Author: Song, Hantao
Title: Gait restoration using exo-neuro-musculo-skeleton and cyber physical social system in home-based telerehabilitation for chronic stroke
Advisors: Hu, Xiaoling (BME)
Degree: M.Sc.
Year: 2024
Subject: Gait in humans -- Analysis
Cerebrovascular disease -- Patients -- Rehabilitation
Hong Kong Polytechnic University -- Dissertations
Department: Department of Biomedical Engineering
Pages: 87 pages : color illustrations
Language: English
Abstract: Background and aims
Hemiplegic foot drop and inversion are the primary complaints in individuals with poststroke ankle-foot motor impairments, compromising gait stability and asymmetry. Tele-rehabilitation can deliver efficient rehabilitation services and overcome geographical barriers to commute access. However, the lack of effective lower limb telerehabilitation programs with social interactions necessitates further investigation. An ankle-foot exoneuromusculoskeleton (AF-ENMS) was developed previously. This study aimed to explore the improvement of gait in chronic stroke patients using AF-ENMS for home-based tele-rehabilitation via cyber physical social system (CPSS)
Eighteen patients with chronic stroke were recruited to attend a 20-session telerehabilitation program assisted by the AF- ENMS. All participants received a pre-training tutorial and three face to face training sessions guided by a registered therapist, followed by 17-session self-help telerehabilitation at home. Online groups were established between two participants with supervision from the therapist and to encourage interaction. Training progress, including the training duration, completed steps, and unbalanced steps was telemonitored. Clinical assessments (e.g., Fugl-Meyer Assessment of the lower extremity (FMA), Modified Ashworth Scale (MAS), Berg Balance Scale(BBS)), as well as kinematic and plantar pressure evaluations were conducted before and after the training.
In this study, we implemented a 20-session telerehabilitation program for post-stroke patients, with a total of 15 participants completing the program, and three dropping out due to Covid-19 or work conflicts. Results indicate a tendency that the telerehabilitation program led to increased training duration and a reduction in unbalanced steps, attesting to improved patient engagement.
Post-training, significant improvements were observed in the Fugl-Meyer Assessment (FMA) and Berg Balance Scale (BBS) scores (P<0.05), demonstrating the program's efficacy in enhancing motor recovery and balance. Gait symmetry P (<0.05), shows the training also has a positive impact on coordination. Furthermore, a significant increase in foot dorsiflexion and a decrease in foot inversion were noted, indicating improved control over lower limb movement.
The study found that balance ability was notably enhanced, significant improvements were observed in conditions of foot drop and foot inversion and gait symmetry showed significant improvement. These findings underscore the potential of telerehabilitation programs in aiding post-stroke recovery and improving gait parameters, thereby contributing to the body of evidence supporting telehealth interventions in neurorehabilitation.
The home-based tele-rehabilitation training assist by Ankle Foot -ENMS via cyber physical social system can improve the gait performance and motor function of chronic stroke patient.
Rights: All rights reserved
Access: restricted access

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