Nándor Prontvai
57219258230
Publications - 8
Effects of walking training with and without a robot and standard care on clinical and mobility outcomes: A randomized clinical trial in acute ischemic stroke patients
Publication Name: Experimental Gerontology
Publication Date: 2025-10-15
Volume: 210
Issue: Unknown
Page Range: Unknown
Description:
Background: Stroke incidence rises with age. A stroke can severely affect walking ability, requiring therapy. Robot-assisted walking therapy (ROB) has been advocated as one form of walking rehabilitation in stroke patients. However, its comparative efficacy remains controversial and three-group comparisons are scant. We compared the effects of ROB, walking training therapy without a robot (WTT) and standard treatment therapy (STT) on clinical and mobility outcomes in acute ischemic stroke patients. Methods: Individuals (n = 45, 71 % males, age 64.4y ±6.34), who have recently experienced an ischemic stroke, were randomized to ROB, WTT or STT. Clinical and mobility outcomes were assessed before and after each intervention (3 weeks, 5 sessions/week) and after 5 weeks of no-intervention follow-up. Results: Outcomes did not differ between groups at baseline (p > 0.05). Modified Rankin Scale (primary outcome), improved (p < 0.05) after ROB and WTT vs. STT. These improvements were retained relative to baseline (p < 0.05) after follow-up. Barthel index, Berg Balance Scale, 10-m walking speed, the distance while walking with and without the robot for six minutes, and center pressure velocity in standing improved most after ROB (all p < 0.001), exceeding the changes after WTT which in turn were greater than the changes after STT (p ≤ 0.040). Conclusion: Older adults shortly after an ischemic stroke can quickly learn to walk with a soft robot and retain substantial clinical and mobility improvements at follow-up.
Open Access: Yes
Effectiveness of High-Intensity Therapy in Rehabilitation of Parkinson’s Disease Patients
Publication Name: Applied Sciences Switzerland
Publication Date: 2025-06-01
Volume: 15
Issue: 11
Page Range: Unknown
Description:
Parkinson’s disease (PD) is a progressive movement disorder with no cure. In this randomized controlled study, 100 patients with PD were assigned to four intervention groups (Exergame, Cycling, Agility, and Robot) for 14 weeks. This study evaluates the effectiveness of high-intensity therapy in a randomized clinical trial. Exergaming, cycling, agility, and robot therapies improved motor function, postural stability, and cardiovascular health. Heart rate monitoring and Borg Scale ratings confirmed the safety and adaptability of high-intensity training, with patients sustaining moderate-to-high exertion without adverse effects. Significant improvements were observed in gait speed (+0.30–0.50 m/s), Functional Independence Measure (FIM) (+25–30 points), and Berg Balance Scale scores. Integrating high-intensity, functional movement-based therapies into PD rehabilitation may offer superior motor, gait, and cardiovascular benefits compared to conventional methods.
Open Access: Yes
DOI: 10.3390/app15115890
Investigation of the Effectiveness of the Robotic ReStore Soft Exoskeleton in the Development of Early Mobilization, Walking, and Coordination of Stroke Patients: A Randomized Clinical Trial
Publication Name: Robotics
Publication Date: 2024-03-01
Volume: 13
Issue: 3
Page Range: Unknown
Description:
Medical robotics nowadays can prevent, treat, or alleviate numerous severe conditions, including the dire consequences of stroke. Our objective was to determine the effect of employing a robotic soft exoskeleton in therapy on the development of the early mobilization, gait, and coordination in stroke patients. The ReStore™ Soft Exo-Suit, a wearable exosuit developed by a leading company with exoskeleton technology, was utilized. It is a powered, lightweight device intended for use in stroke rehabilitation for people with lower limb disability. We performed a randomized clinical intervention, using a before–after trial design in a university hospital setting. A total of 48 patients with a history of stroke were included, of whom 39 were randomized and 30 completed the study. Interventions: Barthel Index and modified Rankin scale (mRS) patients were randomly assigned to a non-physical intervention control (n = 9 of 39 completed, 30 withdrew before baseline testing), or to a high-intensity agility program (15 sessions, 5 weeks, n = 30 completed). The main focus of assessment was on the Modified Rankin Scale. Additionally, we evaluated secondary factors including daily life functionality, five dimensions of health-related quality of life, the Beck depression inventory, the 6 min walk test (6MWT), the Berg Balance Scale (BBS), and static balance (center of pressure). The Robot-Assisted Gait Therapy (ROB/RAGT) program led to significant improvements across various measures, including a 37% improvement in Barthel Index scores, a 56% increase in 10 m walking speed, and a 68% improvement in 6 min walking distance, as well as notable enhancements in balance and stability. Additionally, the intervention group demonstrated significant gains in all these aspects compared to the control group. In conclusion, the use of robotic therapy can be beneficial in stroke rehabilitation. These devices support the restoration and improvement of movement in various ways and contribute to restoring balance and stability.
Open Access: Yes
Telerehabilitation After Brain Injuries: Its Efficacy and Role in Reducing Healthcare Burdens
Publication Name: Acta Polytechnica Hungarica
Publication Date: 2023-01-01
Volume: 20
Issue: 8
Page Range: 305-320
Description:
Rehabilitation following brain injuries, such as stroke and other traumatic injuries, presents significant challenges for both patients and healthcare systems. Traditional in-person rehabilitation often requires regular visits to specialized facilities, which can be difficult for patients in remote areas or those with mobility and financial constraints. Telerehabilitation offers a promising solution by enabling patients to continue essential therapy at home, ensuring continuity of care while reducing the burden on healthcare providers. It can be effectively applied across various patient groups, including children, adults, the elderly, amputees, individuals with traumatic neurological injuries, and those with neurocognitive impairments such as dementia. Our telemedicine platform integrates advanced technologies, i.e., 3D motion analysis and Virtual Reality (VR) to enhance home-based physiotherapy. These tools enable precise monitoring, real-time feedback, and immersive therapy sessions, in order to improve coordination, fine motor skills, hand-eye coordination, and the vestibular system, which is crucial for balance. This platform also performs detailed offline data analysis, allowing healthcare professionals to adjust therapy plans based on individual needs. As the demand for rehabilitation services continues to grow, adopting these technologies will be crucial for sustainable, effective healthcare, ultimately improving patient outcomes and shaping a more efficient and equitable future for healthcare systems.
Open Access: Yes
Virtual Reality in Cerebrovascular Rehabilitation: A Mini Review on Clinical Efficacy and Neurological Impacts
Publication Name: Acta Polytechnica Hungarica
Publication Date: 2023-01-01
Volume: 20
Issue: 8
Page Range: 321-336
Description:
The application of virtual reality (VR) technology in both upper and lower limb rehabilitation represents a significant advancement in the field of medicine. VR-based therapies provide patients with the opportunity to engage in intensive, repetitive, and targeted exercises that promote neuroplasticity and improve the motor skills necessary for daily life. VR has long been recommended for the rehabilitation of conditions such as in case of ischemic stroke, Parkinson’s disease, and multiple sclerosis, further underscoring its versatility and therapeutic potential. In our study, we evaluated the effectiveness of VR therapy focusing on stroke rehabilitation. The reviewed VR systems provided motion analysis, tracking, feedback reinforcement, and realistic environments to facilitate the restoration of motor functions. Furthermore, we developed a VR-based therapy aimed at both upper and lower limb motor functions, combined with traditional rehabilitation. The application of VR technology not only promotes the improvement of motor functions but also offers economic advantages by reducing the burden on healthcare workers and increasing rehabilitation capacity. Further research is needed to determine the optimal conditions for applying VR therapy in clinical practice.
Open Access: Yes
Measuring the Effectiveness of High-Intensity Virtual Training Programs in Stroke Survivors
Publication Name: Acta Polytechnica Hungarica
Publication Date: 2025-01-01
Volume: 22
Issue: 10
Page Range: 103-123
Description:
The objective of this paper is to determine and compare the effects of two high-intensity virtual training programs, with different frequencies and standard care after stroke. First-time ischaemic stroke patients in subacute stage were randomized into three groups: 1 session/day high-intensity virtual training (VT1; n=20), 2 sessions/day high-intensity virtual training (VT2, n=20), standard care (CON, n=20). Each group performed a 5-week-long training program (1 hour/session, 5 days/week). Results were measured before and after the interventions. Our primary outcome was the modified Rankin Scale (mRS), which indicates the degree of independence in daily activities and the severity of disability at stroke survivors. Secondary outcomes were the Barthel Index (BI), the EuroQoL Visual Analogue Scale (EQ VAS), the Berg Balance Scale (BBS), the 6-minute walking test (6mWT), the Beck Depression Inventory (BDI), and posturograpic examination in four different positions (WEO, WEC, NEO, NEC). VT2 and VT1 groups improved significantly all of the results (all p<0,05). The result of the mRS, BI, BBS, 6mWT, BDI improved significantly (all p <0.05) in CON group, but there was no clinically meaningful changes in EQ VAS, WEO, WEC, NEO, and NEC (all p>0.05).Comparing the groups’ measured 10 results: VT2 in 9 cases (mRS, BI, EQ VAS, BBS, 6mWT, BDI, WEC, NEO, NEC), VT1 in 5 cases (mRS, 6mWT, BDI, WEC, NEC) showed greater extent improvement than CON group, furthermore the improvements of mRS and BI were significantly higher at VT2, than at VT1 (all p<0.05). Our results show that the high-intensity virtual training programs could be good opportunities for subacute ischaemic stroke patients to improve their clinical symptoms, mobility, and quality of life. Furthermore, increasing daily frequency of the training, could also increase the beneficial effects. This research is particularly important because the utilized therapies have the potential to yield significant economic benefits, by reducing long-term healthcare costs and improving overall patient outcomes.
Open Access: Yes
Efficacy of Advanced Robotic and Virtual Therapy in the Treatment of Acute and Subacute Stroke Patients: a Feasibility Study
Publication Name: Acta Polytechnica Hungarica
Publication Date: 2025-01-01
Volume: 22
Issue: 10
Page Range: 83-102
Description:
The aim of this study is to compare the effectiveness of advanced robotic therapy, virtual therapy and conventional physiotherapy in the rehabilitation of patients with acute and subacute stroke. In addition, we aim to further demonstrate the importance of an early mobilisation exercise program in the management of acute stroke patients. Participants (first-time ischaemic stroke patients in acute or subacute stages) were randomly divided into three equal groups (n=10 persons/group): a robot-assisted early mobilisation + virtual reality therapy (ROB+VR) group, a robot-assisted early mobilisation + conventional physiotherapy (ROB+FIZ) group, and a conventional physiotherapy (CON) group. Each group performed a 3-week-long training program (1 hour/session, 5 days/week). The results were measured before and after the exercise. The primary outcome measure used was the modified Rankin Scale (mRS) which indicates the severity of disability in daily activities and measures the degree of independence of the individual. The secondary outcomes were measured by the EuroQoL 5 dimensions questionnaire 5 levels version (EQ-5D-5L), the Berg Balance Scale (BBS), the Barthel Index (BI), and the 6-minute walking test (6mWT). All the three groups showed improvements in most outcomes. The scores for BI, EQ-5D-5L, and mRS showed significant improvements in quality of life. Comparing the groups, the ROB+VR group showed the greatest improvement in the scores in almost all of the tests. From the test scores, the 6-minute walk test had the highest improvement at the end of the therapy (94.58% improvement). Our results show that early robotic mobilization, followed by a movement program, combined with a virtual reality therapy, significantly improve both the speed and quality of rehabilitation after a stroke.
Open Access: Yes
Value of Robotics: Comparison of Three Different High-Intensity Training Programs for Rehabilitation After Stroke
Publication Name: Sensors
Publication Date: 2025-12-01
Volume: 25
Issue: 24
Page Range: Unknown
Description:
Strokes are one of the leading causes of adult disability. There are a wide range of therapies available in stroke care for people with stroke, but there can be wide variations in the effectiveness of these therapies, so it is essential to review and compare them from time to time. In our study, we measured and compared the effectiveness of three high-intensity therapies: an agility training program without technological tools, a virtual reality exergaming training program with a low-cost device, and a high-cost robotic training program using augmented and virtual reality. All three therapies helped to improve the patients’ functional abilities, balance, and gait. On average, endurance increased by 104–177%, balance scores by 36–53%, and gait speed by 5–10% depending on the intervention. Robotic therapy and exergaming facilitate greater improvements in walking speed, step length, and balance-related gait metrics. These findings have profound implications for stroke rehabilitation, advocating for the prioritization of robotic and exergaming interventions over conventional functional therapies, like agility training. Given the limited sample size, the results should be interpreted as preliminary, highlighting the need for further studies with larger cohorts.
Open Access: Yes
DOI: 10.3390/s25247667
