Feasibility and Effect of Gait Training with Assistance from a Motorized Wheelchair with Built-In Bodyweight Support Frame on the Balance and Walking Ability of Elderly Individuals with a Risk of Falling

Chirawan Chootip; Tassanee  Promtong; Meuanfun  Boonguasong

Authors

Chirawan Chootip Department of Rehabilitation Medicine, Songkhla Hospital, Songkhla
Tassanee Promtong Department of Rehabilitation Medicine, Songkhla Hospital, Songkhla
Meuanfun Boonguasong Department of Rehabilitation Medicine, Songkhla Hospital, Songkhla

Keywords:

elderly, risk of falling, leg weakness, motorized wheelchairs

Abstract

Objectives: To study the feasibility and effect of gait training with assistance from a motorized wheelchair with a built-in bodyweight support frame (MW-BWSF) on the balance and walking ability of elderly individuals with a risk of falling.

Study design: Experimental study.

Setting: Rehabilitation clinic, Department of Rehabilitation, Songkhla Hospital, Thailand.

Subjects: Elderly individuals aged 60 years or older at rehabilitation clinic, Songkhla hospital between March 2022 and February 2023.

Methods: This experimental trial involved elderly individuals aged 60 years or older with minimal leg muscle weakness or who were at risk of falling. The participants were trained with assistance from the MW-BWSF for eight sessions over four weeks. Gait speed, step length, Time Up and Go Test (TUGT), and Berg Balance Scale (BBS) were assessed three times: before the start of the program, at the end of the fourth training session, and the end of the eighth training session.

Results: A total of 22 elderly individuals participated in the study. The gait training with the MW-BWSF showed a statistically significant improvement in gait speed, step length, TUGT, and BBS score after the eight sessions. The total distance walked during training also increased significantly. The participants reported high satisfaction with the device and with the training method.

Conclusions: The study demonstrated the feasibility and effectiveness of gait training with assistance from the MW-BWSF in improving the balance and walking ability of elderly individuals with a risk of falling. This innovative technology has the potential for use as an assistive device for training at home which would also reduce the burden on public healthcare.

References

Kuptniratsaikul V. Geriatric rehabilitation in common health problems. Bangkok: Siriraj Press; 2018.

Nevitt MC, Lane N. Body weight and osteoarthritis. Am J Med [Internet]. 1999 Dec [cited 2020 May 1];107(6):632–3. Available from: https://pubmed.ncbi.nlm.nih.gov/10625033/ doi: 10.1016/s0002-9343(99)00297-1

Kannus P, Parkkari J, Koskinen S, Niemi S, Palvanen M, Järvinen M, et al. Fall-induced injuries and deaths among older adults. JAMA [Internet]. 1999 May [cited 2020 May 1];281(20):1895-9. Available from: https://pubmed.ncbi.nlm.nih.gov/10349892/ doi: 10.1001/jama.281.20.1895

Lord SR, Ward JA, Williams P, Strudwick M. The effect of a 12-month exercise trial on balance, strength, and falls in older women: a randomized controlled trial. J Am Geriatr Soc [Internet]. 1995 Nov [cited 2020 May 1];43(11):1198-206. Available from: https://pubmed.ncbi.nlm.nih.gov/7594152/ doi: 10.1111/j.1532-5415.1995.tb07394.x

Fiatarone MA, O’Neill EF, Ryan ND, Clements KM, Solares GR, Nelson ME, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med [Internet]. 1994 June [cited 2020 May 1];330(25):1769-1775. Available from: https://pubmed.ncbi.nlm.nih.gov/8190152/ doi: 10.1056/NEJM199406233302501

Judge JO, Whipple RH, Wolfson LI. Effects of resistive and balance exercises on isokinetic strength in older persons. J Am Geriatr Soc [Internet]. 1994 Sep [cited 2020 May 1];42(9):937-46. Available from: https://pubmed.ncbi.nlm.nih.gov/8064101/ doi: 10.1111/j.1532-5415.1994.tb06584.x

Chandler JM, Duncan PW, Kochersberger G, Studenski S. Is lower extremity strength gain associated with improvement in physical performance and disability in frail, community-dwelling elders?. Arch Phys Med Rehabil [Internet]. 1998 Jan [cited 2020 May 1];79(1):24-30. Available from: https://pubmed.ncbi.nlm.nih.gov/9440412/ doi: 10.1016/s0003-9993(98)90202-7

Cress ME, Buchner DM, Questad KA, Esselman PC, deLateur BJ, Schwartz RS. Exercise: effects on physical functional performance in independent older adults. J Gerontol Med Sci [Internet]. 1999 May [cited 2020 May 1];54(5):M242-8. Available from: https://pubmed.ncbi.nlm.nih.gov/10362007/ doi: 10.1093/gerona/54.5.m242

Lord SR, Lloyd DG, Nirui M, Raymond J, Williams P, Stewart RA. The effect of exercise on gait patterns in older women: a randomized controlled trial. J Gerontol Med Sci [Internet]. 1996 Mar [cited 2020 May 1];51(2):M64-70. Available from: https://pubmed.ncbi.nlm.nih.gov/8612105/ doi: 10.1093/gerona/51a.2.m64

Judge JO, Underwood M, Gennosa T. Exercise to improve gait velocity in older persons. Arch Phys Med Rehabil [Internet]. 1993 Apr [cited 2020 May 1];74(4):400-6. Available from: https://pubmed.ncbi.nlm.nih.gov/8466422/

Wolfson L, Whipple R, Derby C, Judge J, King K, Amerman P, et al. Balance and strength training in older adults: intervention gains and Tai Chi maintenance. J Am Geriatr Soc [Internet]. 1996 May [cited 2020 May 1];44(5):498-506. Available from: https://pubmed.ncbi.nlm.nih.gov/8617896/ doi: 10.1111/j.1532-5415.1996.tb01433.x

Prasartkul P, editors. Situation of the Thai elderly. Bangkok: Deuan Tula Printing House; 2017

Wongphaet P, Watchareudomkarn W. Effect of Partial Body Weight Support Treadmill Training on Improvement of Walking and Balance in Elderly Community-dwellers. J Thai Rehabil Med 2016;26(1):19-23.

Catarina OS, Jose AB, Christiane LP, Tania FS, Ana MF. Gait training with partial weight support during overground walking for individuals with chronic stroke: a pilot study. J Neuroeng Rehabil [Internet]. 2011 Aug [cited 2020 May1];8:48. Available from: https://pubmed.ncbi.nlm.nih.gov/21864373/ doi: 10.1186/1743-0003-8-48

Gama GL, Celestino ML, Barela LA, Forrester L3, Whitall J, Barela AM. Effect of gait training with body weight support on a treadmill versus overground in individual with stroke. Arch Phys Med Rehabil [Internet]. 2017 Apr [cited 2020 May 1];98(4):738-745. Available from: https://www.researchgate.net/publication/312223307 doi: 10.1016/j.apmr.2016.11.022

Suphanan P, Plaiwan S. Psychometric Properties of Falls Risk Assessment in Older People with Mild Cognitive Impairment and Dementia: A Systematic Review. Vajira Med J 2018 [Internet]. 2018 Aug [cited 2023 May 10];62(4):335-44. Available from: https://he02.tci-thaijo.org/index.php/VMED/article/view/194827 doi.org/10.14456/vmj.2018.29

Moreland JD, Richardson JA, Goldsmith CH, Clase CM. Muscle weakness and falls in older adults: a systematic review and meta-analysis. J Am Geriatr Soc [Internet]. 2004 July [cited 2023 May 14];52(7):1121-9. Available from: https://pubmed.ncbi.nlm.nih.gov/15209650/ doi: 10.1111/j.1532-5415.2004.52310.x

Ganesan M, Sathyaprabha TN, Gupta A, Pal PK. Effect of partial weight-supported treadmill gait training on balance in patients with Parkinson’s disease. PM R [Internet]. 2014 Jan [cited 2020 May 1];6(1):22-33. Available from: https://pubmed.ncbi.nlm.nih.gov/24021298/ doi: 10.1016/j.pmrj.2013.08.604