Kinect-based rapid movement training to improve balance recovery for stroke fall prevention: a randomized controlled trial

Background Falls 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 fall...

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Bibliographic Details
Published in:Journal of neuroengineering and rehabilitation 2021-10, Vol.18 (1), p.1-150, Article 150
Main Authors: Junata, Melisa, Cheng, Kenneth Chik-Chi, Man, Hok Sum, Lai, Charles Wai-Kin, Soo, Yannie Oi-Yan, Tong, Raymond Kai-Yu
Format: Article
Language:English
Subjects:
Arm
Balance
Cameras
Care and treatment
Caregivers
Clinical trials
Coronaviruses
COVID-19
Electromyography
Exercise therapy
Falls
Falls (Accidents)
Gait
Health risks
Injury prevention
Leg
Medical equipment
Methods
Motion detectors
Movement
Muscles
Older people
Pandemics
Perturbation
Posture
Prevention
Professionals
Recovery
Recovery of function
Rehabilitation
Slip and fall
Stroke
Stroke patients
Stroke rehabilitation
Survival
Telemedicine
Telerehabilitation
Testing
Training
Training evaluation
Workloads
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Summary:Background Falls 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. Objective To evaluate the effectiveness of the interactive RMT and Conventional Balance Training (CBT) on chronic stroke survivors' overall balance and balance recovery reaction. Methods In 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. Results Thirty 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). Conclusion The 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 ( Keywords: Falls, Stroke rehabilitation, Slip and fall, Balance, Posture, Telerehabilitation
ISSN:1743-0003
1743-0003
DOI:10.1186/s12984-021-00922-3