Robotic Assisted Rehabilitation for Balance and Gait in Orthopedic Patients.
Condition: Osteoarthritis, Knee; Osteoarthritis, Hip; Gait Disorders in Old Age; Balance; Distorted
MeSH terms: Osteoarthritis; Osteoarthritis, Knee; Osteoarthritis, Hip
Study type: Interventional

Summary: 
      Osteoarthritis is a chronic, degenerative disease affecting the joints. It is characterized
      by the presence of bone tissue that goes to make up for the loss of articular cartilage,
      causing pain and limitation of movement. Osteoarthritis is a direct consequence of aging: it
      affects almost all 70-year-olds, peaking between 75 and 79 years. The presence of
      osteoarthritic processes at the hip and knee joints can result in pain, difficulty
      maintaining standing for a long time, and difficulty walking with loss of balance, increasing
      the risk of accidental falls to the ground. Falls are a frequent cause of mortality and
      morbidity and, often, limit autonomy leading to premature entry into assisted living
      facilities.

      In Italy, in 2002 it was estimated that 28.6% of people over 65 years fall within a year: of
      these, 43% fall more than once and 60% of falls occur at home. Such falls can often result in
      fractures leading to the need for hospitalization with significant impact on both motor and
      cognitive function. Balance and gait rehabilitation are of primary importance for the
      recovery of a person's autonomy and independence, especially in older individuals who have
      undergone osteosynthesis or prosthesis surgery of the lower limbs. Technological and robotic
      rehabilitation allows for greater intensity, objectivity, and standardization in treatment
      protocols, as well as in outcome measurement. In this context, patient motivation is fuelled
      and maintained by both the sensory stimuli that support technological treatment and the
      challenge of achieving ever better results, objective feedback from instrumental assessments.
      Osteoarthritic patients who have undergone osteosynthesis or lower extremity prosthetic
      surgery require special attention, especially with the goal of preventing further accidents
      and reducing the patient's risk of falling.

      Given these considerations, it is believed that conventional physical therapy combined with
      technological balance treatment may be more effective on rehabilitation outcome than
      conventional therapy alone.
    

Detailed description: 
      Twenty-four patients of both sexes will be recruited, evaluated, and treated at
      Rehabilitation and Physical Medicine Unit, Fondazione Policlinico Universitario A. Gemelli
      IRCCS of Rome, from August 2022 to August 2023. Patients will be divided into two groups by
      1:1 randomization ratio: one group (Technological Group, TG) will perform specific
      rehabilitation for the balance using the robotic platform (Hunova®, Movendo Technology srl,
      Genova, IT) 3 times a week, for 4 weeks (12 total sessions), for 45 minutes of treatment, in
      addition to the conventional treatment and one group will perform only the conventional
      treatment (Control Group, CG), as per daily routine.
    

Intervention name(s): Technological Rehabilitation
Intervention type(s): Device
Intervention description(s): Specific rehabilitation for balance disorder using the robotic platform
Other intervention name(s): Hunova® Movendo Technology srl
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Interventional pilot randomized controlled trial
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Rehabilitation; Technology; Balance