Gait training with a new exoskeleton robot Hybrid Assistive Limb improves gait and balance performances in chronic stroke subjects

WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS1643–eS1721

significantly associated with the WL factor (both P < .01), and gait speed became faster owing to the WL factor. In the multiple linear regression analysis, ASMM (β = 0.586, P < .001), BFM (β = 0.548, P < .001), Alb (β = 0.029, P < .001), and TG (β = 0.022, P < .001) were significantly associated with actual body weight, even after adjusting for the covariates. In the multiple logistic regression analysis, Alb (odds ratio [OR] = 0.521, P < .001) and BFM (OR = 1.047, P < .001) were significantly associated with slow gait speed, even after adjusting for covariates. Conclusion(s): These results suggest that self-conscious weight loss is related to body fat. Self-reported weight loss reflected the actual decrease in body weight, and not only fat but also muscle mass and protein metabolism decreases in the thinner population. Lower body fat mass and faster gait speed were related, and high Alb level was significantly related to slow gait speed in the frailty older adults in this study. Implications: Sarcopenic obesity is a concern in the Japanese community-dwelling older population. To prevent decreased physical function, interventions targeting both body fat and muscle mass may be necessary. Keywords: Frailty; Weight loss; Albumin Funding acknowledgements: This work was supported by national grants and funding from co-author’s affiliation Institute. No potential conflicts of interest were disclosed. Ethics approval: The ethics committee of the National Center for Geriatrics and Gerontology approved this study. http://dx.doi.org/10.1016/j.physio.2015.03.113 Research Report Poster Presentation Number: RR-PO-20-17-Sat Saturday 2 May 2015 12:15 Exhibit halls 401–403 GAIT TRAINING WITH A NEW EXOSKELETON ROBOT HYBRID ASSISTIVE LIMB IMPROVES GAIT AND BALANCE PERFORMANCES IN CHRONIC STROKE SUBJECTS T. Yoshimoto, I. Shimizu, Y. Hiroi, M. Kawaki, D. Sato, M. Nagasawa Kameda Medical Center, Department of Rehabilitation, Kamogawa-City, Japan Background: New robotic locomotion devices have been developed for facilitation of gait training, and there is several evidence of a beneficial effect of the electromechanical devices for gait rehabilitation after stroke. A newly developed exoskeleton robot suit Hybrid Assistive Limb (HAL) has demonstrated its utility for gait rehabilitation after stroke. However, there is still insufficient knowledge about the efficacy of the training with HAL in chronic stroke subjects. Purpose: The aim of this study was to investigate the efficacy of 8 sessions (8 weeks) gait training with an exoskeleton

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HAL in chronic stroke subjects compared with conventional physical therapy. Methods: A total of 18 subjects with >6 months poststroke who were outpatients at the Kameda Clinic were recruited. Nine patients were enrolled as a HAL group, and nine patients as a control group (patient allocation was not randomized). HAL group received the gait training with HAL and a walking device with a harness (All in One) once a week for 8 weeks (8 sessions). The training conditions were as follows:

1) the walking speed of the training was determined as a fast walking speed tolerated without knee buckling or toe drag, 2) the time of walking training with HAL was about 20 min in each session, 3) the distance of walking was set about 400 m.

Control group underwent the conventional physical therapy for gait disturbance once a week or every two weeks in the clinic. Outcome measures were walking speed, cadence and number of steps recorded during a 10-meter walk test (10MWT), timed up and go test (TUGT), functional reach test (FRT) and Berg Balance Scale (BBS). These assessments were performed without wearing HAL prior to training, after 4 and 8 sessions, and at 1 month follow-up training. Results: Participants who received 8 sessions of gait training with HAL improved significantly in walking speed (55.9% increase), number of steps (17.6% decrease) and cadence (32.8% increase) in 10MWT compared with data before the training as baseline (p < 0.01 in all). TUGT, FRT and BBS also exhibited significant improvements after the HAL training (30.2% decrease, 41.4% increase and 13.8% increase, respectively). These improvements were maintained until the 1 month follow-up evaluation. In control group, there were no statistical time-dependent changes through this study periods in all parameters. Conclusion(s): Our results indicated that gait training with robot suit HAL was effective to improve a gait speed, step length, cadence and balance function in chronic stroke subjects compared with conventional therapy, and these effects lasted for 1 month after the training. Implications: In chronic stroke subjects whose recovery of function are believed to be mainly completed, speedincrease gait training with HAL may have a potential for improving gait and balance disturbance. Keywords: Hybrid Assistive Limb; Gait training; Chronic stroke Funding acknowledgements: This study was unfunded. Ethics approval: This study was approved by Chair of the Kameda General Hospital Clinical Study Screening Committee. http://dx.doi.org/10.1016/j.physio.2015.03.114