Proposed Topic (Most preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Proposed Topic (Second preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
Ho HW, Chan WC, Yim ST, Ng CL, Cheng WLO, Woo CWY, Lam S
Affiliation :
Physiotherapy Department, Haven of Hope Hospital
Introduction :
Stroke is a disease that causing various disability to patient, including gait impairment, ADL dysfunction and cognitive impairment. Comparing with conventional physiotherapy gait training, Robot-Assisted Gait Training with body weight support (RAGT) can provide higher intensity and specificity. High frequency of RAGT (3-5/week) was suggested in previous studies in order to achieve positive effect. However, it is difficult to reach the recommended frequency in clinical setting due to high patient demand and labour intensive treatment. It is more feasible to provide twice weekly RAGT in clinical practice.
Objectives :
To evaluate the effectiveness of a less frequent RAGT (twice weekly) on ambulation and balance outcomes in stroke rehabilitation.
Methodology :
Stroke patients who underwent rehabilitation in the Haven of Hope Hospital were included in the study. Patients with postural hypotension, osteoporosis, joint contracture and abdominal aortic aneurysm were excluded. Patients recruited in the study underwent 30 minutes RAGT twice weekly for 12 sessions on top of conventional physiotherapy training. Outcome measures including Modified Functional Ambulation Classification (MFAC), Six-Meter-Timed-Walk (6MTW) and Time-Up-and-Go Test (TUGT) were evaluated in the 1st, 6th and 12th sessions of RAGT. Wilcoxon Signed-Rank test and paired t-test were applied to compare the changes in the outcomes at the three time points.
Result & Outcome :
29 patients with average age 60 were included in the study. 9 patients withdrew from the RAGT before the 6th session. 6 patients completed more than 6 sessions but withdrew before the 12th session. The median of MFAC in 1st, 6th and 12th session was 3.5, 4 and 5 respectively. The mean of 6MTW in 1st, 6th, 12th session was 30.65±13.98s, 18.87±7.91s and 11.12±3.61s respectively. The mean of TUGT in 1st, 6th and 12th session was 55.54±21.37s, 35.51±16.58s and 23.75±8.74s respectively. Significant difference was shown in MFAC, 6MTW and TUGT in 1st - 6th session and 1st - 12th session comparison (p < 0.05). Improving trend was observed between 6th and 12th session in the 3 outcome measures.
Conclusion:
Twice weekly 30-minute-RAGT combining with conventional physiotherapy training was shown to improve gait and balance performance of stroke patients. Small sample size and high dropout rate after 6th session are the limitations of this study. Further randomized controlled trails with larger sample size is recommended.
