The effect of Balance Exercise Assist Robot (BEAR) to patient after allogenetic hematopoietic stem cell transplantation (allo-HSCT): Preliminary study

Abstract

Previous studies have shown that patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT) frequently complicate balance dysfunction, with at least 50% experiencing one or more falls during hospitalization. We investigated the effect of Balance Exercise Assist Robot (BEAR) on patients after allo-HSCT, and the correlation between the effect of BEAR and the severity of balance dysfunction before intervention. Fifteen patients, who were allowed to leave the sterile room after allo-HSCT during hospitalization, participated. Mini-Balance Evaluation Systems Test (mini-BESTest), grip power, knee extension strength, 10-m walk test, Timed Up and Go test (TUG), dual-task TUG, functional reach test, Berg balance scale, sub-items of the mini-BESTest, and single-leg standing time were evaluated before and after intervention using BEAR. The participants performed 15 BEAR sessions, 20 minutes per session. The difficulty level of training task was automatically adjusted for each participants by BEAR. We divided into two groups based on pre-intervention Mini-BESTest scores: less than 70% (low group) and 70% or more (high group) and analyzed. Statistical analyses were performed to compare the groups; P < 0.05 indicated statistically significant differences. Informed consent was obtained from all participants before the intervention. There was no significant difference in pre- and post-intervention mini-BESTest in the low group (52.4 ± 15.9 vs. 70.8 ± 18.5) and high group (86.9 ± 12.0 vs. 88.5 ± 13.0). However, change between pre- and post-intervention scores in the low group was greater than the minimally important change of the mini-BESTest. Furthermore, significant improvement was observed between pre- and post-intervention scores for postural response (18.5 ± 22.7 vs. 51.9 ± 32.8), a mini-BESTest sub-item, in the low group. The other pre- and post-intervention outcomes were not significantly different in either group. BEAR was an effective and safe balance training, especially for postural response, in allo-HSCT patients with pre-intervention scores of less than 70% in the mini-BESTest.