Effects of Balance Exercise Assist Robot training for patients with hemiparetic stroke: a randomized controlled trial

Abstract

Background Robot-assisted rehabilitation for patients with stroke is promising. However, it is unclear whether additional balance training using a balance-focused robot combined with conventional rehabilitation programs supplements the balance function in patients with stroke. The purpose of this study was to compare the effects of Balance Exercise Assist Robot (BEAR) training combined with conventional inpatient rehabilitation training to those of conventional inpatient rehabilitation only in patients with hemiparetic stroke. We also aimed to determine whether BEAR training was superior to intensive balance training. Methods This assessor-blinded randomized controlled trial included 60 patients with first-ever hemiparetic stroke, admitted to rehabilitation wards between December 2016 and February 2019. Patients were randomly assigned to one of three groups, robotic balance training and conventional inpatient rehabilitation (BEAR group), intensive balance training and conventional inpatient rehabilitation (IBT group), or conventional inpatient rehabilitation-only (CR group). The intervention duration was 2 weeks, with assessments conducted pre- and post-intervention, and at 2 weeks follow-up. The primary outcome measure was a change in the Mini-Balance Evaluation Systems Test (Mini-BESTest) score from baseline. Results In total, 57 patients completed the intervention, and 48 patients were evaluated at the follow-up. Significant improvements in Mini-BESTest score were observed in the BEAR and IBT groups compared with in the CR group post-intervention and after the 2-week follow-up period (P < 0.05). Conclusions The addition of balance exercises using the BEAR alongside conventional inpatient rehabilitation improved balance in patients with subacute stroke. Trial registration https://www.umin.ac.jp/ctr; Unique Identifier: UMIN000025129. Registered on 2 December 2016.

Advances in balance training to prevent falls in stroke patients: a scoping review

“…And there is a lack of researches for such stroke patients with early balance training, which may have better recovery effects ( 19 ). However, considering the safety of patients and potential medical disputes, it is often difficult to achieve, so robot-assisted balance training has unique advantages for early intervention of such patients ( 20 ).…”

“…Robot-assisted rehabilitation of stroke patients holds excellent promise. One study with BEAR (Robot for Balance Exercise Assisted), interventions for 2 weeks, assessment before and after the intervention, and at 2 weeks follow-up, improved balance in patients with subacute stroke ( 20 ). Robot-assisted training can improve the safety of home training for patients; in the future, it has great application potential in early/subacute stroke patients with hemiplegia.…”

Comparison of usefulness between the Mini-Balance Evaluation Systems Test and the Berg Balance Scale for measuring balance in patients with subacute stroke: a prospective cohort study

“…The Mini-BESTest sections (anticipatory postural adjustment, postural response, sensory orientation, and stability of gait) indicate the possibility of assessing various elements of balance function, which are not examined in the BBS. In fact, a previous study using the Mini-BESTest as an outcome showed that certain balance interventions selectively improved reactive postural control ( 20 ). Therefore, the Mini-BESTest could provide a more detailed assessment of the problematic parts of a patient's balance function and determine those for which the intervention was effective; hence, it could have high clinical applicability.…”

“…A shortened version of the test, the Mini-Balance Evaluation System Test (Mini-BESTest) ( 14 ), has recently been published, which consists of four balance sections (anticipatory postural adjustments, postural responses, sensory orientation, and stability in gait). Its reliability and validity have been demonstrated in various diseases and different countries ( 15 – 17 ) and it is widely used for balance assessment in clinical situations ( 18 – 20 ).…”

Benefits of a Balance Exercise Assist Robot in the Cardiac Rehabilitation of Older Adults with Cardiovascular Disease: A Preliminary Study

“…Several recent studies have shown that exercises using a Balance Exercise Assist Robot (BEAR) improve balance function [ 19 , 20 , 21 , 22 ]. Compared with traditional exercises only, those incorporating a BEAR improved dynamic balance among community-dwelling frail and prefrail older adults [ 19 ].…”