Effects of Robot-Assisted Gait Training in Patients with Burn Injury on Lower Extremity: A Single-Blind, Randomized Controlled Trial

Abstract

This study investigated the effects of robot-assisted gait training (RAGT) on gait function in burn patients. Briefly, 40 burn patients were randomly divided into an RAGT group or a conventional training (CON) group. SUBAR® (Cretem, Korea) is a wearable robot with a footplate that simulates normal gait cycles. The RAGT group underwent 30 min of robot-assisted training using SUBAR® with 30 min of conventional physiotherapy once a day, 5 days a week for 12 weeks. Patients in the CON group received 30 min of overground gait training and range-of-motion (ROM) exercises twice a day for 5 days a week for 12 weeks. The RAGT group and the CON group underwent 60 min of training per day. The intervention frequency and duration did not differ between the RAGT group and the CON group. The main outcomes were functional ambulatory category (FAC); 6-min walking test (6MWT); visual analogue scale (VAS) during gait movement; ROM; and isometric forces of bilateral hip, knee, and ankle muscles before and after 12 weeks of training. The results of the VAS, FAC, and 6MWT (8.06 ± 0.66, 1.76 ± 0.56, and 204.41 ± 85.60) before training in the RAGT group improved significantly (4.41 ± 1.18, 4.18 ± 0.39, and 298.53 ± 47.75) after training (p < 0.001, p < 0.001, and p < 0.001). The results of the VAS, FAC, and 6MWT (8.00 ± 1.21, 1.75 ± 0.58, and 220.94 ± 116.88) before training in the CON group improved significantly (5.00 ± 1.03, 3.81 ± 1.05, and 272.19 ± 110.14) after training (p < 0.001, p < 0.001, and p = 0.05). There were differences in the improvement of results of the VAS, FAC, and 6MWT between groups after training, but they were not statistically significant (p = 0.23, p = 0.14, and p = 0.05). The isometric strengths of the right hip extensor (p = 0.02), bilateral knee flexor (p = 0.04 in the right, and p = 0.001 in the left), bilateral knee extensor (p = 0.003 in the right, and p = 0.002 in the left), bilateral ankle dorsiflexor (p = 0.04 in the right, and p = 0.02 in the left), and bilateral ankle plantarflexor (p = 0.001 in the right, and p = 0.008 in the left) after training were significantly improved compared with those before training in the RAGT group. The ROMs of the right knee extension (p = 0.03) and bilateral ankle plantarflexion (p = 0.008 in the right, and p = 0.03 in the left) were significantly improved compared with measurements before training in the RAGT. There were no significant differences of the isometric strengths and ROMs of the bilateral hip, knee, and ankle muscles after training in the CON group. There were significant improvements in the isometric strengths of the left knee flexor (p = 0.01), left ankle dorsiflexor (p = 0.01), and left ankle plantarflexor (p = 0.003) between the two groups. The results suggested that RAGT is effective to facilitate early recovery of muscles strength after a burn injury. This is the first study to evaluate the effectiveness of RAGT in patients with burns compared with those receiving conventional training. The absence of complications in burn patients provides an opportunity to enlarge the application area of RAGT.

Effect of Brething Exercise on Reducing Pain Associated With Dressing Among Hospitalized Burned Patients

“…From the perspective of the scientist, this gathering had absence of information in regards to security precautionary measures that expansion danger of consume damage. This finding compatible with (Joo et al, 2020), who demonstrated that, around half of consumed patients had essential and auxiliary instruction. Then again, (Elsherbiny et al, 2011) expressed that, the dominant part of consumed subjects were ignorant; this outcome was conversely with the consequence of present investigation.…”

“…As respects to conjugal status, the most astounding rate was married, this result was in harmonious with (Elsherbiny, Salem, El-Sabbagh, Elhadidy, & Eldeen, 2011); (Joo et al, 2020), who found that, the lion's share of consumed patients were hitched. Then again, Edwards, (2013) detailed that, the greater part of single grown-up most normally influenced with consume damage.…”

“…The result of the current study revealed that, the mean age of patients was (28.79 ± 8.95) years, and the highest of them aged from 20 to less than 30years old. On the other hand Joo, Lee, Cho, Lee, and Seo, (2020) found that, the larger part of subjects were in age between 18-40 years.…”

Effect of the Application of Virtual Reality on Pain Reduction and Cerebral Blood Flow in Robot-Assisted Gait Training in Burn Patients

“…Robotic therapy for musculoskeletal disorders is performed to allow intensive and repetitive training to increase the range of motion (ROM) and improve motor function [1]. While the clinical effectiveness of exoskeleton robot-assisted rehabilitation has been confirmed in burn patients [2][3][4], robotic therapy cannot be performed in patients who complain of severe pain during treatment. Therefore, there is a need for research on treatment methods that can reduce pain during robotic therapy.…”

Effect of robot-assisted gait training on the biomechanical properties of burn scars: a single-blind, randomized controlled trial

“…The primary goals of burn rehabilitation medicine are preventing the formation of burn scar contracture, improving the limited range of motion (ROM) of joints and limiting functional restrictions [ 1 ]. In particular, scar contracture of the lower extremities can lead to pain during walking and limited ROM of the hip, knee and ankle joints, which can result in gait disturbance [ 2 , 3 ]. Appropriate and sufficient rehabilitation therapy following burn injury can decrease hypertrophic scar formation and delay the progression of scar contracture in burn survivors [ 1 , 4 ].…”