2022 Fiscal Year Final Research Report
Verification of the effect of obstacle avoidance training in subacute patients with stroke
| Project/Area Number |
19K19845
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 59010:Rehabilitation science-related
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| Research Institution | Chiba Prefectural University of Health Sciences (2021-2022)
Kameda University of Health Sciences (2019-2020) |
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Principal Investigator |
Muroi Daisuke 千葉県立保健医療大学, 健康科学部, 助教 (90838179)
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| Project Period (FY) |
2019-04-01 – 2023-03-31
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| 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 |
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| 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.
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| Free Research Field |
神経系障害理学療法学
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| 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。
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