Feasibility of supplemental robot-assisted knee flexion exercise following total knee arthroplasty

Kotani, Naoya; Morishita, Takashi; Saita, Kazuya; Kamada, Shin; Maeyama, Akira; Abe, Hiroshi; Yamamoto, Takuya; Shiota, Etsuji; Inoue, Takeshi

doi:10.3233/bmr-181482

Cited by 12 publications

(37 citation statements)

References 35 publications

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“…We considered that HAL-assisted exercise stimulates proper proprioceptive receptors by repeatedly feeding back correct motion at low load and suppresses abnormal spinal reflexes. Actually, our group has shown the possibility of AMI improvement by HAL-assisted exercise in patients who underwent total knee arthroplasty (42,43). Similarly, our non-PD patients showed significant pain reduction following HAL-assisted exercise, and this may partly contribute to the improvement in motor functions.…”

Section: Discussionsupporting

confidence: 54%

Biofeedback Core Exercise Using Hybrid Assistive Limb for Physical Frailty Patients With or Without Parkinson's Disease

et al. 2020

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Introduction: Elderly people often exhibit "frailty," and motor dysfunction occurs. Several studies have reported about the relationship between motor dysfunction and frailty in Parkinson's disease (PD). This study aimed to test whether the core exercise using the hybrid assistive limb lumbar type for care support (HAL-CB02) may improve the motor functions in frailty patients with or without PD and to explore the optimal patient selection from the frailty cohort. Materials and Methods: We recruited 16 frailty patients (PD = 8; non-PD = 8). The participants performed core exercise and squats using HAL-CB02 for five sessions a week. Outcome measures were 10-m walking test, step length, timed up-and-go test, 30-s chair stand test, and visual analog scale. Evaluation was conducted at baseline, post-exercise, and 1-and 3-month follow-ups. Results: Both PD and non-PD patients showed significant improvement in all evaluation items post-exercise. Moreover, no significant difference was found in the improvement value between the two groups. Conclusions: Our results suggest that biofeedback exercise with HAL-CB02 is a safe and promising treatment for frailty patients. Motor dysfunction in PD patients may be partly due to physical frailty, and biofeedback exercise with HAL-CB02 is proposed as a treatment option.

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Section: Discussionsupporting

confidence: 54%

Biofeedback Core Exercise Using Hybrid Assistive Limb for Physical Frailty Patients With or Without Parkinson's Disease

et al. 2020

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“…Our meta-analysis of 2 studies [ 15 , 16 ] showed that HAL training significantly improved pain measured on an 0 to 10-point VAS, compared to CR in patients who underwent TKR (SMD = 1.05, 95% Cl 0.39–1.71) after 5 days of training. Heterogeneity for I 2 value was lower than moderate (tau^2 = 0.0121; I 2 = 5%; P = .30) (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Rehabilitation using HAL resulted in a significantly better improvement in quadriceps strength compared to CR (weeks 1 and 2; weeks 1 and 3: P < .001). In the studies by Kotani et al [ 15 ] and Goto et al, [ 16 ] other outcome measures except VAS were analyzed descriptively to evaluate the function. RAR through HAL was performed to assist knee ROM exercise every other day in the experimental group in the single knee joint.…”

Section: Resultsmentioning

confidence: 99%

“…In the studies by Kotani et al [ 15 ] and Goto et al, [ 16 ] the change in VAS was evaluated using meta-analysis (Table 1). We aggregated the data obtained from 2 studies reporting the effects of HAL in comparison to CR in the form of mean (standard deviation) to produce an overall mean effect (standardized mean effect [SMD]).…”

Section: Methodsmentioning

confidence: 99%

“…In studies using HAL, 6 [14][15][16]19,21,22] included patients having post-TKR rehabilitation and one [20] included patients undergoing post-THR rehabilitation. First of all, among 6 [14][15][16]19,21,22] studies, the outcome measures were analyzed descriptively (with exception of VAS) to evaluate the knee function in the studies by Kotani et al, [15] Goto et al [16] Improvement in active and passive knee ROM and strength of knee flexion were assessed for the evaluation of function in the study by Kotani et al [15] Goto et al [16] reported the effectiveness of HAL assisted rehabilitation through the extension lag. VAS and extension lag were analyzed descriptively as the specific data of VAS was not reported in the study by Yoshioka et al [21] In the other 2 studies, Yoshikawa et al [14] used the following outcome measures: muscle strength of knee extension and flexion, the knee ROM, and WOMAC to evaluate the knee function at the pre-surgery, and at weeks 1, 2, 3, 4, and 8 after training.…”

Section: Data Synthesis and Statistical Analysismentioning

confidence: 99%

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Robot-assisted rehabilitation for total knee or hip replacement surgery patients: A systematic review and meta-analysis

Yoo

Lee

et al. 2022

Medicine

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Background: This study was performed to update the current evidence and evaluate the effects of robot-assisted rehabilitation (RAR) in comparison with conventional rehabilitation (CR) in patients following total knee (TKR) or hip replacements (THR).Methods: PubMed Central, OVID Medline, Cochrane Collaboration Library, and EMBASE for a comprehensive search for all relevant studies, from database inception to July 2022. The following inclusion criteria were used to determine eligibility for studies: randomized and matched controlled trials recruiting men and women who underwent TKR and THR; and studies examining the effect of RAR on outcome measures of physical function and pain.Results: A total of 9 studies (230 patients) were included in this review and 4 were included in the meta-analysis. The metaanalysis of 2 studies showed that Hybrid Assistive Limb (HAL) training for 5 days, significantly improved pain measured on a visual analogue scale, compared to CR in patients following TKR (SMD = 1.05, 95% confidence interval [Cl] 0.39-1.71). Heterogeneity for I 2 value was lower than moderate (tau^2 = 0.0121; I 2 = 5%; P = .30). There were 2 studies that assessed self-selected walking speed. The meta-analysis of these studies showed that HAL training was significantly superior to CR in patients following TKR (SMD = 48.70, 95% Cl -50.53 to 147.94) at 2 months. A high heterogeneity was detected (P < .01; I 2 = 97%). Conclusion:The result of this systematic review and meta-analysis suggest that RAR may be an effective treatment in TKR and THR patients. However, high-quality studies are needed to verify the long-term effect on their recovery. Abbreviations: CI = confidence interval, CR = conventional rehabilitation, HAL = hybrid assistive limb, MCID = minimally clinically important difference, MWS = maximum walking speed, NRS = numerical rating scale, RAR = robot-assisted rehabilitation, RCT = randomized clinical trial, ROM = range of motion, SMD = standardized mean difference, SWS = self-selected walking speed, TCRRT = trunk control rehabilitation robot training, THR = total hip replacements, TKR = total knee replacement, VAS = visual analog scale, WOMAC = Western Ontario and McMaster universities osteoarthritis index.

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Robot‐assisted rehabilitation training improves knee function and daily activity ability in older adults following total knee arthroplasty

Cai

Liu

Wei

et al. 2022

Research in Nursing & Health

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To evaluate the effects of robot‐assisted rehabilitation training on knee function and the daily activity ability of older adults following total knee arthroplasty (TKA). Eighty‐eight patients who underwent TKA were randomly assigned to a robot‐assisted rehabilitation or traditional therapy group. The patients in the control group were treated with traditional manual rehabilitation therapy, while the patients in the experimental group were subjected to the robot‐assisted rehabilitation program. Range of motion of the knee joint, Hospital for Special Surgery Knee Rating Score, and the modified Barthel Index were assessed on the first or second day after TKA (preintervention) and the discharge day (postintervention). Additionally, the length of hospital stay and related hospitalization expenses of the two groups were collected on the discharge day. Improvements in the active range of motion (p < 0.001), passive range of motion (p = 0.001), Hospital for Special Surgery Knee Rating Score (p < 0.001), and modified Barthel Index score (p = 0.004) were significantly better in the robot‐assisted rehabilitation group than in the traditional therapy group. Interestingly, the length of hospital stay in the experimental group (9 days) was shorter than that in the control group (13 days), and the total cost of hospitalization was lower (p = 0.002). The robot‐assisted rehabilitation training program is an effective intervention that significantly improves the daily activity ability and knee function of older adults following TKA.

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Feasibility of supplemental robot-assisted knee flexion exercise following total knee arthroplasty

Cited by 12 publications

References 35 publications

Biofeedback Core Exercise Using Hybrid Assistive Limb for Physical Frailty Patients With or Without Parkinson's Disease

Biofeedback Core Exercise Using Hybrid Assistive Limb for Physical Frailty Patients With or Without Parkinson's Disease

Robot-assisted rehabilitation for total knee or hip replacement surgery patients: A systematic review and meta-analysis

Robot‐assisted rehabilitation training improves knee function and daily activity ability in older adults following total knee arthroplasty

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