Clinical Trials of a Stroke Rehabilitation Trainer Employing a Speed-Adapted Treadmill.

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.