Introduction
hemiplegia, death, Stroke, stroke, deaths, disability
STROKE, STROKE
Stroke is the second leading cause of mortality, comprising 11.8% of all deaths worldwide, and the third most common cause of combined disability and death worldwide [In the acute phase of recovery, frequent, intensive, repetitive and task-specific training with active patient participation has been proposed to enhance neuroplasticity that facilitates gait and functional recovery [A systematic review suggested that patients who receive robotic-assisted treadmill gait training and physiotherapy after stroke might attain more independent walking than patients who receive only conventional training [Despite the effectiveness of robot-assisted treadmill training, overground gait training is required to transfer the acquired skills to practical use in patients, improving the gait speed and endurance. Robotic Treadmill training does not permit the patient to experience real-world gait obstacles, such as walking on uneven terrain, stepping over objects, and stair climbing. Moreover, on treadmill robotics, patients walk with a pre-set speed and body weight support, creating an atmosphere where the patient might have less control in initiating each step and lack of alteration in visuospatial flow. These elements challenge optimum overground walking [Overground robotic devices incorporate wearable powered exoskeletons (e.g. Ekso). Patients with severe deficits, including dense hemiplegia, might be benefited with exoskeleton robotic training [The Mobility Assisted Robotic System-MARS used in the present trial is an overground gait training-assist robot, developed by Bionic Yantra, an Indian start up based in Bengaluru, India. The system can sense the movement of the patient through the harness system, which is integrated with the sensor feedback system, allowing the patient to practice gait training safely and independently. There is a paucity of literature on robotic overground gait training in stroke patients. This pre-post study was aimed to explore the clinical effects of overground walking training with Mobility Assisted Robotic System (MARS) on gait parameters in stroke patients.