Physical Therapy Rehabilitation Science

  • 제10권3호
  • /
  • Pages.270-277
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  • 2021
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  • 2287-7576(pISSN)
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  • 2287-7584(eISSN)
물리치료재활과학회 (korean Academy of Physical Therapy Rehabilitation Science)
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Effects of Robotic Gait Training with Lower Extremity Restraint on Static Balance, Lower Extremity Function, Gait Ability in Subacute Stroke Patients

  • Kang, Yun-Su (Department of Physical Therapy, Graduate school of Health and Medicine, Daejeon University) ;
  • Shin, Won-Seob (Department of Physical Therapy, Graduate school of Health and Medicine, Daejeon University)
  • 투고 : 2021.08.09
  • 심사 : 2021.08.31
  • 발행 : 2021.09.30
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초록

Objective: The purpose of this study is to compare the effect of static balance, lower extremity function, and gait ability between a lower extremity restrain robot gait training and a general robot gait training in subacute stroke subjects. Design: Two-group pretest-posttest design. Methods: A total of 12 subacute stroke patients were randomly divided into an Experimental group (n=6) and a control group (n=6). Both groups were performed for four weeks, three times a week, for 20 minutes. To compare the Static balance function, the center of pressure (COP) path-length and COP velocity were measured. The Fugl-Meyer assessment lower extremity (FMA-LE) were evaluated to compare the Lower Extremity function. 2D Dartfish Program and 10 Meter Walking Test (10 MWT) on Gait ability were evaluated to compare the gait function. Results: In the intra-group comparison, Experimental groups showed significant improvement in COP path-length, velocity, Lower Extremity Function, 10 MWT, Cadence, by comparing the parameters before and after the intervention (p<0.05). Comparison of the amount of change between groups revealed significant improvement for parameters in the COP path-length, velocity, Lower extremity function, 10 MWT by comparing the parameters before and after the intervention (p<0.01). Conclusions: The Experimental group showed enhanced efficacy for variables such as COP path-length, velocity, Lower extremity function, 10 MWT as compared to the control group.

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참고문헌

  1. Choi S, Lee BH. The correlations between fall experience, balance, mobility and confidence in persons with stroke. Phys Ther Rehabil Sci 2020;9:178-83. https://doi.org/10.14474/ptrs.2020.9.3.178
  2. Midha D, Arumugam N. Targeting motor and cognitive networks with multichannel transcranial direct current stimulation along with peripheral stimulation in a subacute stroke survivor. Phys Ther Rehabil Sci 2020;9:318-23. https://doi.org/10.14474/ptrs.2020.9.4.318
  3. Bang DH, Shin WS. Effects of robot-assisted gait training on spatiotemporal gait parameters and balance in patients with chronic stroke. Neuro Rehabilitation 2016;38:343-49.
  4. Lim CG. Effects of trunk control robot training on balance and gait abilities in persons with chronic stroke. Phys Ther Rehabil Sci 2020;9:105-12. https://doi.org/10.14474/ptrs.2020.9.2.105
  5. Miller EW, Quinn ME, Seddon PG. Body weight support tread treadmill and overground ambulation training for two patients with chronic disability secondary to stroke. Phys Ther 2002;82:53-61. https://doi.org/10.1093/ptj/82.1.53
  6. Bogey R. Hornby TG. Gait training strategies utilized in poststroke rehabilitation: Are we really making a difference. Top Stroke Rehabil 2007;14:1-8. https://doi.org/10.1310/tsr1406-1
  7. Kim MK, Chung SH, Kim SS. The influence of dual task oriented robot assisted gait training on balance and gait ability in chronic stroke patients. J Korean Acad Ther 2016;8:7-20.
  8. Lin J, Hu G, Ran J, Chen L, Zhang X, Zhang Y. Effects of bodyweight support and guidance force on muscle activation during Locomat walking in people with stroke: A cross-sectional study. J Neuroeng Rehabil 2020;17:1-9. https://doi.org/10.1186/s12984-019-0634-5
  9. Westlake KP, Patten C. Pilot study of Lokomat versus manual-assisted treadmill training for locomotor recovery post-stroke. J Neuroeng Rehabil 2009;6:1-11. https://doi.org/10.1186/1743-0003-6-1
  10. Riener R, Luenburger L, Maier IC, Colombo G, Dietz V. Locomotor training in subjects with sensori-motor deficits: An overview of the robotic gait orthosis Lokomat. J Healthc Eng 2010;1:197-216. https://doi.org/10.1260/2040-2295.1.2.197
  11. Han EY, Im SH, Kim BR, Seo MJ, Kim MO. Robot-assisted gait training improves brachial ankle pulse wave velocity and peak aerobic capacity in subacute stroke patients with totally dependent ambulation: Randomized controlled trial. Medicine 2016;95:41.
  12. Mehrholz J, Pohl M, Kugler J, Elsner B. Electromechanical-Assisted Training for Walking after Stroke: Update of the Evidence. Stroke 2021;52:153-54.
  13. Bang DH, Shin WS, Choi HS. Effects of modified constraint-induced movement therapy with trunk restraint in early stroke patients: A single-blinded, randomized, controlled, pilot trial. Neuro Rehabilitation 2018;42:29-35.
  14. Regnaux JP, Pradon D, Roche N, Robertson J, Bussel B, Dobkin B. Effects of loading the unaffected limb for one session of locomotor training on laboratory measures of gait in stroke. Clin Biomech 2008;23:762-68. https://doi.org/10.1016/j.clinbiomech.2008.01.011
  15. Bonnyaud C, Pradon D, Zory R, Bussel B, Bensmail D, Vuillerme N, et al. Effects of a gait training session combined with a mass on the non-paretic lower limb on locomotion of hemiparetic patients: A randomized controlled clinical trial. Gait Posture 2013;37:627-30. https://doi.org/10.1016/j.gaitpost.2012.09.010
  16. Marklund I, Klasbo M. Effects of lower limb intensive mass practice in poststroke patients: Single-subject experimental design with long-term follow-up. Chlin Rehabil 2006;2:568-76. https://doi.org/10.1191/0269215506cr973oa
  17. Bonnyaud C, Zory R, Boudarham J, Pradon D, Bensmail D, Roche N. Effect of a robotic restraint gait training versus robotic conventional gait training on gait parameters in stroke patients. Exp Brain Res 2014;232:31-42. https://doi.org/10.1007/s00221-013-3717-8
  18. Park JH, Kwon YC. Standardization of Kprean Version of the Mini-Mental State Examination (MMSE-K) for Use in the Elderly. Part II. Diagnostic Validity. J Korean Neuropsychiatr Assoc. 1989;28:508-13.
  19. Husemann B, Muler F, Krewer C, Heller S, Koenig E. Effects of locomotion training with assistance of a robot-driven gait orthosis in hemiparetic patients after stroke: A randomized controlled pilot study. Stroke 2007;38:349-54. https://doi.org/10.1161/01.str.0000254607.48765.cb
  20. Kwon SC, Shin WS. Comparison of Robotic Tilt-table Training and Body Weight Support Treadmill Training on Lower Extremity Strength, Balance, Gait, and Satisfaction with Rehabilitation, in Patients with Subacute Stroke. J Korean Soc Phys Med 2020;15:163-74. https://doi.org/10.13066/kspm.2020.15.4.163
  21. Holmes JD, Jenkins ME, Johnson AM, Hunt MA, Clark R. Validity of the Nintendo Wii® balance board for the assessment of standing balance in Parkinson's disease. Chlin Rehabil 2013;27:316-66.
  22. Park DS, Lee DY, Choi SJ, Shin WS. Reliability and Validity of the Balancia using Wii Balance Board for Assessment of Balance with Stroke Patients. J Korea Acad Coop Soc 2013;14:2767-72.
  23. Balasubramanian CK, Li CY, Bowden MG, Duncan PW, Kautz SA, Velozo CA. Dimensionality and Item-Difficulty Hierarchy of the Lower Extremity Fugl-Meyer Assessment in Individuals With Subacute and Chronic Stroke. Arch Phys Med Rehabil 2016;97:582-89. https://doi.org/10.1016/j.apmr.2015.12.012
  24. Duncan PW, Propst M, Nelson SG. Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident. Phys Ther 1983;63:1606-10. https://doi.org/10.1093/ptj/63.10.1606
  25. Borel S, Schneider P, Newman CJ. Video analysis software increases the interrater reliability of video gait assessments in Children with cerebral palsy. Gait Posture 2011;33:727-29. https://doi.org/10.1016/j.gaitpost.2011.02.012
  26. Eltoukhy M, Asfour S, Thompson C, Latta L. Evaluation of the Performance of Digital Video Analysis of Human Motion: Dartfish Tracking System. IJSER. 2012;3:1-6.
  27. Kim DY, Choi JD, Ki Kl. A Reliability Study of Sit-to-walk for Dynamic Balance Assessment in Stroke Patient. J Korean Soc Phys Ther 2013;25:303-10.
  28. Steffen TM, Hacker TA, Mollinger L. Age-and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther 2002;82:128-37. https://doi.org/10.1093/ptj/82.2.128
  29. Kim JH. Effects of Robot-assisted Therapy on Lower Limb in Patients with Subacute Stroke. J Korea Acad Coop 2016;17:459-566.
  30. Park JH, Lee DY, Kim JS, Hong HJ. Effects of Robot-Assisted Training on Balance and Foot Pressure in Stroke Patients. Neurotherapy 2020;24:1-7.
  31. Hidler J, Nichols D, Pelliccio M, Brady K, Campbell DD, Kahn JH, et al. Multicenter randomized clinical trial evaluating the effectiveness of the Lokomat in subacute stroke. Neurorehabil Neural Repair 2009;23:5-13. https://doi.org/10.1177/1545968308326632