1
|
Oh BH, Kim CS, Kim DS, Kim GW, Won YH, Ko MH, Seo JH, Park SH. Effects of robot exoskeletal-assisted gait training on gait ability in a pediatric patient with peripheral polyneuropathy: a case report. J Phys Ther Sci 2024; 36:583-587. [PMID: 39239406 PMCID: PMC11374170 DOI: 10.1589/jpts.36.583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 06/02/2024] [Indexed: 09/07/2024] Open
Abstract
[Purpose] This study aims to investigate the effects of robotic exoskeleton-assisted gait training on a pediatric patient with peripheral polyneuropathy. [Participant and Methods] A 10-year-old boy with lower extremity weakness attributed to peripheral polyneuropathy underwent a two-week program comprising 10 rehabilitation sessions of powered robotic exoskeleton-assisted gait training (REGT). He was evaluated before and after treatment using the 10-meter walk test, 6-minute walk test, Berg Balance Scale, the Timed Up and Go Test, the Functional Reach Test, the Modified Functional Reach Test, hip and knee flexion/extension angles, and cardiopulmonary exercise testing. [Results] The patient demonstrated improved gait speed, balance, joint mobility, cadence, the maximum oxygen consumption and metabolic equivalents after the REGT. [Conclusion] Robotic exoskeleton devices could provide additional benefits to pediatric patients with peripheral polyneuropathy, pending larger studies to confirm the significance of treatment.
Collapse
Affiliation(s)
- Byeong Hun Oh
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School: 20 Geonji-ro, Deokjin-gu, Jeonju-si, Jeollabuk-do 54907, Republic of Korea
| | - Chul-Su Kim
- Department of Physical Therapy, Jeonbuk National University Hospital, Republic of Korea
| | - Da-Sol Kim
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School: 20 Geonji-ro, Deokjin-gu, Jeonju-si, Jeollabuk-do 54907, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Republic of Korea
| | - Gi-Wook Kim
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School: 20 Geonji-ro, Deokjin-gu, Jeonju-si, Jeollabuk-do 54907, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Republic of Korea
| | - Yu-Hui Won
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School: 20 Geonji-ro, Deokjin-gu, Jeonju-si, Jeollabuk-do 54907, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Republic of Korea
| | - Myoung-Hwan Ko
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School: 20 Geonji-ro, Deokjin-gu, Jeonju-si, Jeollabuk-do 54907, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Republic of Korea
| | - Jeong-Hwan Seo
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School: 20 Geonji-ro, Deokjin-gu, Jeonju-si, Jeollabuk-do 54907, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Republic of Korea
| | - Sung-Hee Park
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School: 20 Geonji-ro, Deokjin-gu, Jeonju-si, Jeollabuk-do 54907, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Republic of Korea
| |
Collapse
|
2
|
Gavrila Laic RA, Firouzi M, Claeys R, Bautmans I, Swinnen E, Beckwée D. A State-of-the-Art of Exoskeletons in Line with the WHO's Vision on Healthy Aging: From Rehabilitation of Intrinsic Capacities to Augmentation of Functional Abilities. SENSORS (BASEL, SWITZERLAND) 2024; 24:2230. [PMID: 38610440 PMCID: PMC11014060 DOI: 10.3390/s24072230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024]
Abstract
The global aging population faces significant health challenges, including an increasing vulnerability to disability due to natural aging processes. Wearable lower limb exoskeletons (LLEs) have emerged as a promising solution to enhance physical function in older individuals. This systematic review synthesizes the use of LLEs in alignment with the WHO's healthy aging vision, examining their impact on intrinsic capacities and functional abilities. We conducted a comprehensive literature search in six databases, yielding 36 relevant articles covering older adults (65+) with various health conditions, including sarcopenia, stroke, Parkinson's Disease, osteoarthritis, and more. The interventions, spanning one to forty sessions, utilized a range of LLE technologies such as Ekso®, HAL®, Stride Management Assist®, Honda Walking Assist®, Lokomat®, Walkbot®, Healbot®, Keeogo Rehab®, EX1®, overground wearable exoskeletons, Eksoband®, powered ankle-foot orthoses, HAL® lumbar type, Human Body Posturizer®, Gait Enhancing and Motivation System®, soft robotic suits, and active pelvis orthoses. The findings revealed substantial positive outcomes across diverse health conditions. LLE training led to improvements in key performance indicators, such as the 10 Meter Walk Test, Five Times Sit-to-Stand test, Timed Up and Go test, and more. Additionally, enhancements were observed in gait quality, joint mobility, muscle strength, and balance. These improvements were accompanied by reductions in sedentary behavior, pain perception, muscle exertion, and metabolic cost while walking. While longer intervention durations can aid in the rehabilitation of intrinsic capacities, even the instantaneous augmentation of functional abilities can be observed in a single session. In summary, this review demonstrates consistent and significant enhancements in critical parameters across a broad spectrum of health conditions following LLE interventions in older adults. These findings underscore the potential of LLE in promoting healthy aging and enhancing the well-being of older adults.
Collapse
Affiliation(s)
- Rebeca Alejandra Gavrila Laic
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium; (R.A.G.L.); (M.F.); (R.C.); (D.B.)
| | - Mahyar Firouzi
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium; (R.A.G.L.); (M.F.); (R.C.); (D.B.)
- Brain, Body and Cognition Research Group, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
- Brubotics (Human Robotics Research Center), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
| | - Reinhard Claeys
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium; (R.A.G.L.); (M.F.); (R.C.); (D.B.)
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
- Brubotics (Human Robotics Research Center), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
| | - Ivan Bautmans
- FRIA, Frailty in Ageing, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
| | - Eva Swinnen
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium; (R.A.G.L.); (M.F.); (R.C.); (D.B.)
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
- Brubotics (Human Robotics Research Center), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
| | - David Beckwée
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium; (R.A.G.L.); (M.F.); (R.C.); (D.B.)
- Brubotics (Human Robotics Research Center), Vrije Universiteit Brussel, Pleinlaan 2, 1050 Elsene, Belgium
- FRIA, Frailty in Ageing, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
| |
Collapse
|
3
|
Bogaert A, Romanò F, Cabaraux P, Feys P, Moumdjian L. Assessment and tailored physical rehabilitation approaches in persons with cerebellar impairments targeting mobility and walking according to the International Classification of Functioning: a systematic review of case-reports and case-series. Disabil Rehabil 2023:1-23. [PMID: 37639546 DOI: 10.1080/09638288.2023.2248886] [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: 03/31/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE Cerebellar impairment (CI) manifests from different etiologies resulting in a heterogenic clinical presentation affecting walking and mobility. Case-reports were reviewed to provide an analytical clinical picture of persons with CI (PwCI) to differentiate cerebellar and non-cerebellar impairments and to identify interventions and assessments used to quantify impact on walking and mobility according to the International Classification of Functioning, Disability and Health (ICF). MATERIALS AND METHODS Literature was searched in PubMed, Web Of Science and Scopus. Case-reports conducting physical rehabilitation and reporting at least one outcome measure of ataxia, gait pattern, walking or mobility were included. RESULTS 28 articles with a total of 38 different patients were included. Etiologies were clustered to: spinocerebellar degenerations, traumatic brain injuries, cerebellar tumors, stroke and miscellaneous. The interventions applied were activity-based, including gait and balance training. Participation based activities such as tai chi, climbing and dance-based therapy had positive outcomes on mobility. Outcomes on body function such as ataxia and gait pattern were only reported in 22% of the patients. CONCLUSIONS A comprehensive test battery to encompass the key features of a PwCI on different levels of the ICF is needed to manage heterogeneity. Measures on body function level should be included in interventions.
Collapse
Affiliation(s)
- Anne Bogaert
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Francesco Romanò
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Pierre Cabaraux
- Service de Neurologie, Médiathèque Jean Jacquy, CHU-Charleroi, Charleroi, Belgium
| | - Peter Feys
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
- UMSC Hasselt, Pelt, Belgium
| | - Lousin Moumdjian
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
- UMSC Hasselt, Pelt, Belgium
- IPEM Institute of Psychoacoustics and Electronic Music, Faculty of Arts and Philosophy, Ghent University, Ghent, Belgium
| |
Collapse
|
4
|
Lamberti G, Sesenna G, Marina M, Ricci E, Ciardi G. Robot Assisted Gait Training in a Patient with Ataxia. Neurol Int 2022; 14:561-573. [PMID: 35893280 PMCID: PMC9326713 DOI: 10.3390/neurolint14030045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 12/02/2022] Open
Abstract
Background: Ataxia is a neurological sign characterized by motor coordination during gait/voluntary limb movements impairment. Ataxic gait leads to disability and worsening of quality of life; physiotherapy intervention is recommended to improve motor function. Recent studies showed benefits due to repetitive robotized assisted gait training using a static exoskeleton in patients affected by acquired ataxias. The aim of the study was to perform a preliminary evaluation of the short-term effects of overground UAN.GO®-assisted gait training in an adult patient with ataxia but with no clear genetic pattern. Methods: This case report study was conducted on a single male adult patient, who presented ataxic spastic gait, posterior chain tightness, pes cavus, and unstable standing position. The patient underwent two preliminary sessions to take part in the study. Treatment protocol planned 10 sessions and each one lasted 80 min, 60 of which were spent in gait training using the mobile overground exoskeleton UAN.GO®. At T1 (start of the study) and T10 (final evaluation) assessments using the Scale for the Assessment and Rating of Ataxia, Berg Balance Scale, 6-Minute Walking Test, and Likert Scale were administered. Space-time parameters of gait cycle were also evaluated: left and right step length, stance and swing percentages. Results: improvements on the Scale for the Assessment and Rating of Ataxia, Berg Balance Scale, and in the distance travelled at 6-Minute Walking Test emerged. The patient gave a positive opinion towards the treatment, showed by Likert Scale results. Kinematic gait analysis showed more physiological step length, stance and swing percentages, joint angles. The patient completed the training program with an excellent compliance. Discussion: Since these encouraging outcomes were obtained, it is possible to consider robot-assisted gait training performed with UAN.GO® as a therapeutic option to improve motor and functional performance in patients with ataxic gait.
Collapse
Affiliation(s)
- Gianfranco Lamberti
- Spinal Unit, Azienda Usl, 29121 Piacenza, Italy; (G.L.); (E.R.)
- Degree Course of Physiotherapy, University of Parma-Piacenza Training Center, Viale Abruzzo 12, 29017 Fiorenzuola d’Arda, Italy
| | | | - Martina Marina
- Degree Course of Physiotherapy Student, University of Parma-Piacenza Training Center, Viale Abruzzo 12, 29017 Fiorenzuola d’Arda, Italy;
| | - Emanuela Ricci
- Spinal Unit, Azienda Usl, 29121 Piacenza, Italy; (G.L.); (E.R.)
- Degree Course of Physiotherapy, University of Parma-Piacenza Training Center, Viale Abruzzo 12, 29017 Fiorenzuola d’Arda, Italy
| | - Gianluca Ciardi
- Spinal Unit, Azienda Usl, 29121 Piacenza, Italy; (G.L.); (E.R.)
- Degree Course of Physiotherapy, University of Parma-Piacenza Training Center, Viale Abruzzo 12, 29017 Fiorenzuola d’Arda, Italy
- Correspondence:
| |
Collapse
|
5
|
The Effects of Over-Ground Robot-Assisted Gait Training for Children with Ataxic Cerebral Palsy: A Case Report. SENSORS 2021; 21:s21237875. [PMID: 34883877 PMCID: PMC8659941 DOI: 10.3390/s21237875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/15/2021] [Accepted: 11/24/2021] [Indexed: 11/17/2022]
Abstract
Poor balance and ataxic gait are major impediments to independent living in ataxic cerebral palsy (CP). Robot assisted-gait training (RAGT) has been shown to improve the postural balance and gait function in children with CP. However, there is no report on the application of RAGT for children with ataxic CP. Here, we report two cases of children with ataxic CP who underwent over-ground RAGT along with conventional therapy for 4 weeks. Outcome measures including the gross motor function measure (GMFM), pediatric balance scale, pediatric reach scale, one-minute walk test, and Timed Up and Go test were assessed before and after the 4-week intervention. Both cases were well adapted to the RAGT system without any significant adverse event. Improvements in the GMFM after RAGT, compared with that in the GMFM, after intensive conventional therapy have been reported previously. It is noteworthy that over-ground RAGT improved areas of the GMFM that did not improve with conventional therapy. In addition, over-ground RAGT with conventional therapy led to improvements in functional balance and walking capacity. These findings suggest that over-ground RAGT is feasible and may be a potential option for enhancing balance and functional walking capacity in children with ataxic CP.
Collapse
|