Résumé
Objective@#To measure muscle activity before and after robot-assisted gait training (RAGT) in patients with stroke and examine the differences in muscle activity changes compared with conventional gait training (CGT). @*Methods@#Thirty patients with stroke (RAGT group, n=17; CGT group, n=13) participated in the study. All patients underwent RAGT using a footpad locomotion interface or CGT for 20 minutes for a total of 20 sessions. Outcome measures were lower-limb muscle activity and gait speed. Measurements were performed before the start of the intervention and after the end of the 4-week intervention. @*Results@#The RAGT group showed increased muscle activity in the gastrocnemius, whereas the CGT group showed high muscle activity in the rectus femoris. In the terminal stance of the gait cycle, the gastrocnemius, the increase in muscle activity was significantly higher in the RAGT group than in the CGT group. @*Conclusion@#The results suggest that RAGT with end-effector type is more effective than CGT to increase the gastrocnemius muscle activity.
Résumé
<b>Background: </b>The current study aimed to investigate factors associated with the prognosis of activities of daily living (ADL) in elderly patients with pneumonia who had undergone rehabilitation during their hospitalization.<br><b>Methods: </b>The study included patients of age ≥65 years who were hospitalized due to pneumonia and had undergone rehabilitation for disuse syndrome at Tsukuba Memorial Hospital. The main outcome was measured using the functional independence measure (FIM) scores to assess ADL. The participants were divided into a high-recovery group (≥80%) and a low-recovery group (<80%) based on the FIM recovery rate score. Further, factors associated with the prognosis of ADL were evaluated using multivariate logistic regression analysis. Basic characteristics, consciousness, usual mode of transportation, FIM score, grip strength, range of motion, orthostatic hypotension, exercise tolerance (6-minutes walking distance), respiratory disorder (Hugh–Jones classification), constipation, malnutrition (mini-nutritional assessment), cognitive (mini-mental state examination), depression (geriatric depression scale), balance (functional balance scale), urinary incontinence, and pressure ulcers were included as the evaluation items.<br><b>Results: </b>Among the 51 elderly patients with pneumonia (average age ± SD; 82.0 ± 11.3), 34 patients were classified in the high-recovery group and 17 in the low-recovery group. In multivariate logistic regression analysis, it was revealed that the number of days from the onset until the initiation of rehabilitation (days of inactivity) and nutritional status were factors associated with a high-recovery FIM score.<br><b>Conclusions: </b>The study results suggest that days of inactivity and early management of nutritional status after hospitalization are important for elderly patients with pneumonia to return to their ADL.