Szilvia Kóra
58570756900
Publications - 2
Walking on a Balance Beam as a New Measure of Dynamic Balance to Predict Falls in Older Adults and Patients with Neurological Conditions
Publication Name: Sports Medicine Open
Publication Date: 2024-12-01
Volume: 10
Issue: 1
Page Range: Unknown
Description:
Background: Beam walking is a new test to estimate dynamic balance. We characterized dynamic balance measured by the distance walked on beams of different widths in five age groups of healthy adults (20, 30, 40, 50, 60 years) and individuals with neurological conditions (i.e., Parkinson, multiple sclerosis, stroke, age: 66.9 years) and determined if beam walking distance predicted prospective falls over 12 months. Methods: Individuals with (n = 97) and without neurological conditions (n = 99, healthy adults, age 20–60) participated in this prospective longitudinal study. Falls analyses over 12 months were conducted. The summed distance walked under single (walking only) and dual-task conditions (walking and serial subtraction by 7 between 300 to 900) on three beams (4, 8, and 12-cm wide) was used in the analyses. Additional functional tests comprised grip strength and the Short Physical Performance Battery. Results: Beam walking distance was unaffected on the 12-cm-wide beam in the healthy adult groups. The distance walked on the 8-cm-wide beam decreased by 0.34 m in the 20-year-old group. This reduction was ~ 3 × greater, 1.1 m, in the 60-year-old group. In patients, beam walking distances decreased sharply by 0.8 m on the 8 versus 12 cm beam and by additional 1.6 m on the 4 versus 8 cm beam. Beam walking distance under single and dual-task conditions was linearly but weakly associated with age (R2 = 0.21 for single task, R2 = 0.27 for dual-task). Age, disease, and beam width affected distance walked on the beam. Beam walking distance predicted future falls in the combined population of healthy adults and patients with neurological conditions. Based on receiver operating characteristic curve analyses using data from the entire study population, walking ~ 8.0 of the 12 m maximum on low-lying beams predicted future fallers with reasonable accuracy. Conclusion: Balance beam walking is a new but worthwhile measure of dynamic balance to predict falls in the combined population of healthy adults and patients with neurological conditions. Future studies are needed to evaluate the predictive capability of beam walking separately in more homogenous populations. Clinical Trial Registration Number NCT03532984.
Open Access: Yes
Investigation of the Effectiveness of the Robotic ReStore Soft Exoskeleton in the Development of Early Mobilization, Walking, and Coordination of Stroke Patients: A Randomized Clinical Trial
Publication Name: Robotics
Publication Date: 2024-03-01
Volume: 13
Issue: 3
Page Range: Unknown
Description:
Medical robotics nowadays can prevent, treat, or alleviate numerous severe conditions, including the dire consequences of stroke. Our objective was to determine the effect of employing a robotic soft exoskeleton in therapy on the development of the early mobilization, gait, and coordination in stroke patients. The ReStore™ Soft Exo-Suit, a wearable exosuit developed by a leading company with exoskeleton technology, was utilized. It is a powered, lightweight device intended for use in stroke rehabilitation for people with lower limb disability. We performed a randomized clinical intervention, using a before–after trial design in a university hospital setting. A total of 48 patients with a history of stroke were included, of whom 39 were randomized and 30 completed the study. Interventions: Barthel Index and modified Rankin scale (mRS) patients were randomly assigned to a non-physical intervention control (n = 9 of 39 completed, 30 withdrew before baseline testing), or to a high-intensity agility program (15 sessions, 5 weeks, n = 30 completed). The main focus of assessment was on the Modified Rankin Scale. Additionally, we evaluated secondary factors including daily life functionality, five dimensions of health-related quality of life, the Beck depression inventory, the 6 min walk test (6MWT), the Berg Balance Scale (BBS), and static balance (center of pressure). The Robot-Assisted Gait Therapy (ROB/RAGT) program led to significant improvements across various measures, including a 37% improvement in Barthel Index scores, a 56% increase in 10 m walking speed, and a 68% improvement in 6 min walking distance, as well as notable enhancements in balance and stability. Additionally, the intervention group demonstrated significant gains in all these aspects compared to the control group. In conclusion, the use of robotic therapy can be beneficial in stroke rehabilitation. These devices support the restoration and improvement of movement in various ways and contribute to restoring balance and stability.
Open Access: Yes