Journal of the Korean Burn Society (대한화상학회지)

Korean Burn Society (대한화상학회)
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The Pilot Study of Robot-Assisted Training for the Lower Extremity Rehabilitation of Burn Patients

하지 화상 환자의 재활치료를 위한 보행보조 로봇훈련의 선행연구

  • Cho, Yoon Soo (Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Noh, Min Hye (Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Joo, So Young (Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Seo, Cheong Hoon (Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University)
  • 조윤수 (한림대학교 한강성심병원 재활의학과) ;
  • 노민혜 (한림대학교 한강성심병원 재활의학과) ;
  • 주소영 (한림대학교 한강성심병원 재활의학과) ;
  • 서정훈 (한림대학교 한강성심병원 재활의학과)
  • Received : 2020.05.19
  • Accepted : 2020.06.23
  • Published : 2020.12.31
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Abstract

Purpose: Scar contracture influence the outcome of burn patients significantly. This study aims to investigate the feasibility of robot-assisted training for the lower extremity rehabilitation of burn patients. Methods: This pilot study was conducted on 7 burn patients for 8 weeks between January 2019 and November 2019. Two of 7 patients withdrew from this study because one had skin abrasion on the legs which thigh fastening devices were applied on and the other was not participate in the assessment at 4 weeks after training. Final 5 patients received gait training with SUBAR® and numeric rating scale (NRS), 6-minutes walking test, and range of motion in flexion and extension of knee and ankle joint were evaluated before training, 4 weeks and 12 weeks after training. Results: The subjects had a mean age of 51.8±98 years, mean total burn surface area of 30.8±13.7%, mean duration from injury to 1st assessment of 102.8±39.3 days. Anyone of 5 patients did not have musculoskeletal or cardiovascular side effects such as increased or decreased blood pressure or dizziness. The significant improvement in NRS, gait speed, and range of motion in knee extension and ankle plantarflexion after robotic training (all P<0.05). Conclusion: Robot-assisted training could be feasible for the rehabilitation of burn patients and it could improve muscle strength and range of motion in lower extremities, and gait function.

Keywords

Acknowledgement

This work was supported by Market Creation Robot Supply Project 2018 through the Ministry of Trade, Industry and Energy of the Republic of Korea and Korea institute for robot industry advancement (Medical & Rehabilitation Robot Pilot Program 2018).

References

  1. Oosterwijk AM, Mouton LJ, Schouten H, Disseldorp LM, van der Schans CP, Nieuwenhuis MK. Prevalence of scar contractures after burn: a systematic review. Burns 2017;43:41-9. https://doi.org/10.1016/j.burns.2016.08.002
  2. Oosterwijk AM, Mouton LJ, Akkerman M, Stoop MM, van Baar ME, Scholten-Jaegers SMH, et al. Course of prevalence of scar contractures limiting function: A preliminary study in children and adolescents after burns. Burns 2019;45:1810-18. https://doi.org/10.1016/j.burns.2019.05.003
  3. Tan J, Chen J, Zhou J, Song H, Deng H, Ao M, et al. Joint contractures in severe burn patients with early rehabilitation intervention in one of the largest burn intensive care units in China: a descriptive analysis. Burns Trauma 2019;7:17. https://doi.org/10.1186/s41038-019-0151-6
  4. Richard R, Baryza MJ, Carr JA, Dewey WS, Dougherty ME, Forbes-Duchart L, et al. Burn rehabilitation and research: proceedings of a consensus summit. J Burn Care Res 2009;0:543-73. https://doi.org/10.1097/BCR.0b013e3181adcd93
  5. Richard R, Santos-Lozada AR. Burn patient acuity demographics, scar contractures and rehabilitation treatment time related to patient outcomes: the ACT study. J Burn Care Res 2017;38:230-42. https://doi.org/10.1097/BCR.0000000000000490
  6. Richard R, Santos-Lozada AR, Dewey WS, Chung KK. Profile of patients without burn scar contracture development. J Burn Care Res 2017;38:e62-e69. https://doi.org/10.1097/BCR.0000000000000418
  7. Esselman PC. Burn rehabilitation: an overview. Arch Phys Med Rehab 2007;88:S3-S6. https://doi.org/10.1016/j.apmr.2007.09.020
  8. Van Peppen RP, Kwakkel G, Wood-Dauphinee S, Hendriks HJ, Van der Wees PJ, Dekker J. The impact of physical therapy on functional outcomes after stroke: what's the evidence? Clin Rehabil 2004;18:833-62. https://doi.org/10.1191/0269215504cr843oa
  9. Bayona NA, Bitensky J, Salter K, Teasell R. The role of task-specific training in rehabilitation therapies. Top Stroke Rehabil 2005;12:58-65.
  10. Langhammer B, Stanghelle JK. Bobath or motor relearning program? A comparison of two different approaches of physiotherapy in stroke rehabilitation: a randomized controlled study. Clin Rehabil 2000;14:361-9. https://doi.org/10.1191/0269215500cr338oa
  11. Richards CL, Malouin F, Wood-Dauphinee S, Williams JI, Bouchard JP, Brunet D. Task-specific physical therapy for optimization of gait recovery in acute stroke patients. Arch Phys Med Rehab 1993;74:612-20. https://doi.org/10.1016/0003-9993(93)90159-8
  12. Nilsson A, Vreede KS, Haglund V, Kawamoto H, Sankai Y, Borg J. Gait training early after stroke with a new exoskeleton - the hybrid assistive limb: a study of safety and feasibility. J Neuroeng Rehabil 2014;11:92. https://doi.org/10.1186/1743-0003-11-92
  13. Sczesny-Kaiser M, Hoffken O, Aach M, Cruciger O, Grasmucke D, Meindl R, et al. HALI exoskeleton training improves walking parameters and normalizes cortical excitability in primary somatosensory cortex in spinal cord injury patients. J Neuroeng Rehabil 2015;12:68. https://doi.org/10.1186/s12984-015-0058-9
  14. Galli M, Cimolin V, De Pandis MF, Le Pera D, Sova I, Albertini G, et al. Robot-assisted gait training versus tread-mill training in patients with Parkinson's disease: a kinematic evaluation with gait profile score. Funct Neurol 2016;31:163.
  15. Li J, Wu T, Xu Z, Gu X. A pilot study of post-total knee replacement gait rehabilitation using lower limbs robot-assisted training system. Eur J Orthop Surg Tr 2014;24:203-8. https://doi.org/10.1007/s00590-012-1159-9
  16. Setoguchi D, Kinoshita K, Kamada S, Sakamoto T, Kise N, Kotani N, et al. Hybrid Assistive Limb improves restricted hip extension after total hip arthroplasty. Assist Technol 2020 (just-accepted). https://doi.org/10.1080/10400435.2011.648717
  17. Hoffman HG, Patterson DR, Carrougher GJ. Use of virtual reality for adjunctive treatment of adult burn pain during physical therapy: a controlled study. Clin J Pain 2000;16:244-50. https://doi.org/10.1097/00002508-200009000-00010
  18. Sharar SR, Miller W, Teeley A, Soltani M, Hoffman HG, Jensen MP, et al. Applications of virtual reality for pain management in burn-injured patients. Expert Rev Neurother 2008;8:1667-74. https://doi.org/10.1586/14737175.8.11.1667
  19. Cho YS, Lee J, Joo SY, Seo CH. Crosstalk among adipose tissue, vitamin D level, and biomechanical properties of hypertrophic burn scars. Burns 2019;45:1430-37. https://doi.org/10.1016/j.burns.2019.04.019
  20. Jung KH, Ha H, Shin HJ, Ohn SH, sung DH, Lee P, et al. Effects of robot-assisted gait therapy on locomotor recovery in stroke patients. J Korean Acad Rehabil Med 2008;32:258-66.
  21. Bohannon RW, Crouch R. Minimal clinically important difference for change in 6-minute walk test distance of adults with pathology: a systematic review. J Eval Clin Pract 2017;23:377-81. https://doi.org/10.1111/jep.12629
  22. Raymond I, Nielsen TA, Lavinge G, et al. Quality of sleep and its daily relationship to pain intensity in hospitalized adult burn patients. Pain 2001;92:391-8.
  23. Choinie M, Melzack R, Papillon J. Pain and paresthesia in patients with healed burns: an exploratory study. J Pain Symptom Manage 1991;6:43744.
  24. Yoshikawa K, Mutsuzaki H, Sano A, Koseki K, Fukaya T, Mizukami M, et al. Training with hybrid assistive limb for walking function after total knee arthroplasty. J Orthop Surg Res 2018;13:163. https://doi.org/10.1186/s13018-018-0875-1
  25. Tanaka Y, Oka H, Nakayama S, Ueno T, Matsudaira K, Miura T, et al. Improvement of walking ability during postoperative rehabilitation with the hybrid assistive limb after total knee arthroplasty: a randomized controlled study. SAGE Open Medicine 2017;5:2050312117712888.
  26. Barthuly AM, Bohannon RW, Gorack W. Gait speed is a responsive measure of physical performance for patients undergoing short-term rehabilitation. Gait Posture 2012;36:61-4. https://doi.org/10.1016/j.gaitpost.2012.01.002
  27. Sprague RB. Factors related to extension lag at the knee joint. J Orthop Sport Phys 1982;3:178-82. https://doi.org/10.2519/jospt.1982.3.4.178