Effects of speed increase gait training with a new exoskeleton robot for subacute stroke subjects

WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS1238–eS1642

balloon as a walking aid. Previous studies have reported that somatosensory finger-tip (light touch contact, LTC) input from an external reference provides spatial orientation (Jeka, 1995) and that LTC changes the unstable walking of a baby into independent walking (Chen, 2008). In addition, the electromyography pattern of an infant during walking acquisition transforms into that of an infant who experienced walking via hand support for 3 months (Okamoto, 2011). Requests for consultations by parents or childcare workers regarding the unstable walking of an infant are common. However, there is no appropriate method of support for infants learning to walk. Purpose: The purpose of this study was to evaluate the use of a floating balloon as a walking aid for infants in order to improve unstable walking. Methods: The participants were 6 normal children (5 girls, 1 boy) who were in the initial walking period. We used a three-dimensional accelerometer by MicroStone and 4 digital video cameras by Sony and MW-1000 to measure the feet during gait by Anima. We set 2 measurement conditions: walking normally and walking with a floating balloon. The balloon was filled with helium; the buoyancy was approximately 2 g. The walking distance was 5 m, and the walking speed was not defined. We measured each condition thrice. We calculated body sway using root mean square error of the acceleration data of the X–Y–Z axis and examined step length, step width, and center of pressure (COP). We compared the data for infants when walking normally versus when walking with the balloon. Results: The root mean square during walking with the balloon was significantly smaller than that during walking normally (p < 0.05). The step length was significantly smaller when walking with the balloon; however, the step width was not significant. Changes in COP during a shift of the stance phase of the lower extremities were not significantly different between the conditions. In comparison with walking normally, changes in COP in the foot during each stance phase of walking with the balloon tended to be smaller. Conclusion(s): We showed that body sway decreased when the infants were walking with the balloon. The weight shift to the lower extremities was unaffected by the balloon. However, COP in the foot during each stance phase was well-controlled when using the balloon as a walking aid. Implications: We observed that infant body sway decreased on using the balloon. Infant body sway during walking acquisition is improved by supporting the hand of the infant (Ivanenko, 2005). The unstable body sway of infants may transform to periodic body sway of stable walking by using a floating balloon as a walking aid. Keywords: Floating balloon; Infant; Walking aid Funding acknowledgements: This work was supported by JSPS KAKENHI Grant Number 25560388. Ethics approval: This research got permission of ethics committee in Prefectural University of Hiroshima. http://dx.doi.org/10.1016/j.physio.2015.03.1334

eS1389

Research Report Poster Presentation Number: RR-PO-20-17-Sun Sunday 3 May 2015 12:15 Exhibit halls 401–403 EFFECTS OF SPEED INCREASE GAIT TRAINING WITH A NEW EXOSKELETON ROBOT FOR SUBACUTE STROKE SUBJECTS I. Shimizu, T. Yoshimoto, Y. Hiroi, M. Kawaki, D. Sato, M. Nagasawa Kameda Medical Center, Department of Rehabilitation, Kamogawa-Shi, Japan Background: Electromechanical gait trainings are becoming used for the rehabilitation after stroke. Although the effectiveness of such techniques has been investigated, it has been unclear in how to approach concretely. We have experienced that stroke patients could walk speedier and comfortably when used a new exoskeleton robot suit hybrid assistive limb (HAL). Purpose: The aim of this study was to evaluate the immediate effects of speed increase gait training with HAL for subacute stroke subjects. Methods: Thirteen subjects with stroke who were inpatients at the Kameda rehabilitation hospital were recruited (9 men and 4 women). The mean ± standard deviation age at the time of study was 65.8 ± 12.1 years, and the duration of stroke was 140.2 ± 20.1 days. They had a walking ability with manual assistance or supervision. All patients underwent the gait training with HAL and a body weight support walker (All in One) on a floor. Gait training was performed once each in two conditions: comfortable walking speed (C) and fast walking speed (F, 1.7–2.0 times the speed in C condition). The gait training was conducted in F condition 2 days after the training in C condition. The time of walking training with HAL was about 20 min in each condition, and the distance of walking was set about 400 m. We assessed a walking speed, number of steps and cadence using a 10 mwalk-test (10MWT) under comfortable and maximum speed. The assessment in 10MWT was performed before, after each gait training and 2 days after the training in F condition. Results: All patients had no adverse events during the training with HAL. In the 10MWT under comfortable walking speed, there were no significant changes in all parameters after the gait training in C condition, but the training in F condition had significant improvements in all parameters (speed, p < 0.01; steps, p < 0.05; cadence, p < 0.01). In the 10MWT under maximum walking speed, the immediate effects of each training were remarkably similar to the results in the 10MWT under comfortable speed. At 2 days after the training in F condition, the date in maximum walking speed and cadence were kept to significantly compared with the data before the training in F condition (speed, p < 0.05; cadence, p < 0.01). Conclusion(s): Our results showed that fast speed gait training with HAL was effective immediately in overground

eS1390

WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS1238–eS1642

walking speed, step length and cadence compared with comfortable speed gait training with HAL. Implications: Our approach and principle of speed increase gait training, which could provide the walking opportunity in the speed that are difficult with manual assistance, can contribute to draw out patients’ potential in may have a potential to elicit a gait capability in stroke patients. Keywords: Stroke; Speed increase gait training; Hybrid assistive limb Funding acknowledgements: This study received no specific grant from any funding agency. Ethics approval: The study was approved by Chair of the Kameda General Hospital Clinical Study Screening Committee (13-090). http://dx.doi.org/10.1016/j.physio.2015.03.1335 Research Report Poster Presentation Number: RR-PO-14-03-Sat Saturday 2 May 2015 12:15 Exhibit halls 401–403 RELATIONSHIP BETWEEN DIETARY HABITS AND COGNITIVE FUNCTION AMONG COMMUNITY-DWELLING ELDERLY ADULTS K. Shimizu 1 , H. Ihira 2 , A. Mizumoto 2 , K. Makino 1 , T. Ishida 1 , H. Shimada 3 , T. Furuna 2 1 Sapporo

Medical University Graduate School of Health Science, Sapporo, Japan; 2 Sapporo Medical University School of Health Science, Physical Therapy, Sapporo, Japan; 3 National Center for Geriatrics and Gerontology, Section for Health Promotion, Department for Research and Development to Support Independent Life of Elderly, Center for Gerontology and Social Science, Obu, Japan Background: The decline of cognitive function is known to be associated with nutritional factors in addition to aging itself. Recent studies have revealed that acute glucose intake improves cognitive function and that antioxidants such as ␤-carotene protect cognitive impairment. However, whether dietary habits such as eating breakfast affect cognitive function among community-dwelling elderly is unknown. Purpose: To cross-sectionally examine the relationship between dietary habits and cognitive function among community-dwelling elderly. Methods: Three-hundred and four community-dwelling elderly adults (age ≥ 65 years) participated in this crosssectional study (191 women, 113 men; mean age: 70.3 years). Participants filled out questionnaires regarding basic information and dietary habits (breakfast intake, regular diet, snacking, and an 11-item Food Diversity Scale). Participants were also assessed with neuropsychological tests of memory (stories and word lists), figure recognition, executive function

(Symbol Digit Substitution-Task), attention (Trail Making Test-A and B; TMT-A/B), and general cognitive function (Mini Mental State Examination; MMSE). All neuropsychological tests were conducted using an iPad tablet running the National Center for Geriatrics and Gerontology functional assessment tool. A Mann–Whitney U test was used to assess the differences in dietary habits (breakfast intake, regular diet, snacking). Spearman’s correlations were calculated to examine the relation between the score on the 11-item Food Diversity Scale and cognitive function. Level of significance was set at p < 0.05. Results: MMSE score (p = 0.044) and the time to complete one TMT-A item (p = 0.046) were significantly different depending on whether participants ate breakfast regularly or not. No significant correlations were found between scores on the 11-item Food Diversity Scale and cognitive function. Conclusion(s): Elderly adults who eat breakfast habitually have significantly better cognitive function (as measured by the MMSE and TMT-A) than those who do not. However, dietary habits do not appear to be related to other cognitive functions such as executive function, switching attention, or memory. Thus, dietary habits of community-dwelling elderly adults may affect their ability to continuously maintain attention. Implications: Our findings support the notion that dietary habits can affect cognitive function. Future research should reveal the effect of intervention targeted to improve dietary habits. Keywords: Dietary habits; Elderly adults; Continuous attention Funding acknowledgements: This study was no funding. Ethics approval: This study was approved by the Sapporo Medical University Ethics Committee. http://dx.doi.org/10.1016/j.physio.2015.03.1336 Research Report Poster Presentation Number: RR-PO-99-13-Sat Saturday 2 May 2015 12:15 Exhibit halls 401–403 RELIABILITY OF PHYSICAL ACTIVITY MEASURED USING TRIAXIAL ACCELEROMETER AND THE RELATIONSHIP BETWEEN DAYTIME ACTIVITY AND THERAPY-TIME ACTIVITY IN STROKE INPATIENTS N. Shimizu 1 , H. Hashidate 2 , A. Saitou 2 1 Hatsudai

Rehabilitation Hospital, Department of Physical Therapy, Tokyo, Japan; 2 Kyorin University, School of Health Sciences, Department of Physical Therapy, Tokyo, Japan Background: Increased physical activity (PA) during not only therapy-time, but also daytime, is important to improve