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The Effects of Robot-Assisted Gait Training with Visual Feedback on Gait, Balance and Balance Confidence in Chronic Stroke Patients

  • Ham, Sin-Cheol (Department of Graduate School of Public Health, College of Health Science, Gachon University) ;
  • Lim, Chae-Gil (Department of Physical Therapy, College of Health Science, Gachon University)
  • Received : 2016.03.22
  • Accepted : 2016.04.18
  • Published : 2016.04.30

Abstract

Purpose: This study was conducted to assess the effects of robot-assisted gait training with visual feedback on gait, balance, and balance confidence in patients with chronic stroke. Methods: Thirty subjects with chronic stroke were randomly assigned to two groups: the experimental group (n=15) and the control group (n=15). The experimental group performed robot-assisted gait training for 30 minutes and the control group performed gait training with assisted devices training for 30 minutes after both groups performed conventional physical therapy for 30 minutes. Both groups performed the therapeutic interventions for 5 days per week, for a period of 4 weeks. For assessment of the 10 m walking test (10 MWT), Figure of 8 on the walk test (F8WT), Timed-Up and Go test (TUG), and Berg Balance Scale (BBS) were used to test the gait and balance, and the Korean version of the Activities-specific Balance Confidence Scale was used to test the balance confidence. Results: The experimental group showed significant improvement in the 10 MWT and the K-ABC (p<0.05), and the control group showed significant improvement in the BBS and the TUG (p<0.05). In four measurements, there were significant differences between the two groups (p<0.05), and the control group showed significant improvement in the F8WT at pre and post intervention (p<0.05). Conclusion: This study demonstrated that Robot-assisted gait training with visual feedback is an effective intervention for improving straight gait abilities and balance confidence, while the control group showed some improvement in curve gait and balance. Thus, we suggest both Robot-assisted gait training with visual feedback and gait training with assisted devices training exercise as a therapeutic intervention in chronic stroke rehabilitation.

Keywords

References

  1. Statistics Korea. Annual report on the cause of death statistics, Seoul: Statistics Korea. 2012.
  2. Monahan FD, Phipps WJ Phipps' Medical-Surgical Nursing Health & Illness Perspectives. 8th ed. Missouri: Elsevier Mosby. 2007;1428-29.
  3. Werner C, Von Frankenberg S, TreigT et al. Treadmill training with partial body weight support and an electromechanical gait trainer for restoration of gait in subacute stroke patients: A randomized cross over study. Stroke. 2002;33(12):2895-901. https://doi.org/10.1161/01.STR.0000035734.61539.F6
  4. Teasell RW, Fo1ey NC, Bhogal SK et al. An evidence-based review of stroke rehabilitation. Top Stroke Rehabil. 2003;10(1):29-58. https://doi.org/10.1310/8YNA-1YHK-YMHB-XTE1
  5. TauE. Harnessing brain plasticity through behavioral techniques to produce new treatments in neurorehabilitation. American Psychologist. 2004;59:692-704. https://doi.org/10.1037/0003-066X.59.8.692
  6. Chen JC., Shaw FZ. Progress in sensorimotor rehabilitative physical therapy programs for stroke patients. World J Clin Cases.2014;2(8):316-26. https://doi.org/10.12998/wjcc.v2.i8.316
  7. Seo DK, Oh DW, Lee SH. Effectiveness of ankle visuoperceptual feedback training on balance and gait functions in hemiparetic patients. J Kor Phys Ther. 2010;22(4):35-41. https://doi.org/10.1589/jpts.22.35
  8. Weiss PL, Rand D, Katz N. Video capture virtual reality as a flexible and effective rehabilitation tool. J Neuroeng Rehabil. 2004;1(1):1-12. https://doi.org/10.1186/1743-0003-1-1
  9. Shumway-Cook A, Woollacott MH. Motor control: translating research into clinical practice. 3rd ed. Philadelphia: Lippincott Williams & Wilkins. 2007;3-83.
  10. Walker C, Brouwer BJ, Culham EG. Use of visual feedback in retraining balance following acute stroke. Phys Ther. 2000;80(9):886-95.
  11. Berg K, Wood-Dauphin S, Williams JI. The Balance Scale: Reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med. 1995;27(1):27-36.
  12. Blum L, Korner-Bitensky N. Usefulness of the Berg Balance Scale in stroke rehabilitation: a systematic review. Phys Ther. 2008;88(5):559-66. https://doi.org/10.2522/ptj.20070205
  13. Powell LE, Myers AM. The Activities-specific Confidence (ABC) Scale. J Gerontol A Biol Sci Med Sci. 1995;50(1):M28-M34.
  14. Jang SN, Cho SI, Ou SW et al. The Validity and Reliability of Korean Fall Efficacy Scale(FES) and Activities-specific Balance Confidence Scale(ABC). J Korean Geriatr Soc. 2003;7(4): 255-68.
  15. Dean CM, Richards CL, Malouin F. Walking speed over 10metres overestimates locomotor capacity after stroke. Clin Rehabil. 2001;15(4): 415-21. https://doi.org/10.1191/026921501678310216
  16. Green J, Forster A, Young J. Reliability of gait speed measured by a timed walking test in patients one year after stroke. Clin Rehabil. 2002; 16(3):306-14. https://doi.org/10.1191/0269215502cr495oa
  17. Hess RJ, Brach JS, Piva SR et al. Walking Skill Can Be Assessed in Older Adults: Validity of the Figure-of-8 Walk Test. Phys Ther. 2010;90(1):89-99. https://doi.org/10.2522/ptj.20080121
  18. Podsiadlo D, Richardson S. The timed "Up & Go": A test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  19. Ng SS, Hui-Chan CW. The timed up & go test: Its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke. Arch Phys Med Rehabil. 2005;86(8):1641-7. https://doi.org/10.1016/j.apmr.2005.01.011
  20. Song BK. The Effect of Somatosensory Training on Postural Alignment and Trunk Control with Impairment of Visual Perception and Somatosensary in stroke, Korea Association occupational Therapy Policy. 2011; 3(1):1-12.
  21. Kim JY, Woo JH, Woo YK. The effect of virtual Horse-riding therapy on trunk control ability, balance and gait ability of stroke patients. J Korean Acad Ther. 2014;6(1):12-20.
  22. Hornby TG, Campbell DD, Kahn JH. et al. Enhanced gait-related improvements after therapist versus robotic-assisted locomotor training in subjects with chronic stroke: A randomized controlled study. Stroke. 2008;39(6):1786-92. https://doi.org/10.1161/STROKEAHA.107.504779
  23. Colombo G, Wirz M, Dietz V. Driven gait orthosis for improvement of locomotor training in paraplegic patients. Spinal Cord. 2001;39(5):252-5. https://doi.org/10.1038/sj.sc.3101154
  24. Dite W, Temple VA. Development of a clinical measure of turning for older adults. Am J Phys Med Rehabil. 2002;81(11):857-66. https://doi.org/10.1097/00002060-200211000-00010
  25. Podsiadlo D, Richardson S. The timed" Up & Go": A test of basic functional mobility for frail elderly persons. J Am Geriatr Soc.1991;39(2):142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  26. Wolf SL, Catlin PA, Gage K et al. Establishing the reliability and validity of measurements of walking time using the Emory Functional Ambulation Profile. Phys Ther. 1999;79(12):1122-33.
  27. Jonsdottir J, Cattaneo D. Reliability and validity of the dynamic gait index in persons with chronic stroke. Arch Phys Med Rehabil. 2007;88(11): 1410-5. https://doi.org/10.1016/j.apmr.2007.08.109
  28. Kim YD, Lee IK. The Effects of Treadmill Walking on the Strait Lines of Travel for People with Visual Impairments. Korean Journal of Adapted Physical Activity. 2006;14(2):55-72.
  29. Kwon OH, Woo JH, Woo YK. The Effects of task-oriented treadmill gait training on the walking ability and balance of sub-acute stroke patient. J Korean Acad Ther. 2013;5(1):13-23
  30. Sackley CM, Baguley BI, Gent S et al. The use of a balance performance monitor in the treatment of weight-bearing and weight-transference problems after stroke. Physiotherapy. 1992;78(12):907-13. https://doi.org/10.1016/S0031-9406(10)60498-1
  31. Warren M. Evaluation and treatment of visual deficit. In: Pedretti LW,Occupational therapy practice skill for physical dysfunction, 5th ed, st Louis, Mosby. 2001.
  32. Srivastava A, Taly AB, Gupta A et al. Post-stroke balance training: Role of force platform with visual feedback technique. J Neurol Sci. 2009;287:1-2:89-93. https://doi.org/10.1016/j.jns.2009.08.051
  33. Kang HK, Chung YJ. Effects of treadmill training with real optic flow scene on balance and balance self-efficacy in individuals following stroke: A pilot randomized controlled trial. Phys Ther Rehabil Sci. 2012; 1(1): 33-39.

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