Abstract
BackgroundFalls are more prevalent in stroke survivors than age-matched healthy older adults because of their functional impairment. Rapid balance recovery reaction with adequate range-of-motion and fast response and movement time are crucial to minimize fall risk and prevent serious injurious falls when postural disturbances occur. A Kinect-based Rapid Movement Training (RMT) program was developed to provide real-time feedback to promote faster and larger arm reaching and leg stepping distances toward targets in 22 different directions.ObjectiveTo evaluate the effectiveness of the interactive RMT and Conventional Balance Training (CBT) on chronic stroke survivors’ overall balance and balance recovery reaction.MethodsIn this assessor-blinded randomized controlled trial, chronic stroke survivors were randomized to receive twenty training sessions (60-min each) of either RMT or CBT. Pre- and post-training assessments included clinical tests, as well as kinematic measurements and electromyography during simulated forward fall through a “lean-and-release” perturbation system.ResultsThirty participants were recruited (RMT = 16, CBT = 14). RMT led to significant improvement in balance control (Berg Balance Scale: pre = 49.13, post = 52.75; P = .001), gait control (Timed-Up-and-Go Test: pre = 14.66 s, post = 12.62 s; P = .011), and motor functions (Fugl-Meyer Assessment of Motor Recovery: pre = 60.63, post = 65.19; P = .015), which matched the effectiveness of CBT. Both groups preferred to use their non-paretic leg to take the initial step to restore stability, and their stepping leg’s rectus femoris reacted significantly faster post-training (P = .036).ConclusionThe RMT was as effective as conventional balance training to provide beneficial effects on chronic stroke survivors’ overall balance, motor function and improving balance recovery with faster muscle response.Trial registration: The study was registered at Clinicaltrials.gov (https://clinicaltrials.gov/ct2/show/NCT03183635, NCT03183635) on 12 June 2017.
Highlights
Telerehabilitation and interactive body motion detection technology using Kinect and Wii Fit have become more popular [1, 2]
Rapid Movement Training (RMT) led to significant improvement in balance control (Berg Balance Scale: pre = 49.13, post = 52.75; P = .001), gait control (Timed-Up-and-Go Test: pre = 14.66 s, post = 12.62 s; P = .011), and motor functions (Fugl-Meyer Assessment of Motor Recovery: pre = 60.63, post = 65.19; P = .015), which matched the effectiveness of conventional balance training (CBT)
Healthcare professionals and stroke survivors are interested in the feasibility of using these computer-assisted training systems for balance training, and they would like to know the effectiveness when compared with conventional balance training (CBT) in the rehabilitation center
Summary
Telerehabilitation and interactive body motion detection technology using Kinect and Wii Fit have become more popular [1, 2]. Telerehabilitation or computer-assisted training system using body motion detection technology can be applied for stroke rehabilitation during the COVID-19 pandemic by minimizing face-to-face interaction and the risk of infection. A recently published study in 2019 examined the effectiveness of an invention program which aimed to improve arm motor function in stroke survivors through 36 therapy sessions (70 min each) [1]. The program consisted of exercises, functional games, and stroke education. Their results showed homebased telerehabilitation was as effective as in-clinic rehabilitation and had significant improvements in arm motor function. Balance control and fall prevention are another important rehabilitation programs for stroke survivors. A Kinect-based Rapid Movement Training (RMT) program was developed to provide real-time feedback to promote faster and larger arm reaching and leg stepping distances toward targets in 22 different directions
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