Burns Clinical Trial
Official title:
The Effects of Gait Performance and Brain Activity After Robot-assisted Gait Training(RAGT) On Patients With Lower Extremity Thermal Injury : a Prospective, Randomized, Single-blinded Study
This study aimed to elucidate the efficacy and investigate the mechanism of motor recovery after RAGT on patients with lower extremity burn. To investigate RAGT effects, we compare the results of RGAT group to the results of matched conventional(CON) rehabilitation group.
Gait enables individuals to move forward and is considered a natural skill. However, gait
disturbances are very common in patients with burn injury. Major causes of functional
impairment are pain and joint contractures. Contractures at the lower extremities such as the
hip, knee, and ankle significantly limit gait. Recent studies focused on the application of
robot-assisted gait training (RAGT).
This single-blinded, randomized, controlled trial involved 40 patients with lower extremity
burns. Patients were randomized into a RAGT or a CON group.
SUBAR® (CRETEM, Korea) is a wearable robot with a footplate that assists patients to perform
voluntary muscle movements. RAGT enables training of automatically programmed normal gait
pattern. Patients underwent 30 min of RAGT using SUBAR® and conventional exercise
rehabilitation each for 30 min once a day for 5 days a week for 12 weeks. The CON group
focused on gait training such as passive ROM exercise, weight bearing training, manual
lymphatic drainage, and hypertrophic scar care for 60 min once a day for 5 days a week for 12
weeks.
A wearable functional near-infrared spectroscopy (fNIRS) device has been developed for
studying cortical hemodynamics. Changes in cortical activity has not previously been
documented in patients with burn injury. Cortical activity was measured by evaluating
relative changes in oxyhemoglobin level. The NIRST Analysis Tool v2.1 was utilized to analyze
fNIRS data in a MATLAB environment. Functional scores of functional ambulation category
(FAC), 6-minute walking test (6MWT) distances, and numeric rating scale (NRS) scores of pain
before and after 12 weeks RAGT were measured. Numeric rating scale (NRS) was used to rate the
degree of subjective pain during gait movement: 0 points were assigned when no pain was
noted, and unbearable pain was assigned 10 points. To evaluate functional recovery, FAC
scores and 6-minute walking test (6MWT) distances were measured. FAC was evaluated based on
six scales. Scale 0 means that the patient cannot walk or can only walk with assistance of
two people. Scale 5 means that the patient can walk independently. We measured
walking-related cortical activity using an fNIRS device before and after 12 weeks RAGT.
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