2014;42(2):101–107.Tong R., Ng M., Li L., So E. Gait Training of Patients After Stroke Using an Electromechanical Gait Trainer Combined With Simultaneous Functional Electrical Stimulation. Physical Therapy. 2006;86(9):1282–1294. https://doi.org/10.2522/ptj.20050183Tong R., Ng M., Li L., So E. Gait Training of Patients After Stroke Using an Electromechanical Gait Trainer Combined With Simultaneous Functional Electrical Stimulation. Physical Therapy. 2006;86(9):1282–1294. https://doi.org/10.2522/ptj.20050183Saunders D., Greig C., Mead G. Physical Activity and Exercise After Stroke. Stroke. 2014;45(12):3742–3747. https://doi.org/10.1161/STROKEAHA.114.004311Saunders D., Greig C., Mead G. Physical Activity and Exercise After Stroke. Stroke. 2014;45(12):3742–3747. https://doi.org/10.1161/STROKEAHA.114.004311Duncan P., Sullivan K., Behrman A., Azen S., Wu S., Nadeau S. et al. Body-Weight — Supported Treadmill Rehabilitation after Stroke. New England Journal of Medicine. 2011;364(21):2026–2036. https://doi.org/10.1056/NEJMoa1010790Duncan P., Sullivan K., Behrman A., Azen S., Wu S., Nadeau S. et al. Body-Weight — Supported Treadmill Rehabilitation after Stroke. New England Journal of Medicine. 2011;364(21):2026–2036. https://doi.org/10.1056/NEJMoa1010790

The authors declare that there are no conflicts of interest present.