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Fundarò C, Casale R, Maestri R, Traversoni S, Colombo R, Salvini S, Ferretti C, Bartolo M, Buonocore M, Giardini A. Technology Assisted Rehabilitation Patient Perception Questionnaire (TARPP-Q): development and implementation of an instrument to evaluate patients' perception during training. J Neuroeng Rehabil 2023; 20:35. [PMID: 36964543 PMCID: PMC10037786 DOI: 10.1186/s12984-023-01146-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 01/27/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND The introduction of technology-assisted rehabilitation (TAR) uncovers promising challenges for the treatment of motor disorders, particularly if combined with exergaming. Patients with neurological diseases have proved to benefit from TAR, improving their performance in several activities. However, the subjective perception of the device has never been fully addressed, being a conditioning factor for its use. The aims of the study were: (a) to develop a questionnaire on patients' personal experience with TAR and exergames in a real-world clinical setting; (b) to administer the questionnaire to a pilot group of neurologic patients to assess its feasibility and statistical properties. METHODS A self-administrable and close-ended questionnaire, Technology Assisted Rehabilitation Patient Perception Questionnaire (TARPP-Q), designed by a multidisciplinary team, was developed in Italian through a Delphi procedure. An English translation has been developed with consensus, for understandability purposes. The ultimate version of the questionnaire was constituted of 10 questions (5 with multiple answers), totalling 29 items, exploring the patient's performance and personal experience with TAR with Augmented Performance Feedback. TARPP-Q was then administered pre-post training in an observational, feasible, multi-centric study. The study involved in-patients aged between 18 and 85 with neurological diseases, admitted for rehabilitation with TAR (upper limb or gait). FIM scale was run to control functional performance. RESULTS Forty-four patients were included in the study. All patients answered the TARPP-Q autonomously. There were no unaccounted answers. Exploratory factor analyses identified 4 factors: Positive attitude, Usability, Hindrance perception, and Distress. Internal consistency was measured at T0. The values of Cronbach's alpha ranged from 0.72 (Distress) to 0.92 (Positive attitude). Functional Independence Measure (FIM®) scores and all TARPP-Q factors (Positive attitude, Usability, Hindrance perception, except for Distress (p = 0.11), significantly improved at the end of the treatment. A significant positive correlation between Positive attitude and Usability was also recorded. CONCLUSIONS The TARPP-Q highlights the importance of patients' personal experience with TAR and exergaming. Large-scale applications of this questionnaire may clarify the role of patients' perception of training effectiveness, helping to customize devices and interventions.
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Affiliation(s)
- Cira Fundarò
- Istituti Clinici Scientifici Maugeri Spa SB IRCCS Neurophysiopathology Unit of Montescano Institute, Pavia, PV, Italy.
| | - Roberto Casale
- OPUSMedica PC&R, Persons, Care & Research, Piacenza, Italy
| | - Roberto Maestri
- Istituti Clinici Scientifici Maugeri, IRCCS Department of Biomedical Engineering of Montescano Institute, Pavia, PV, Italy
| | - Silvia Traversoni
- Istituti Clinici Scientifici Maugeri IT Department, IRCCS Pavia, Pavia, PV, Italy
| | - Roberto Colombo
- Istituti Clinici Scientifici Maugeri IRCCS Veruno, Veruno, NO, Italy
| | - Silvana Salvini
- Istituti Clinici Scientifici Maugeri Spa SB IRCCS Neurophysiopathology Unit of Montescano Institute, Pavia, PV, Italy
| | - Chiara Ferretti
- Istituti Clinici Scientifici Maugeri IRCSS Neuromotor Rehabilitation Unit of Montescano Institute, Pavia, PV, Italy
| | - Michelangelo Bartolo
- Habilita Department of Rehabilitation, Neurorehabilitation Unit, HABILITA Zingonia, Ciserano, Bergamo, Italy
| | - Michelangelo Buonocore
- Istituti Clinici Scientifici Maugeri Spa SB IRCCS Neurophysiopathology Unit of Montescano Institute, Pavia, PV, Italy
| | - Anna Giardini
- Istituti Clinici Scientifici Maugeri IT Department, IRCCS Pavia, Pavia, PV, Italy
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The effectiveness of a novel cable-driven gait trainer (Robowalk) combined with conventional physiotherapy compared to conventional physiotherapy alone following stroke: a randomised controlled trial. Int J Rehabil Res 2020; 42:377-384. [PMID: 31567605 DOI: 10.1097/mrr.0000000000000375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
There is increasing interest in gait training devices to improve walking ability in people following stroke. This randomised controlled trial aimed to compare the effectiveness of the Robowalk, a novel cable-driven gait trainer combined with conventional physiotherapy to conventional physiotherapy alone in improving walking speed, endurance, balance, functional outcomes, and quality of life in people following stroke. Rehabilitation inpatients within 3 months following stroke (n = 40) were randomised to standard care with conventional physiotherapy ('control,' n = 20) and cable-driven gait trainer combined with conventional physiotherapy ('intervention,' n = 20). All participants received 1 hour of physiotherapy a day, 5 days a week. The control group received conventional physiotherapy only; the intervention group received a combination of 30 minutes of conventional physiotherapy and 30 minutes of cable-driven gait trainer consecutively. Outcome measures were 10-metre walk test (primary outcome), 6-minute walk test, timed up and go, step test, Functional Independence Measure, and EuroQol five-dimension scale. Evaluation timepoints were on admission (T0), discharge (T1), and 4 weeks post discharge (T2). There were no differences between groups at T0, T1, and T2 in all outcome measures although there was a trend towards a larger and more sustained improvement in 10-metre walk test in favour of the intervention group and in Functional Independence Measure motor and self-care in favour of the control group, both at T2. The combination of cable-driven gait trainer with conventional physiotherapy appears as effective as conventional physiotherapy alone in improving gait outcomes in people following a recent stroke. Further studies are required to confirm these findings and determine optimal dosing regimens and long-term outcomes.
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Reichl S, Weilbach F, Mehrholz J. Implementation of a gait center training to improve walking ability and vital parameters in inpatient neurological rehabilitation- a cohort study. J Neuroeng Rehabil 2020; 17:38. [PMID: 32131857 PMCID: PMC7055071 DOI: 10.1186/s12984-020-00669-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 02/27/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Many studies showed that robot-assisted gait training might improve walking of patients after stroke. The question remains whether patients with other neurological diagnoses can improve their ability to walk by training in a gait center. Aim of the present study was therefore to investigate the effects of a gait center training in inpatient neurological rehabilitation on walking ability. METHODS We implemented a gait center training in addition to individual inpatient rehabilitation. Our primary outcome was walking ability based on the Functional Ambulation Categories (FAC). Our secondary outcomes were vital capacity and blood pressure. We predefined subgroups of patients with ischemic and hemorrhagic stroke and critical illness myopathy (CIM) and polyneuropathy (CIP). RESULTS We included 780 patients from our inpatient rehabilitation center in our cohort study. We analyzed 329 patients with ischemic, 131 patients with hemorrhagic stroke and 74 patients with CIP/ CIM. A large number of patients were able to improve their ability to walk. At the end of rehabilitation, patients with ischemic stroke and FAC 3 = increased theirFAC scores by 5%, FAC 4 = 4% and FAC 5 = 7%. Patients with hemorrhagic stroke and FAC 3 = increased by 5%, FAC 4 = 11% and FAC 5 = 9% and patients with CIP/CIM increased by FAC 3 = 3%, FAC 4 = 22% and FAC 5 = 26%. The largest improvement in walking ability during rehabilitation had patients with a FAC = 1 at baseline who improved by a median of 1.4 FAC points (p < 0.001). After adjusting for the number of gait training sessions, the largest improvement in walking ability during rehabilitation had patients with a FAC = 0 at baseline who improved by 1.8 FAC points (p < 0.001). CONCLUSIONS Implementation of an additional gait center training may significantly improve walking ability in neurological rehabilitation.
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Affiliation(s)
- Stephanie Reichl
- Klinik Bavaria Bad Kissingen, Von-der-Tann-Straße 18- 22, 97688, Bad Kissingen, Germany
| | - Franz Weilbach
- Klinik Bavaria Bad Kissingen, Von-der-Tann-Straße 18- 22, 97688, Bad Kissingen, Germany
| | - Jan Mehrholz
- Department of Public Health, Dresden Medical School, Technical University Dresden, 01062, Dresden, Germany. .,Wissenschaftliches Institut, Private Europäische Medizinische Akademie der Klinik Bavaria in Kreischa GmbH, An der Wolfsschlucht 1-2, 01731, Kreischa, Germany.
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Chaparro-Cárdenas SL, Lozano-Guzmán AA, Ramirez-Bautista JA, Hernández-Zavala A. A review in gait rehabilitation devices and applied control techniques. Disabil Rehabil Assist Technol 2018; 13:819-834. [PMID: 29577779 DOI: 10.1080/17483107.2018.1447611] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE The aim of this review is to analyse the different existing technologies for gait rehabilitation, focusing mainly in robotic devices. Those robots help the patient to recover a lost function due to neurological gait disorders, accidents or after injury. Besides, they facilitate the identification of normal and abnormal features by registering muscle activity providing the doctor important data where he can observe the evolution of the patient. METHOD A deep literature review was realized using selected keywords considering not only the most common medical and engineering databases, but also other available sources that provide information on commercial and scientific gait rehabilitation devices. The founded literature for this review corresponds to control techniques for gait rehabilitation robots, since the early seventies to the present year. RESULTS Different control strategies for gait analysis in rehabilitation devices have been developed and implemented such as position control, force and impedance control, haptic simulation, and control of EMG signals. These control techniques are used to analyze the force of the patient during therapy, compensating it with the force generated by the mechanism in the rehabilitation device. It is observed that the largest number of studies reported, focuses on the impedance control technique. Leading to include new control techniques and validate them using the necessary protocols with ill patients, obtaining reliable results that allows a progressive and active rehabilitation. CONCLUSIONS With this exhaustive review, we can conclude that the degree of complexity of the rehabilitation device influences in short and long-term therapeutic results since the movements become more controlled. However, there is still a lot of work in the sense of motion control in order to perform trajectories that are more alike the natural movements of humans. There are many control techniques in other areas, which seek to improve the performance of the process. These techniques may possibly be applicable in gait rehabilitation devices, obtaining controllers that are more efficient and that adapts to different people and the necessities that entail every disease. Implications for Rehabilitation Rehabilitation helps people to improve the activities of their daily life, allowing them to observe their progress in the functional abilities as the months pass by with intensive and repetitive therapies. There is a mobility issue when the patient needs to move to the hospital or to the laboratory, which is not always feasible. For overcoming it, patients use the equipment at home to perform their daily therapy. However, they need the sufficient knowledge about its operation, also about the therapeutic movements, the therapy duration and the movement speed. Besides, is necessary to place the equipment in a proper and lively environment that helps to forget or reduce pain while the patient moves his joints progressively. The purpose of robotic rehabilitation devices is to generate repetitive and progressive movements, according to the motor disability. There are training trajectories to follow, which motivate patients to generate active movements. The benefits of robotic rehabilitation depend on the ability of each patient to adapt to the speed and load variations generated by the device, improving and reinforcing motor functions in therapy, especially in patients with advanced disabilities in early rehabilitation. Multi-joint rehabilitation devices are more effective than single-joint rehabilitation devices because they involve a higher number of muscles in the therapy. The greater the number of degrees of freedom (DoF) of the device, it cushions its effect in the patient because the inertia is reduced and higher torques are generated. The assistive technological devices allows to explore different rehabilitation techniques that motivate the patient in therapy, increasing appropriately the energy and pressure in the blood which is reflected in gradually recovering his ability to walk.
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Affiliation(s)
- Silvia L Chaparro-Cárdenas
- a Department of Mechatronics , Centro de Investigación en Ciencia Aplicada y Tecnología Avanzada - Instituto Politécnico Nacional , Querétaro , Querétaro , México
| | - Alejandro A Lozano-Guzmán
- a Department of Mechatronics , Centro de Investigación en Ciencia Aplicada y Tecnología Avanzada - Instituto Politécnico Nacional , Querétaro , Querétaro , México
| | - Julian Andres Ramirez-Bautista
- a Department of Mechatronics , Centro de Investigación en Ciencia Aplicada y Tecnología Avanzada - Instituto Politécnico Nacional , Querétaro , Querétaro , México
| | - Antonio Hernández-Zavala
- a Department of Mechatronics , Centro de Investigación en Ciencia Aplicada y Tecnología Avanzada - Instituto Politécnico Nacional , Querétaro , Querétaro , México
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Lee JH, Min DK, Choe HS, Lee JH, Shin SH. The effects of upper and lower limb position on symmetry of vertical ground reaction force during sit-to-stand in chronic stroke subjects. J Phys Ther Sci 2018; 30:242-247. [PMID: 29545686 PMCID: PMC5851355 DOI: 10.1589/jpts.30.242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 11/15/2017] [Indexed: 12/02/2022] Open
Abstract
[Purpose] The purpose of this study was to evaluate the influence of arm and leg posture
elements on symmetrical weight bearing during Sit to Stand tasks in chronic stroke
patients. [Subjects and Methods] The subjects were diagnosed with stroke and 22 patients
(15 males and 7 females) participated in this study. All participants performed Sit to
Stand tasks on three foot postures and two arm postures. Two force plates were used to
measure peak of vertical ground reaction force and symmetrical ratio to peak Fz. The data
were analyzed using independent t-test and two-way repeated ANOVA. [Results] The results
of this study are as follows: 1) Peak Fz placed more weight in non-paretic leg during Sit
to Stand. 2) A symmetrical ratio to Peak Fz indicated significant difference between foot
and arm posture, and had non-paretic limb supported on a step and paretic at ground level
(STP) and grasped arm posture that lock fingers together with shoulder flexion by 90°(GA)
(0.79 ± 0.09). [Conclusion] These results suggest that STP posture of the legs and GA
posture of the arms should be able to increase the use of the paretic side during Sit to
Stand behavior and induce normal Sit to Stand mechanism through the anterior tilt of the
hip in clinical practices, by which loads onto the knee joint and the ankle joint can be
reduced, and the trunk righting response can be promoted by making the back fully
stretched. The outcome of this study is expected to be a reference for exercise or
prognosis of Sit to Stand in stroke patients.
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Affiliation(s)
- Jae Hong Lee
- Department of Physical Therapy, Daegu Health College: 15 Youngsongro, Bukgu, Daegu 702-722, Republic of Korea
| | - Dong Ki Min
- Department of Physical Therapy, Daegu Health College: 15 Youngsongro, Bukgu, Daegu 702-722, Republic of Korea
| | - Han Seong Choe
- Department of Physical Therapy, Catholic University of Daegu, Republic of Korea
| | - Jin Hwan Lee
- Department of Physical Therapy, Daegu Health College: 15 Youngsongro, Bukgu, Daegu 702-722, Republic of Korea
| | - So Hong Shin
- Department of Nursing Science, Kyongbuk College of Science, Republic of Korea
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Cho KH, Pyo S, Shin GS, Hong SD, Lee SH, Lee D, Song S, Lee G. A novel one arm motorized walker for hemiplegic stroke survivors: a feasibility study. Biomed Eng Online 2018; 17:14. [PMID: 29378582 PMCID: PMC5789543 DOI: 10.1186/s12938-018-0446-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 01/17/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND A hemiplegic stroke survivor with a moderate to severe gait disturbance may have difficulty walking using a one-arm walker. This study aimed to test the safety and feasibility of a prototype one-arm motorized walker that uses a power-driven device to provide gait assistance to hemiplegic stroke survivors with moderate to severe gait disturbances. METHODS A one-arm motorized walker with a power-driven device was developed and tested with respect to 10 distinct variables, including weight, degrees of freedom, handle, handle substitution function, two-sided use function, variable handle height, redirecting function, electric moving parts through the handle control, brake function using the handle control, folding chairs, and design stability. Its safety and feasibility were tested in 19 hemiplegic stroke individuals using the Likert scale and a simple interview. RESULTS The walker consists of a frame platform including a handle, electric motor for driving, one wheel for driving, two wheels for turning, unlocking sensor, driving button, and turning buttons. The walker is programmed so that a touch sensor in the handle can unlock the locking system. Furthermore, it is programmed so that a user can propel it by pushing the handle downward or pressing a button and can control directions for turning right or left by pressing buttons. Safety and performance testing was achieved for 10 separate variables, and a Likert scale score of 3.5 of 5 was recorded. CONCLUSION This walker's novel design was developed for hemiplegic stroke survivors with moderate to severe gait disturbances. Our findings indicate that the walker is both safe and feasible for providing walking assistance to hemiplegic stroke survivors and establish the potential advantages of the one-arm motorized walker.
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Affiliation(s)
- Ki-Hun Cho
- Department of Physical Therapy, Korea National University of Transportation, Chungju, 27469 Republic of Korea
- Department of Rehabilitative & Assistive Technology, National Rehabilitation Research Institute, National Rehabilitation Center, Seoul, 01022 Republic of Korea
| | - SeungHyeon Pyo
- Department of Physical Therapy, Graduate School of Kyungnam University, Changwon, 51767 Republic of Korea
| | - Gi-Su Shin
- Anytoy Co., Ltd., Changwon, 51233 Republic of Korea
| | | | - Se-Han Lee
- Department of Mechanical Engineering, Kyungnam University, Changwon, 51767 Republic of Korea
| | - DongGeon Lee
- Department of Physical Therapy, Graduate School of Kyungnam University, Changwon, 51767 Republic of Korea
| | - SunHae Song
- Department of Physical Therapy, Graduate School of Kyungnam University, Changwon, 51767 Republic of Korea
| | - GyuChang Lee
- Department of Physical Therapy, Kyungnam University, 7 Kyungnamdaehak-ro, Masanhappo-gu, Changwon, Gyeongsangnam-do 51767 Republic of Korea
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Swinnen E, Lefeber N, Willaert W, De Neef F, Bruyndonckx L, Spooren A, Michielsen M, Ramon T, Kerckhofs E. Motivation, expectations, and usability of a driven gait orthosis in stroke patients and their therapists. Top Stroke Rehabil 2016; 24:299-308. [PMID: 27996894 DOI: 10.1080/10749357.2016.1266750] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND In the development of efficacious driven gait orthoses (DGO), it is an added value to consider patients' and therapists' perspectives concerning robot-assisted gait training (RAGT). A better understanding of these issues may improve the process of care and outcome. OBJECTIVES This study aimed to examine stroke patients' motivation and expectations of RAGT, and therapists' expectations and perspectives on the usability of RAGT. Additionally, the differences in expectations between stroke patients and their therapists were analyzed. METHODS A cross sectional, multi-center, three-group trial was conducted. Included were (1) stroke patients who have experience with RAGT (i.e. the stroke user group), (2) stroke patients who have no experience with RAGT (i.e. the stroke non-user group), and (3) therapists who have experience with RAGT (i.e. the therapist user group). The Intrinsic Motivation Inventory (IMI), Credibility/Expectancy Questionnaire (CEQ), and Usefulness, Satisfaction and Ease of Use Questionnaire (USE) were used. Descriptive statistics and non-parametric Kruskal-Wallis tests were conducted. RESULTS In total, 46 subjects were assessed (stroke user group: n = 23, stroke non-user group: n = 14, therapist user group: n = 9). IMI subscale scores ranged from 42 to 88%. Mean credibility and expectancy ranged from 80 to 85% and 57 to 72%, respectively, with no significant differences between groups. USE subscale scores ranged from 61 to 72%. CONCLUSIONS Stroke user group patients seem quite motivated to train with the DGO and both patients and therapists reasonably believe that this training could improve gait functioning. Therapists are moderately satisfied with the usability of the DGO, but there is room for improvement with respect to usefulness and ease of use.
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Affiliation(s)
- Eva Swinnen
- a Rehabilitation Research - Neurological Rehabilitation, Department of Physiotherapy, Human Physiology and Anatomy , Vrije Universiteit Brussel , Brussels , Belgium.,b Center for Neurosciences , Vrije Universiteit Brussel , Brussels , Belgium.,c BruBotics , Vrije Universiteit Brussel , Brussels , Belgium
| | - Nina Lefeber
- a Rehabilitation Research - Neurological Rehabilitation, Department of Physiotherapy, Human Physiology and Anatomy , Vrije Universiteit Brussel , Brussels , Belgium.,b Center for Neurosciences , Vrije Universiteit Brussel , Brussels , Belgium.,c BruBotics , Vrije Universiteit Brussel , Brussels , Belgium
| | - Ward Willaert
- a Rehabilitation Research - Neurological Rehabilitation, Department of Physiotherapy, Human Physiology and Anatomy , Vrije Universiteit Brussel , Brussels , Belgium
| | - Fallon De Neef
- a Rehabilitation Research - Neurological Rehabilitation, Department of Physiotherapy, Human Physiology and Anatomy , Vrije Universiteit Brussel , Brussels , Belgium
| | - Lyn Bruyndonckx
- a Rehabilitation Research - Neurological Rehabilitation, Department of Physiotherapy, Human Physiology and Anatomy , Vrije Universiteit Brussel , Brussels , Belgium
| | - Annemie Spooren
- d Centre of Expertise - Care in Innovation , PXL University College , Hasselt , Belgium.,e Faculty of Medicine and Life Sciences, REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute , Hasselt University , Hasselt , Belgium
| | - Marc Michielsen
- f St. Ursula Rehabilitation Centre , Jessa Hospital , Herk-de-Stad , Belgium
| | - Tine Ramon
- g AZ Delta Hospital , Roeselare , Belgium
| | - Eric Kerckhofs
- a Rehabilitation Research - Neurological Rehabilitation, Department of Physiotherapy, Human Physiology and Anatomy , Vrije Universiteit Brussel , Brussels , Belgium.,b Center for Neurosciences , Vrije Universiteit Brussel , Brussels , Belgium.,c BruBotics , Vrije Universiteit Brussel , Brussels , Belgium
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Min DG, Lee JH, Choe HS, Kim EJ, Shin SH, Lee JH. Comparison of bone density on the dominant and nondominant sides between healthy elderly individuals and stroke patients. J Phys Ther Sci 2016; 28:2533-2536. [PMID: 27799687 PMCID: PMC5080169 DOI: 10.1589/jpts.28.2533] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 05/23/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study evaluated differences between healthy elderly individuals and stroke
patients by comparing their dominant and nondominant sides. [Subjects and Methods]
Thirty-five elderly individuals participated in this study and divided into a stroke group
and a control group. The outcome measures were general characteristics and bone mineral
density. Bone mineral density was evaluated by using the osteoporosis index. OsteoPro,
T score, and Z score were used for the calcaneus
region of the dominant side, and OsteoPro was used for that of the nondominant side. Data
were analyzed by using the SPSS 12.0 software, paired-samples t-test, and
independent-samples t-test. [Results] The T and Z scores
showed no significant differences between the dominant and recessive sides in the control
group. However, the stroke group showed significant differences in osteoporosis index,
T score, and Z score between the paretic and
nonparetic sides. Changes in the scores between the recessive and dominant sides showed
significant differences between the two groups. [Conclusion] A positive relationship was
found between physical activity and bone mineral density in the stroke patients.
Therefore, improved physical activity can be beneficial by reducing osteoporosis in stroke
patients.
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Affiliation(s)
- Dong Gi Min
- Department of Rehabilitation Medicine, Keimyung University Dongsan Medicine Center, Republic of Korea
| | - Jae Hong Lee
- Department of Physical Therapy, Daegu Health College, Republic of Korea
| | - Han Seong Choe
- Department of Physical Therapy, Catholic University of Daegu, Republic of Korea
| | - Eun Jung Kim
- Department of Physical Therapy, Masan College, Republic of Korea
| | - So Hong Shin
- Department of Nursing Science, Kyongbuk College of Science, Republic of Korea
| | - Jin Hwan Lee
- Department of Physical Therapy, Daegu Health College, Republic of Korea
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Yoshimoto T, Shimizu I, Hiroi Y. Sustained effects of once-a-week gait training with hybrid assistive limb for rehabilitation in chronic stroke: case study. J Phys Ther Sci 2016; 28:2684-2687. [PMID: 27799720 PMCID: PMC5080202 DOI: 10.1589/jpts.28.2684] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 05/23/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate the accumulated and sustained effects of once-a-week gait training with a powered exoskeleton suit, Hybrid Assistive Limb, in a subject with chronic stroke. [Subject and Methods] The subject was a woman in her early sixties who had stroke onset approximately 5 years ago. A single-case ABA design was used. A 2-month baseline period was followed by an 8-week period of weekly gait training and a subsequent 2-month follow-up period. Throughout the study period, she underwent conventional physiotherapy. Outcome measures were the 10-meter walking test, timed up and go test, functional reach test, two-step test, and Berg Balance Scale. [Results] Significant improvements were seen in all outcome measures during the gait training period. Improvements in all outcome measures except walking speed were maintained at follow-up. [Conclusion] Continued gait training with Hybrid Assistive Limb once a week can improve gait and balance performance in patients with chronic stroke, and these improvements are maintained at least for two months.
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Affiliation(s)
| | - Issei Shimizu
- Department of Rehabilitation, Kameda Medical Center, Japan
| | - Yasuhiro Hiroi
- Department of Rehabilitation, Kameda Medical Center, Japan
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Kasai R, Takeda S. The effect of a hybrid assistive limb(®) on sit-to-stand and standing patterns of stroke patients. J Phys Ther Sci 2016; 28:1786-90. [PMID: 27390416 PMCID: PMC4932057 DOI: 10.1589/jpts.2016.1786] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 02/29/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The Hybrid Assistive Limb(®) (HAL(®)) robot suit is a powered exoskeleton that can assist a user's lower limb movement. The purpose of this study was to assess the effectiveness of HAL(®) in stroke rehabilitation, focusing on the change of the sit-to-stand (STS) movement pattern and standing posture. [Subjects and Methods] Five stroke patients participated in this study. Single leg HAL(®) was attached to each subject's paretic lower limb. The subjects performed STS three times both with and without HAL(®) use. A tri-axial accelerometer was used to assess the STS movement pattern. Forward-tilt angle (FTA) and the time required for STS were measured with and without HAL(®) use. Surface electromyography (EMG) of STS and standing were recorded to assess the vastus medialis muscle activities of the paretic limb. [Results] The average FTA without HAL(®) use was 35° and it improved to 43° with HAL(®) use. The time required for STS was longer for all subjects with HAL(®) use (without HAL(®) use: 3.42 s, with HAL(®) use: 5.11 s). The integrated EMGs of HAL(®) use compared to those without HAL(®), were 83.6% and 66.3% for STS and standing, respectively. [Conclusion] HAL(®) may be effective in improving STS and standing patterns of stroke patients.
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Affiliation(s)
- Rie Kasai
- Department of Physical Therapy, International University of Health and Welfare, Japan
| | - Sunao Takeda
- Waseda Research Institute for Science and Engineering, Japan
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