| 소속 |
Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea, 1Department of Rehabilitation Medicine1, Korea National Rehabilitation Research Institute, National Rehabilitation Center, 3Dept. of Rehabilitation & Assistive Technology2 |
Purpose
This study investigated the effects of robot-assisted gait training (RAGT) on gait function in burn patients.
Methods
28 burn patients were randomly divided into a RAGT group or conventional training (CON) group. SUBAR® (Cretem, Korea) is a wearable robot with a footplate that simulates normal gait cycles. The RAGT group underwent 30 minutes of robot-assisted training using SUBAR® with 30 minutes conventional physiotherapy once a day, 5 days a week for 12 weeks. The patients in CON group received 30 min of overground gait training and range of motion (ROM) exercises twice a day for 5 days a week for 12 weeks. RAGT group and CON group underwent a 60-minute training per day. The intervention frequency and duration did not differ between the RAGT group and CON group. The main outcomes were functional ambulatory category (FAC), 6-minute walking test (6MWT), visual analogue scale (VAS) during gait movement, ROM, and isometric forces of bilateral hip, knee and ankle muscles before and after 12 weeks of training.
Results
The results of the VAS, FAC, and 6MWT (7.91 ± 1.14, 1.82 ± 0.60, and 163.55 ± 75.97) before training in the RAGT group were significantly improved compared with the those ( 4.36 ± 1.21, 4.18 ± 0.40, and 285.00 ± 42.25) after training (p < 0.001, p = 0.003, and p < 0.001). The results of the VAS, FAC, and 6MWT (7.90 ± 1.10, 1.60 ± 0.52, and 185.50 ± 136.31) before training in CON group were significantly improved compared with the those ( 5.30 ± 1.25, 3.50 ± 0.97, and 250.50 ± 83.61) after training (p < 0.001, p = 0.004, and p = 0.03). The results of the VAS, FAC, and 6MWT were more improved between groups after training, but there were not statistically significant (p = 0.11, p = 0.11, and p = 0.24). Isometric measurements (left knee flexor, bilateral knee extensors, bilateral ankle dorsiflexors, and bilateral ankle plantar flexors) and ROM (right hip flexion, right hip extension, right knee flexion, and bilateral ankle plantar flexion) after training were significantly improved compared with the measurements before training in the RAGT group (p < 0.05). There are no significant differences of the isometric strengths and ROM of the bilateral hip, knee, and ankle muscles after training in the CON group (p > 0.05). There were significant improvements in the isometric strengths of left knee flexor (p=0.02) and left ankle plantarflexor (p=0.04) between the two groups.
Conclusion
The results suggested that RAGT is effective to facilitate early recovery on muscles strengths after burn injury. This is the first study to evaluate the effectiveness of RAGT in patients with burns compared with conventional training. The absence of complications on burn patients provide an opportunity to enlarge the application area of RAGT.
|
