Comparison of Heart Rate Reserve-Guided and Ratings of Perceived Exertion-Guided Methods for High-Intensity Robot-Assisted Gait Training in Patients With Chronic Stroke Focused on the Motor Function and Gait Ability

The present study was to compare the effectiveness of heart rate reserve (HRR)-guided high-intensity robot-assisted gait training (RAGT) to RPE-guided high-intensity RAGT on motor function and gait ability in patients with chronic stroke. The HRR-guided high-intensity RAGT group received the RAGT at 70% of HRR, whereas the RPE-guided high-intensity RAGT group received RAGT at RPE of 15. Both groups received their assigned therapy for 30 minutes per session, 3 days per week for 6 weeks. HRR-guided high-intensity RAGT group was significantly more improved than the RPE-guided high-intensity RAGT group in Fugl-Meyer assessment Lower extremity score, walking speed, cadence, step length, stride length, swing time, double support rate, single support rate, symmetrical index of swing, symmetrical index of stance, and 10-m velocity test (P<.05). Thus, HRR-guided high-intensity RAGT group improved in terms of motor function, gait ability, and controlled symmetric gait pattern more than the RPE-guided high-intensity RAGT group by physiological gait training at more high intensity. These results suggest that HRR-guided high-intensity RAGT group is safe and effective for improvement of motor function and gait ability in chronic stroke.