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The Effects of Lokomat Virtual Reality Applications on Balance and Gait in Stroke Patients

2022年11月16日 更新者:Murat Akıncı、Ankara Yildirim Beyazıt University
The effectiveness of applying robot-assisted walking training together with conventional physiotherapy is widely accepted. Virtual reality is another component and its contribution to rehabilitation is important. When we look at the literature on virtual reality applications on balance and walking, it is seen that some systems are beneficial while some systems have no effect. This raises the possibility that virtual reality applications may produce different results due to the task in the exercise, patient motivation or any other reason. There is a need to investigate whether virtual reality applications have different effects, if any, what is the source of this and what care should be taken in the development of these applications in the future. Therefore, we focused on investigating the different effects of Lokomat virtual reality applications.

調査の概要

詳細な説明

Stroke is an important health problem worldwide. Emotional, cognitive, sensory and motor problems occur with stroke. Motor problems are especially balance and walking problems and they are related to each other. So balance and gait rehabilitation are primary goals in stroke.

Although the first study to support the efficacy of Lokomat is that Lokomat is superior to conventional physiotherapy in walking, there are also studies reporting that there is no difference between the effects of Lokomat and conventional physiotherapy and that conventional physiotherapy is superior. In the light of all these studies, the effectiveness of applying robotic systems together with conventional physiotherapy is widely accepted.

Robot Assisted Walking Training has many components such as guiding force, walking speed, body weight support. Virtual reality is one of these components and there is literature in which Lokomat virtual reality applications are effective on balance and walking. Although the virtual reality effect is emphasized for Lokomat, there is a lack of literature on the specific effect of different virtual reality applications. In our study, it was aimed to examine the changes caused by different Lokomat virtual reality applications in the spatiotemporal parameters of balance and gait.

Method: This study was conducted to examine the effects of Lokomat VR applications on balance and spatiotemporal parameters of gait in patients with chronic stroke; It is a prospective, randomized controlled, single-blind study. The study will be carried out in a single-blind manner, and the evaluator will not know which group the individual is in. 56 individuals with chronic stroke included our study. All individuals have been informed about the study and read and signed the consent form stating that they voluntarily participated in the study. For balance evaluation we used Berg Balance Scale and Huber 360 device, which measures postural stability and limits of stability. And for gait evaluation we used 10 MWT, 6 MWT and spatiotemporal gait analysis for C-Mill VR+.

研究の種類

介入

入学 (実際)

56

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

      • Ankara、七面鳥、06000
        • Ankara City Hospital

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年~80年 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

男

説明

  • Inclusion Criteria:

    • Clinical diagnosis is stroke
    • The time period have to be chronic period (+6 months)
    • The patient must have the ability to walk with or without support
    • The patiens should be able to understand Lokomat exercises
  • Exclusion Criteria:

    • Any condition that may prevent walking with Lokomat
    • Not volunteering to participate in the study

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:独身

武器と介入

参加者グループ / アーム
介入・治療
実験的:Lokomat Group I (Endurance)
  • Faster application used with Lokomat gait training
  • Conventional Physiotherapy
  • Faster application (using for Endurance) : 3 days in a week for 6 weeks,very season was 40 min.
  • Conventional Physiotherapy : 5 days in a week for 6 weeks, every seanson was 40 min.
-Conventional Physiotherapy : 5 days in a week for 6 weeks, every seanson was 40 min.
実験的:Lokomat Group II (Attention and Motivation)
  • Smile and Gabarello applications used with Lokomat gait training
  • Conventional Physiotherapy
-Conventional Physiotherapy : 5 days in a week for 6 weeks, every seanson was 40 min.
  • Smile application (using for Attetion and Motivation) : 3 days in a week for 6 weeks,very season was 20 min.
  • Gabarello application (using for Attetion and Motivation) : 3 days in a week for 6 weeks,very season was 20 min.
  • Conventional Physiotherapy : 5 days in a week for 6 weeks, every seanson was 40 min.
実験的:Lokomat Group III (Activity Timing)
  • High Flyer, Curve Pursuit and Treasures applications used with Lokomat gait training
  • Conventional Physiotherapy
-Conventional Physiotherapy : 5 days in a week for 6 weeks, every seanson was 40 min.
  • High Flyer application (using for Activity Timing) : 3 days in a week for 6 weeks,very season was 20 min.
  • Treasures application (using for Activity Timing) : 3 days in a week for 6 weeks,very season was 10 min.
  • Curve Pursuit application (using for Activity Timing) : 3 days in a week for 6 weeks,very season was 10 min.
  • Conventional Physiotherapy : 5 days in a week for 6 weeks, every seanson was 40 min.
他の:Control
-Only Conventional Physiotherapy
-Conventional Physiotherapy : 5 days in a week for 6 weeks, every seanson was 40 min.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Change in 6 MWT
時間枠:6 weeks after treatment
6 Minutes Walk Test is a test using for walking distance. We evaluated the change in walking distance with 6 MWT.
6 weeks after treatment
Change in 10 MWT
時間枠:6 weeks after treatment
10 MWT is a test using for evaluate the gait speed. Gait speed is a spatiotemporal parameter.
6 weeks after treatment
Change in BBS
時間枠:6 weeks after treatment
Berg Balance Scale used for balance assesment. The scale consists of 14 items and each item gets a score between 0-4. As a result, the person evaluated gets a score between 0-56 on the berg balance scale. A higher score means the person has better balance skills.
6 weeks after treatment
Change in Limits of Stability
時間枠:6 weeks after treatment
Limits of Stability (LoS) are defined as the points at which the center of gravity (CoG) approaches the limits of the base of support (BoS) and a correction strategy is required to return the center of mass (CoM) to within the BoS. In other words, LoS is the amount of maximum excursion an individual is able to intentionally cover in any direction without losing his/her balance or taking a step. We used Huber 360 device to evaluate the LoS.
6 weeks after treatment
Change in Spatiotemporal Gait Analysis
時間枠:6 weeks after treatment

Spatiotemporal gait analysis gives spatial (distance) parameters along with temporal (time) parameters.

  • Spatial parameters:

    • Step Length
    • Step Width
    • Stride Length
  • Temporal Parameters

    • Step Time
    • Stride Time
    • Stance Time
    • Swing Time
    • Double Support Time We used C-Mill device to evaluate the spatiotemporal parameters.
6 weeks after treatment

二次結果の測定

結果測定
メジャーの説明
時間枠
Change in Spatial Symmetry
時間枠:6 weeks after treatment
It is the ratio of the hemiplegic side step lenght to the non-hemiplegic side step lenght.
6 weeks after treatment
Change in Temporal Symmetry
時間枠:6 weeks after treatment
For temporal symmetry we used the description "Gait Symmetry". Gait symmetry is calculated by the ratio of the hemiplegic side sway phase to the hemiplegic side stance phase ratio and the ratio of the non-hemiplegic side sway phase to the non-hemiplegic side stance phase ratio.
6 weeks after treatment
Change in Postural Stability
時間枠:6 weeks after treatment
Postural stability refers to the ability to maintain your body in a position to effectively complete a task or demand, using large muscle groups at the shoulders, trunk, and hips. We used Huber 360 device to evaluate the postural staiblity. The assesments were combination of opened and closed eyes. We recorded the COP vellocity and area.
6 weeks after treatment

協力者と研究者

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研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2021年11月11日

一次修了 (実際)

2022年6月1日

研究の完了 (実際)

2022年6月1日

試験登録日

最初に提出

2022年6月8日

QC基準を満たした最初の提出物

2022年6月11日

最初の投稿 (実際)

2022年6月15日

学習記録の更新

投稿された最後の更新 (実際)

2022年11月21日

QC基準を満たした最後の更新が送信されました

2022年11月16日

最終確認日

2022年11月1日

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