Development and Clinical Validation of a Rehabilitation Platform for Hip Fracture in Elderly Population

Hip fracture is one of the most common traumatisms associated with falls in the elderly, severely affecting the patient’s mobility and independence. In recent years, the use of robotic technology has proven to be effective in gait rehabilitation, especially for neurological disorders. How...

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Bibliographic Details
Main Authors: Vanina Costa, Oscar Ramirez, Luis Perea, Alexander Velasquez, Abraham Otero, Eduardo Rocon, Rafael Raya
Format: Article
Language:English
Published: IEEE 2022-01-01
Series:IEEE Transactions on Neural Systems and Rehabilitation Engineering
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Online Access:https://ieeexplore.ieee.org/document/9775981/
Description
Summary:Hip fracture is one of the most common traumatisms associated with falls in the elderly, severely affecting the patient&#x2019;s mobility and independence. In recent years, the use of robotic technology has proven to be effective in gait rehabilitation, especially for neurological disorders. However, there is a lack of research validating these devices for hip fracture in elderly patients. This paper presents the design and evaluation of a novel assistive platform for hip rehabilitation, SWalker, aimed at improving the rehabilitation of this condition. Functional validation of the SWalker platform was carried out with five healthy elderly subjects and two physiotherapists. Clinical validation was conducted with 34 patients with hip fracture. The control group (<inline-formula> <tex-math notation="LaTeX">$\text {n}=24$ </tex-math></inline-formula>, age<inline-formula> <tex-math notation="LaTeX">$= 86.38\pm 6.16$ </tex-math></inline-formula> years, 75&#x0025; female) followed conventional therapy, while the intervention group (<inline-formula> <tex-math notation="LaTeX">$\text{n}=10$ </tex-math></inline-formula>, age<inline-formula> <tex-math notation="LaTeX">$= 86.80\pm 6.32$ </tex-math></inline-formula> years, 90&#x0025; female) was rehabilitated using SWalker. The functional validation of the device reported good acceptability (System Usability Scale &#x003E;85). In the clinical validation, the control group required 68.09&#x00B1;27.38 rehabilitation sessions compared to 22.60&#x00B1;16.75 in the intervention group (<inline-formula> <tex-math notation="LaTeX">$\text{p}&lt; 0.001$ </tex-math></inline-formula>). Patients in the control group needed 120.33&#x00B1;53.64 days to reach ambulation, while patients rehabilitated with SWalker achieved that stage in 67.11&#x00B1;51.07 days (<inline-formula> <tex-math notation="LaTeX">$\text{p}=0.021$ </tex-math></inline-formula>). FAC and Tinetti indexes presented a larger improvement in the intervention group when compared with the control group (<inline-formula> <tex-math notation="LaTeX">$\text{p}=0.007$ </tex-math></inline-formula> and <inline-formula> <tex-math notation="LaTeX">$\text{p}=0.01$ </tex-math></inline-formula>, respectively). The SWalker platform can be considered an effective tool to enhance autonomous gait and shorten rehabilitation therapy in elderly hip fracture patients. This result encourages further research on robotic rehabilitation platforms for hip fracture.
ISSN:1558-0210