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

2022년 11월 16일 업데이트: 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.

연구 개요

상세 설명

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+.

연구 유형

중재적

등록 (실제)

56

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

      • Ankara, 칠면조, 06000
        • Ankara City Hospital

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

18년 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

남성

설명

  • 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

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 하나의

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: 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.
실험적: 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.
실험적: 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.
다른: Control
-Only Conventional Physiotherapy
-Conventional Physiotherapy : 5 days in a week for 6 weeks, every seanson was 40 min.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Change in 6 MWT
기간: 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
기간: 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
기간: 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
기간: 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
기간: 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

2차 결과 측정

결과 측정
측정값 설명
기간
Change in Spatial Symmetry
기간: 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
기간: 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
기간: 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

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연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2021년 11월 11일

기본 완료 (실제)

2022년 6월 1일

연구 완료 (실제)

2022년 6월 1일

연구 등록 날짜

최초 제출

2022년 6월 8일

QC 기준을 충족하는 최초 제출

2022년 6월 11일

처음 게시됨 (실제)

2022년 6월 15일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2022년 11월 21일

QC 기준을 충족하는 마지막 업데이트 제출

2022년 11월 16일

마지막으로 확인됨

2022년 11월 1일

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