Toshio Fuwa

Preliminary Trial of Postural Strategy Training Using a Personal Transport Assistance Robot for Patients With Central Nervous System Disorder

OBJECTIVE To examine the efficacy of postural strategy training using a personal transport assistance robot (PTAR) for patients with central nervous system disorders. DESIGN Single-group intervention trial. SETTING Rehabilitation center at a university hospital. PARTICIPANTS Outpatients (N=8; 5 men, 3 women; mean age, 50±13y) with a gait disturbance (mean time after onset, 34±29mo) as a result of central nervous system disorders were selected from a volunteer sample. INTERVENTIONS Two methods of balance exercise using a PTAR were devised: exercise against perturbation and exercise moving the center of gravity. The exercises were performed twice a week for 4 weeks. MAIN OUTCOME MEASURES Preferred and tandem gait speeds, Functional Reach Test, functional base of support, center of pressure (COP), muscle strength of lower extremities, and grip strength were assessed before and after the completion of the exercise program. After the exercise program, enjoyment of exercise was investigated via a visual analog scale questionnaire. RESULTS After the program, statistically significant improvements were noted for tandem gait speeds (P=.009), Functional Reach Test (P=.003), functional base of support (P=.014), and lower extremity muscle strength (P<.001-.042). On the other hand, preferred gait speeds (P=.151), COP (P=.446-.714), and grip power (P=.584) did not change. Finally, subjects rated that this exercise was more enjoyable than traditional balance exercises. CONCLUSIONS Dynamic balance and lower extremity muscle strength were significantly improved in response to postural strategy training with the PTAR. These results suggest that postural strategy training with the PTAR may contribute to fall prevention of patients with a balance disorder.