Physical Therapy Rehabilitation Science

korean Academy of Physical Therapy Rehabilitation Science (물리치료재활과학회)
권호 표지
DOI QR코드

DOI QR Code

The effects of providing visual feedback and auditory stimulation using a robotic device on balance and gait abilities in persons with stroke: a pilot study

  • Park, Jae Ho (Department of Physical Therapy, The Graduate School, Sahmyook University) ;
  • Chung, Yijung (Department of Physical Therapy, College of Health and Welfare, Sahmyook University)
  • Received : 2016.08.21
  • Accepted : 2016.09.12
  • Published : 2016.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: The purpose of this study was to investigate the effects of providing visual feedback and auditory stimulation using a robotic device on balance and gait abilities in stroke patients. Design: Randomized controlled pilot trial. Methods: Fifteen subjects were randomly divided into three groups where five subjects were in the visual feedback robotic device assist gait training (VRGT) group, five subjects in the auditory stimulation robotic device assist gait training (ARGT) group, and five subjects in the control group. Subjects received visual feedback and auditory stimulation while undergoing robotic gait training for 45 minutes, three times a week for 2 weeks, and all subjects had undergone general physical therapy for 30 minutes, five times a week for 2 weeks. All subjects were assessed with the Berg balance scale (BBS), timed up and go (TUG) test, and 10-meter walking test (10MWT) pre- and post-intervention. Results: All subjects showed that BBS, TUG test, and 10MWT scores significantly improved post-intervention (p<0.05), and the control group also had significantly improved post-treatment (p<0.05). The VRGT and the ARGT showed significant improvements in BBS, TUG, and 10MWT scores compared with the control group (p<0.05). The VRGT group showed a significant improvement in BBS, TUG, and 10MWT scores compared with the control group (p<0.05). In addition, it has been confirmed that VRGT had significantly improved in BBS, TUG test, and 10MWT scores compared with the auditory stimulation and control group (p<0.05). Conclusions: The results of this study showed improved balance and gait abilities after VRGT and ARGT groups compared with general physical therapy and was found to be effective in enhancing the functional activity of persons affected with stroke.

Keywords

References

  1. Poli P, Morone G, Rosati G, Masiero S. Robotic technologies and rehabilitation: new tools for stroke patients' therapy. Biomed Res Int 2013;2013:153872.
  2. Perry J. Gait analysis: normal and pathological function. Thorofare (NJ): Slack; 1992.
  3. Mirelman A, Patritti BL, Bonato P, Deutsch JE. Effects of virtual reality training on gait biomechanics of individuals post-stroke. Gait Posture 2010;31:433-7. https://doi.org/10.1016/j.gaitpost.2010.01.016
  4. Krishnan C, Kotsapouikis D, Dhaher YY, Rymer WZ. Reducing robotic guidance during robot-assisted gait training improves gait function: a case report on a stroke survivor. Arch Phys Med Rehabil 2013;94:1202-6. https://doi.org/10.1016/j.apmr.2012.11.016
  5. Esquenazi A, Packel A. Robotic-assisted gait training and restoration. Am J Phys Med Rehabil 2012;91(11 Suppl 3):S217-27;quiz S228-31. https://doi.org/10.1097/PHM.0b013e31826bce18
  6. Kwakkel G, Kollen B, Lindeman E. Understanding the pattern of functional recovery after stroke: facts and theories. Restor Neurol Neurosci 2004;22:281-99.
  7. Mehrholz J, Werner C, Kugler J, Pohl M. Electromechanical-assisted training for walking after stroke. Cochrane Database Syst Rev 2007;(4):CD006185.
  8. Mehrholz J, Pohl M. Electromechanical-assisted gait training after stroke: a systematic review comparing end-effector and exoskeleton devices. J Rehabil Med 2012;44:193-9. https://doi.org/10.2340/16501977-0943
  9. Hidler J, Neckel N. Inverse-dynamics based assessment of gait using a robotic orthosis. Conf Proc IEEE Eng Med Biol Soc 2006;1:185-8.
  10. Riener R, Lunenburger L, Jezernik S, Anderschitz M, Colombo G, Dietz V. Patient-cooperative strategies for robot-aided treadmill training: first experimental results. IEEE Trans Neural Syst Rehabil Eng 2005;13:380-94. https://doi.org/10.1109/TNSRE.2005.848628
  11. Tefertiller C, Pharo B, Evans N, Winchester P. Efficacy of rehabilitation robotics for walking training in neurological disorders: a review. J Rehabil Res Dev 2011;48:387-416. https://doi.org/10.1682/JRRD.2010.04.0055
  12. Schuck A, Labruyere R, Vallery H, Riener R, Duschau-Wicke A. Feasibility and effects of patient-cooperative robot-aided gait training applied in a 4-week pilot trial. J Neuroeng Rehabil 2012;9:31. https://doi.org/10.1186/1743-0003-9-31
  13. Shumway-Cook A, Anson D, Haller S. Postural sway biofeedback: its effect on reestablishing stance stability in hemiplegic patients. Arch Phys Med Rehabil 1988;69:395-400.
  14. Reynolds RF, Day BL. Visual guidance of the human foot during a step. J Physiol 2005;569:677-84. https://doi.org/10.1113/jphysiol.2005.095869
  15. Kang YJ, Ku J, Han K, Kim SI, Yu TW, Lee JH, et al. Development and clinical trial of virtual reality-based cognitive assessment in people with stroke: preliminary study. Cyberpsychol Behav 2008;11:329-39. https://doi.org/10.1089/cpb.2007.0116
  16. Yang JK, Ahn NE, Kim DH, Kim DY. Plantar pressure distribution during robotic-assisted gait in post-stroke hemiplegic patients. Ann Rehabil Med 2014;38:145-52. https://doi.org/10.5535/arm.2014.38.2.145
  17. Bonnyaud C, Pradon D, Boudarham J, Robertson J, Vuillerme N, Roche N. Effects of gait training using a robotic constraint (Lokomat(R)) on gait kinematics and kinetics in chronic stroke patients. J Rehabil Med 2014;46:132-8. https://doi.org/10.2340/16501977-1248
  18. Brutsch K, Koenig A, Zimmerli L, Merillat-Koeneke S, Riener R, Jancke L, et al. Virtual reality for enhancement of robot-assisted gait training in children with central gait disorders. J Rehabil Med 2011;43:493-9. https://doi.org/10.2340/16501977-0802
  19. Shumway-Cook A, Horak FB. Assessing the influence of sensory interaction of balance. Suggestion from the field. Phys Ther 1986;66:1548-50. https://doi.org/10.1093/ptj/66.10.1548
  20. Dias D, Lains J, Pereira A, Nunes R, Caldas J, Amaral C, et al. Can we improve gait skills in chronic hemiplegics? A randomised control trial with gait trainer. Eura Medicophys 2007;43:499-504.
  21. Wong CK, Bishop L, Stein J. A wearable robotic knee orthosis for gait training: a case-series of hemiparetic stroke survivors. Prosthet Orthot Int 2012;36:113-20. https://doi.org/10.1177/0309364611428235
  22. Sale P, De Pandis MF, Le Pera D, Sova I, Cimolin V, Ancillao A, et al. Robot-assisted walking training for individuals with Parkinson's disease: a pilot randomized controlled trial. BMC Neurol 2013;13:50. https://doi.org/10.1186/1471-2377-13-50
  23. Jang SH, You SH, Hallett M, Cho YW, Park CM, Cho SH, et al. Cortical reorganization and associated functional motor recovery after virtual reality in patients with chronic stroke: an experimenter- blind preliminary study. Arch Phys Med Rehabil 2005;86:2218-23. https://doi.org/10.1016/j.apmr.2005.04.015
  24. Thaut MH, McIntosh GC, Rice RR. Rhythmic facilitation of gait training in hemiparetic stroke rehabilitation. J Neurol Sci 1997;151:207-12. https://doi.org/10.1016/S0022-510X(97)00146-9
  25. Jang SH, Kim YH, Cho SH, Lee JH, Park JW, Kwon YH. Cortical reorganization induced by task-oriented training in chronic hemiplegic stroke patients. Neuroreport 2003;14:137-41. https://doi.org/10.1097/00001756-200301200-00025
  26. Harvey RL. Improving poststroke recovery: neuroplasticity and task-oriented training. Curr Treat Options Cardiovasc Med 2009;11:251-9. https://doi.org/10.1007/s11936-009-0026-4
  27. Druzbicki M, Rusek W, Snela S, Dudek J, Szczepanik M, Zak E, et al. Functional effects of robotic-assisted locomotor treadmill thearapy in children with cerebral palsy. J Rehabil Med 2013;45:358-63. https://doi.org/10.2340/16501977-1114

Cited by

  1. Effect of backward walking training using an underwater treadmill on muscle strength, proprioception and gait ability in persons with stroke vol.6, pp.3, 2017, https://doi.org/10.14474/ptrs.2017.6.3.120
  2. Effects of real-time feedback training on weight shifting during golf swinging on golf performance in amateur golfers vol.6, pp.4, 2017, https://doi.org/10.14474/ptrs.2017.6.4.189
  3. 3D 모션입력장치를 이용한 거울치료가 뇌졸중 환자의 상지 운동 기능, 삶의 질, 우울감에 미치는 영향 vol.4, pp.4, 2016, https://doi.org/10.15268/ksim.2016.4.4.041
  4. 전신진동자극훈련을 병행한 PNF 결합패턴 훈련이 뇌졸중환자의 근력, 균형 및 보행에 미치는 효과 vol.15, pp.2, 2016, https://doi.org/10.21598/jkpnfa.2017.15.2.185
  5. Effects of virtual reality combined with balance training on upper limb function, balance, and activities of daily living in persons with acute stroke: a preliminary study vol.8, pp.4, 2016, https://doi.org/10.14474/ptrs.2019.8.4.187
  6. Effects of sensory stimulation on upper limb strength, active joint range of motion and function in chronic stroke virtual reality training vol.9, pp.3, 2016, https://doi.org/10.14474/ptrs.2020.9.3.171
  7. Gait Training in Virtual Reality Home Environment for Stroke Patients: A Case Study vol.10, pp.None, 2016, https://doi.org/10.14326/abe.10.150