Beyond conventional rehabilitation: an observational study on RYSEN body weight supported gait training in individuals after stroke and spinal cord injury

Purpose
The RYSEN body weight support device enables multidirectional overground gait training and can be combined with augmented reality (RYSEN-AR). The aim of this study was to investigate differences in training goals, intensity and acceptance between RYSEN, RYSEN-AR and conventional gait training (CGT) during rehabilitation.

Materials and Methods
Eleven individuals after stroke (60.1 ± 13.4 years) and eleven individuals with SCI (66.5 ± 13.2 years) performed CGT, RYSEN and RYSEN-AR as part of their rehabilitation program. Heart rate and trunk accelerometry data were collected to assess training intensity. Patients rated their confidence in balance control, level of conscious movement processing and training experiences using questionnaires. Therapists reported their intended training goals. The (interaction) effects of modality and group on these outcomes were assessed using linear mixed-effects models.

Results
Training intensity in terms of heart rate and trunk accelerometry did not differ between modalities. Confidence in balance control was higher during RYSEN-AR than during CGT (p = 0.004). The level of conscious movement processing did not differ between modalities. Training goals did not considerably differ between modalities overall. RYSEN and RYSEN-AR training were well-accepted among patients and therapists.

Conclusions
In current practice, there is limited distinction in terms of training intensity and goals between RYSEN and RYSEN-AR training relative to CGT. Further research, guideline development and implementation strategies are needed to use the RYSEN to its full potential in rehabilitation practice.

IMPLICATIONS FOR REHABILITATION

There is limited differentiation between RYSEN and RYSEN with augmented reality (RYSEN-AR) relative to conventional gait training in terms of training goals and intensity, which may indicate that the development of more clear and directive guidelines for the use of RYSEN and RYSEN-AR is necessary.

RYSEN and RYSEN-AR training are accepted equally well as conventional gait training among patients and therapists, providing opportunities for further implementation.

Further research may determine how RYSEN, RYSEN with augmented reality and conventional gait training could be used as complementary modalities in rehabilitation in order to support further implementation and the development of guidelines to use the RYSEN to its full potential.