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Verification of the effect of obstacle avoidance training in subacute patients with stroke

Research Project

Project/Area Number 19K19845
Research Category

Grant-in-Aid for Early-Career Scientists

Allocation TypeMulti-year Fund
Review Section Basic Section 59010:Rehabilitation science-related
Research InstitutionChiba Prefectural University of Health Sciences (2021-2022)
Kameda University of Health Sciences (2019-2020)

Principal Investigator

Muroi Daisuke  千葉県立保健医療大学, 健康科学部, 助教 (90838179)

Project Period (FY) 2019-04-01 – 2023-03-31
Project Status Completed (Fiscal Year 2022)
Budget Amount *help
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2022: ¥520,000 (Direct Cost: ¥400,000、Indirect Cost: ¥120,000)
Fiscal Year 2021: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2020: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000)
Fiscal Year 2019: ¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000)
Keywords脳卒中 / 歩行 / 障害物回避 / ランダム化比較試験 / 半側空間無視者 / 半側空間無視 / リハビリテーション / 脳卒中片麻痺 / 予定サンプルサイズ / フォローアップ / 障害物回避トレーニング / ランダム比較試験 / 動作解析
Outline of Research at the Start

本研究の目的は、転倒のリスクが高い脳卒中者に対して、麻痺側からの隙間通過動作練習を継続的に介入することで、障害物回避能力や歩行・バランス能力を向上させ、さらにはその後の転倒発生率を軽減させるかどうかを検討することである。隙間通過トレーニングの重要性が明らかになることで、通常に実施される脳卒中者の歩行リハビリテーションにおいて、積極的に取り入れるべき課題となる。

Outline of Final Research Achievements

We determined whether training for walking through an opening (T-WTO) while entering from the paretic side would improve collision avoidance behavior and prevent falls after 6 months. Thirty-eight adults with stroke who were hospitalized in a rehabilitation setting were randomly allocated the T-WTO (n=20) or regular rehabilitation (R-Control; n=18) program. T-WTO included walking through openings of various widths while rotating with the paretic side in front, and R-Control involved normal walking without body rotation. Obstacle avoidance ability, gait, balance, and fall incidence (after 6 months) were assessed. As a result, the collision rate and time to passage of the opening in obstacle avoidance task significantly improved in the T-WTO group compared with those in the R-Control group. Contrastingly, T-WTO did not lead to significant improvements in other outcomes. In conclusion, T-WTO improved efficiency and safety in managing subacute stroke patients.

Academic Significance and Societal Importance of the Research Achievements

本研究では、回復期病院入院中の脳卒中者に対して、麻痺側からの隙間通過練習を3週間介入することで、障害物回避能力を向上させることを明らかにした。この結果から、繰り返しの練習により、課題特異的に能力が改善されたことが示唆された。自宅退院後にも狭い隙間を通過する場面が想定されるため、この練習を入院中に繰り返し実施しておくことが望ましい。さらに、1症例の検討ではあるが、半側空間無視者においても同様に、麻痺(無視)側からの隙間通過練習によって、接触率が軽減することを明らかにした。これらの結果から、麻痺側を意識的に前に出して身体を回旋させる動作は安全な障害物回避方法である可能性が高いことが示唆された。

Report

(5 results)
  • 2022 Annual Research Report   Final Research Report ( PDF )
  • 2021 Research-status Report
  • 2020 Research-status Report
  • 2019 Research-status Report
  • Research Products

    (9 results)

All 2023 2022 2020 2019

All Journal Article (5 results) (of which Peer Reviewed: 5 results,  Open Access: 1 results) Presentation (4 results) (of which Int'l Joint Research: 1 results)

  • [Journal Article] Pathophysiological and motor factors associated with collision avoidance behavior in individuals with stroke2023

    • Author(s)
      Muroi Daisuke、Ohtera Shosuke、Saito Yutaro、Koyake Aki、Higuchi Takahiro
    • Journal Title

      NeuroRehabilitation

      Volume: 52 Issue: 2 Pages: 155-163

    • DOI

      10.3233/nre-220174

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Training for walking through an opening improves collision avoidance behavior in subacute patients with stroke: a randomized controlled trial2023

    • Author(s)
      Muroi Daisuke、Saito Yutaro、Koyake Aki、Hiroi Yasuhiro、Higuchi Takahiro
    • Journal Title

      Disability and Rehabilitation

      Volume: in press Issue: 5 Pages: 887-895

    • DOI

      10.1080/09638288.2023.2181412

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Walking through a narrow opening improves collision avoidance behavior in a patient with stroke and unilateral spatial neglect: an ABA single-case design2022

    • Author(s)
      Muroi Daisuke、Saito Yutaro、Koyake Aki、Yasuda Kazuhiro、Higuchi Takahiro
    • Journal Title

      Neurocase

      Volume: 28 Issue: 2 Pages: 149-157

    • DOI

      10.1080/13554794.2022.2042566

    • Related Report
      2022 Annual Research Report 2021 Research-status Report
    • Peer Reviewed
  • [Journal Article] Walking through an aperture while penetrating from the paretic side improves safety managing the paretic side for individuals with stroke who had previous falls.2022

    • Author(s)
      Muroi D, Saito Y, Koyake A, Higo F, Numaguchi T, Higuchi T
    • Journal Title

      Human Movement Science

      Volume: 81 Pages: 102906-102906

    • DOI

      10.1016/j.humov.2021.102906

    • Related Report
      2022 Annual Research Report 2021 Research-status Report
    • Peer Reviewed
  • [Journal Article] Obstacle avoidance training for individuals with stroke: a systematic review and meta-analysis2019

    • Author(s)
      Muroi Daisuke、Ohtera Shosuke、Kataoka Yuki、Banno Masahiro、Tsujimoto Yasushi、Tsujimoto Hiraku、Higuchi Takahiro
    • Journal Title

      BMJ Open

      Volume: 9 Issue: 12 Pages: e028873-e028873

    • DOI

      10.1136/bmjopen-2018-028873

    • NAID

      120006861124

    • Related Report
      2019 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] 脳卒中片麻痺者の隙間通過課題における行動調整 ―歩行の速度と複雑性に着目して―2023

    • Author(s)
      室井大佑・児玉謙太郎・友野貴之・齋藤祐太郎・小宅綾希・樋口貴広
    • Organizer
      第28回千葉県理学療法学会学術大会
    • Related Report
      2022 Annual Research Report
  • [Presentation] 回復期脳卒中者に対する隙間通過トレーニングは歩行中の障害物回避能力を改善させる ―ランダム化比較試験―2022

    • Author(s)
      室井大佑・齋藤祐太郎・小宅綾希・廣居康博・樋口貴広
    • Organizer
      第20回日本神経理学療法学会学術大会
    • Related Report
      2022 Annual Research Report
  • [Presentation] 脳卒中片麻痺者に対する麻痺側侵入での隙間通過トレーニングの効果 ―ランダム化比較試験による検証―2020

    • Author(s)
      室井大佑
    • Organizer
      第18回日本神経理学療法学会学術大会
    • Related Report
      2020 Research-status Report
  • [Presentation] Walking through an aperture while penetrating from the paretic side reduces the rate of collision for stroke individuals2019

    • Author(s)
      Daisuke Muroi, Yutaro Saito, Aki Koyake, Takahiro Higuchi
    • Organizer
      International Society Posture and Gait Research (ISPGR) World Congress
    • Related Report
      2019 Research-status Report
    • Int'l Joint Research

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Published: 2019-04-18   Modified: 2024-01-30  

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