Morning Walk®-Assisted Gait Training Improves Walking Ability and Balance in Patients with Ataxia: a Randomized Controlled Trial
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초록
This study aimed to investigate walking ability and balance improvement of patients with ataxia caused by brain lesions after end-effector type robot (Morning Walk®)-assisted gait training. This study randomly assigned 19 patients to one of two groups: 30 minutes of Morning Walk® training with 1 hour of conventional physiotherapy (Morning Walk® group; n = 10) or 1.5 hours of conventional physiotherapy (Control group; n = 9). Five treatment sessions per week were given for 3 weeks. The primary outcomes were walking ability and balance, which were assessed by the functional ambulation category (FAC) and Berg Balance Scale (BBS), respectively. The secondary outcomes included 10-meter Walk Test (10mWT), Rivermead Mobility Index (RMI), Motricity Index (MI), and Modified Barthel Index (MBI). At baseline, there was no statistically significant difference between the two groups except MBI. After the treatment, the Morning Walk® group showed significant improvement in the FAC, BBS, 10mWT, RMI and MBI. The control group showed significant improvement in the BBS, 10mWT, RMI and MBI. Inter-group comparison demonstrated that the ∆FAC, ∆10mWT and ∆RMI of the Morning Walk® group were significantly higher than those of the control group. Our results suggest that the patients with ataxia receiving Morning Walk®-assisted gait training might improve greater in walking ability and balance than those trained with conventional physiotherapy.
Abstract
This study aimed to investigate walking ability and balance improvement of patients with ataxia caused by brain lesions after end-effector type robot (Morning Walk®)-assisted gait training. This study randomly assigned 19 patients to one of two groups: 30 minutes of Morning Walk® training with 1 hour of conventional physiotherapy (Morning Walk® group; n = 10) or 1.5 hours of conventional physiotherapy (Control group; n = 9). Five treatment sessions per week were given for 3 weeks. The primary outcomes were walking ability and balance, which were assessed by the functional ambulation category (FAC) and Berg Balance Scale (BBS), respectively. The secondary outcomes included 10-meter Walk Test (10mWT), Rivermead Mobility Index (RMI), Motricity Index (MI), and Modified Barthel Index (MBI). At baseline, there was no statistically significant difference between the two groups except MBI. After the treatment, the Morning Walk® group showed significant improvement in the FAC, BBS, 10mWT, RMI and MBI. The control group showed significant improvement in the BBS, 10mWT, RMI and MBI. Inter-group comparison demonstrated that the ∆FAC, ∆10mWT and ∆RMI of the Morning Walk® group were significantly higher than those of the control group. Our results suggest that the patients with ataxia receiving Morning Walk®-assisted gait training might improve greater in walking ability and balance than those trained with conventional physiotherapy.
참고문헌 (40)
- Brunberg JA, "Ataxia", AJNR Am J Neuroradiol, 29, pp.1420~1422 (2008)
- Winstein CJ, "Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association", American Stroke Association, 2016, pp.47, e98~e169
- Belas Dos Santos M, "A comparative study of conventional physiotherapy versus robot-assisted gait training associated to physiotherapy in individuals with ataxia after stroke", Behav Neurol, 2018, pp.2892065~ (2018)
- Terry JB, "Frontal lobe ataxia", Surg Neurol, 44, pp.583~588 (1995)
- Hallett M, "Physiologic studies of dysmetria in patients with cerebellar deficits", Can J Neurol Sci, 20(Suppl 3), pp.S83~S92 (1993)
- Ilg W, "Specific influences of cerebellar dysfunctions on gait", Brain, 130, pp.786~798 (2007)
- Morton SM, "Relative contributions of balance and voluntary leg-coordination deficits to cerebellar gait ataxia", J Neurophysiol, 89, pp.1844~1856 (2003)
- Sawacha Z, "Relationship between clinical and instrumental balance assessments in chronic post-stroke hemiparesis subjects", J Neuroeng Rehabil, 10, pp.95~ (2013)
- Garson JG, "The Frenkel system of exercises for tabes", BMJ, 2, pp.420~421 (1911)
- Hesse S, "Treadmill training with partial body weight support after stroke : a review", NeuroRehabilitation, 23, pp.55~65 (2008)
- Zesiewicz TA, "Comprehensive systematic review summary : treatment of cerebellar motor dysfunction and ataxia : Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology", Neurology, 90, pp.464~471 (2018)
- Calabrò RS, "Robotic gait rehabilitation and substitution devices in neurological disorders : where are we now", Neurol Sci, 37, pp.503~514 (2016)
- 장원혁, "Robot-assisted Therapy in Stroke Rehabilitation", 대한뇌졸중영문학회지, 15(3), pp.174~181 (2013), 대한뇌졸중학회[DOI]
- 황승원, "Improved Gait Speed After Robot-Assisted Gait Training in Patients With Motor Incomplete Spinal Cord Injury: A Preliminary Study", Annals of Rehabilitation Medicine, 41(1), pp.34~41 (2017), 대한재활의학회
- 성준현, "Feasibility of Rehabilitation Training With a Newly Developed, Portable, Gait Assistive Robot for Balance Function in Hemiplegic Patients", Annals of Rehabilitation Medicine, 41(2), pp.178~187 (2017), 대한재활의학회
- Swinnen E, "Does robot-assisted gait rehabilitation improve balance in stroke patients? A systematic review", Top Stroke Rehabil, 21, pp.87~100 (2014)
- Kim J, "Effects of robot-(Morning Walk®)assisted gait training for patients after stroke : a randomized controlled trial", Clin Rehabil, 33, pp.516~523 (2019)
- Peurala SH, "Effects of intensive therapy using gait trainer or floor walking exercises early after stroke", J Rehabil Med, 41, pp.166~173 (2009)
- Tong RK, "Effectiveness of gait training using an electromechanical gait trainer, with and without functional electric stimulation, in subacute stroke : a randomized controlled trial", Arch Phys Med Rehabil, 87, pp.1298~1304 (2006)
- Hafsteinsdóttir TB, "Neurodevelopmental treatment after stroke : a comparative study", J Neurol Neurosurg Psychiatry, 76, pp.788~792 (2005)
- Holden MK, "Gait assessment for neurologically impaired patients. Standards for outcome assessment", Phys Ther, 66, pp.1530~1539 (1986)
- Mehrholz J, "Predictive validity and responsiveness of the functional ambulation category in hemiparetic patients after stroke", Arch Phys Med Rehabil, 88, pp.1314~1319 (2007)
- Dundar U, "A comparative study of conventional physiotherapy versus robotic training combined with physiotherapy in patients with stroke", Top Stroke Rehabil, 21, pp.453~461 (2014)
- Miyamoto ST, "Brazilian version of the Berg balance scale", Braz J Med Biol Res, 37, pp.1411~1421 (2004)
- Graham JE, "Assessing walking speed in clinical research : a systematic review", J Eval Clin Pract, 14, pp.552~562 (2008)
- Hirsch MA, "Reliability of the timed 10-metre walk test during inpatient rehabilitation in ambulatory adults with traumatic brain injury", Brain Inj, 28, pp.1115~1120 (2014)
- Schwartz I, "The effectiveness of locomotor therapy using robotic-assisted gait training in subacute stroke patients : a randomized controlled trial", PM R, 1, pp.516~523 (2009)
- Roorda LD, "The Rivermead Mobility Index allows valid comparisons between subgroups of patients undergoing rehabilitation after stroke who differ with respect to age, sex, or side of lesion", Arch Phys Med Rehabil, 93, pp.1086~1090 (2012)
- Fayazi M, "Test-retest reliability of Motricity Index strength assessments for lower extremity in post stroke hemiparesis", Med J Islam Repub Iran, 26, pp.27~30 (2012)
- de Sousa Britto HM, "Correlation between balance, speed, and walking ability in individuals with chronic hemiparesis", Fisioter Mov, 29, pp.87~94 (2016)
- de Haart M, "Recovery of standing balance in postacute stroke patients : a rehabilitation cohort study", Arch Phys Med Rehabil, 85, pp.886~895 (2004)
- Garland SJ, "Recovery of standing balance and functional mobility after stroke", Arch Phys Med Rehabil, 84, pp.1753~1759 (2003)
- Kollen B, "Predicting improvement in gait after stroke : a longitudinal prospective study", Stroke, 36, pp.2676~2680 (2005)
- Suzuki K, "Determinants of maximum walking speed in hemiparetic stroke patients", Tohoku J Exp Med, 162, pp.337~344 (1990)
- Hamada O, "Three cases with ataxic gait disorder improved by using a hybrid assistive limb robot suit", Jpn J Neurosurg, 24, pp.413~418 (2015)
- Hesse S, "Treadmill walking with partial body weight support versus floor walking in hemiparetic subjects", Arch Phys Med Rehabil, 80, pp.421~427 (1999)
- Mao YR, "The effect of body weight support treadmill training on gait recovery, proximal lower limb motor pattern, and balance in patients with subacute stroke", BioMed Res Int, 2015, pp.175719~ (2015)
- McCain KJ, "Locomotor treadmill training with partial body-weight support before overground gait in adults with acute stroke : a pilot study", Arch Phys Med Rehabil, 89, pp.684~691 (2008)
- Wallard L, "Effects of robotic gait rehabilitation on biomechanical parameters in the chronic hemiplegic patients", Neurophysiol Clin, 45, pp.215~219 (2015)
- Lee KB, "Six-month functional recovery of stroke patients: a multi-time-point study", Int J Rehabil Res, 38, pp.173~180 (2015)
