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Our study aims to investigate the effectiveness of a more individualized and personalized feedback-oriented approach using a Robotic Assisted System, the Hunova Movendo Robotic System. This system is tailored to specific needs of individuals and is dynamically adjustable relative to patients' balance and functional demands. It will be compared to Otago Exercise Programme which is more generalized. Given the generalized nature of the Otago Exercise Programme, we aim to compare it with the Robotic Assisted Systems in the enhancement of Balance, Postural Stability, Functional Gait and Fall Efficacy in older adults.
Aging comes with increased risk of fall and a steep decline in adequate motor functioning, as such due to the decline in proprioception, balance and general functional independence the risk of falls and injury is high in aging adults impacting quality of life.
Traditional approaches like the Otago Exercise Programmes (and other Balance and Mobility exercise protocols) have been relatively effective in the management of falls yet there's a remarkable and persistent increase in fall rates, postural instability and functional gait limitations in older adults largely due to the generalized nature of these protocols. The limitations of these traditional approaches in individualizing treatment protocols created a need for advanced and more dynamic systems that can fill this gap and/or complement these traditional approaches.
Modern Technology, including Hunova Robotic systems are novel approaches that seek to solve these limitations by tailoring interventions to patients' needs creating real time feedback mechanisms assisting in intervention prescriptions and analysis. The preciseness of these modern systems assist in creating integrated systems that enhance organization of these interventions improving overall outcomes.
Literature supporting the use of the Robotic Assisted Systems on Fall efficacy, postural stability and functional gait is very limited, necessitating a need for studies comparing the effectiveness of this technology on these components compared to Otago Exercise Programme. This research aims to investigate the effectiveness of a Robotic Assisted System in improving fall efficacy, postural stability and functional gait in older adults and in general geriatric rehabilitation. With the increased emphasis on robotic-assisted rehabilitation due to its accuracy, individualized patient focused design and feedback mechanisms, the study becomes all the more imperative.
This Research attempts to compare the Robotic Assisted System on Fall Efficacy, Functional Gait and postural stability with Otago Exercise Programme.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Robotic Assisted Group Using the Hunova Movendo Robotic Device. | Experimental | Balance Training on Robotic Assisted System: Bipodalic Stance: On Static platform; Elastic Platform, Fluid platform, Wobble Base, Balance on variable counter resistance platform, Sagittal Lunges. Monopodalic (Left & Right): On Static platform; Elastic Platform, Fluid platform, Wobble Base, Balance on variable counter resistance platform, Isometric Ankle. Strengthening: Balance on Counter-resistance platform, raises, Ping Pong on Elastic platform, Bipodalic Sit to Stand Mobility and Gait: Bipodalic Stance: Balance on Elastic Platform, Balance on Fluid Platform, Balance on Proprioceptive Platform, Balance on Linear PAssive Combined Passive platform, Balance on Passive Spiral Base. In addition: Stair walking on standardized stairs. Rest Period: 5 mins incorporated in between intervention. Duration : 45 minutes/day Frequency: 2 days per week for a period of 12 weeks |
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| Otago Exercise Programme | Active Comparator |
Rest Period: 5mins incorporated in-between intervention. Duration : 45 minutes/day Frequency: 2 days per week for a period of 12 weeks |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Robotic Assisted System | Device | Hunova Movendo Robotic System |
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| Measure | Description | Time Frame |
|---|---|---|
| Hunova Evaluation Tools: | Hunova's precise assessment tools assist clinicians tailor prevention interventions with Quantitative data. Assessment Domains: Static & dynamic postural control Visual dependency in balance (Romberg Index) Trunk stability Functional sit-to-stand transitions Limits of stability Scoring: No single cumulative score; results are reported through individual biomechanical parameters such as: Sway Area (cm²) (CE,OE) COP Path Length (cm) (CE,OE) Romberg Index (unitless ratio) Trunk Oscillation Range (deg) (multi directionally) (CE,OE) 5x Sit-to-Stand Duration (seconds) Limits of Stability (LoS) (cm) (Max COP & LEAN multi directionally). Interpretation: Lower values (individualized normative values) in Sway Area, Path Length, & Romberg Index indicate better balance, greater postural control, & lower fall risk. Higher values (individualized normative values) in Trunk Oscillation, LoS & Sit-to-Stand times reflect reduced functional stability & potential impairments in dynamic control. | Baseline and 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Berg's Balance Scale (BBS) | A Gold Standard in the assessment of Balance Impairments Score range: 0 to 56 Interpretation: Higher scores indicate better balance and lower fall risk. | Baseline and 12 weeks |
| Star Excursion Balance Test (SEBT) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Meruna Bose, PHD | Gulf Medical University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Thumbay Physical Therapy and Rehabilitation Hospital | Ajman | United Arab Emirates |
Data might be shared based on the request
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| Otago Exercise Programme | Other | Otago Exercise Programme |
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This test assesses dynamic balance by measuring reach distance while balancing on one leg in various directions. Used to detect deficits in balance and flexibility, it has an interrater reliability and has been validated in the identification of balance deficits in lower extremity. It is useful in assessment of the functional strength of older adults as they're prone to balance, proprioception and flexibility decline.
Range: Reach distance measured in centimeters; often normalized to leg length.
Intepretation: Greater reach distance indicates better dynamic postural control.
| Baseline and 12 weeks |
| Functional Gait Assessment (FGA): | FGA is an assessment scoring scale that measures gait stability under different conditions and tasks. It ranges from 0-30. Lower scores signify higher gait impairments. It has an interrater reliability (ICC > 0.9). It also has high sensitivity to functional gait changes supporting its use care in baseline and follow up assessments in Older Adults | Baseline and 12 weeks |
| Fall Efficacy Scale- International (FES-I): | FES-I is a 16 to 64 self-reporting tool that is used to assess confidence in performing activities without the risk of fall. Higher scores signify a greater fear of falling. It gives insight on how much the fear of falling influences activities. It has an internal consistency (Cronbach's Alpha > 0.9) suggesting reliability and validity in research | Baseline and 12 weeks |