title: Training with a balance exercise assist robot is more effective than conventional training for frail older adults.
abstract: OBJECTIVE
  To examine the efficacy of postural strategy training using a balance exercise assist robot (BEAR) as compared with conventional balance training for frail older adults.
  
  
  METHODS
  The present study was designed as a cross-over trial without a washout term. A total of 27 community-dwelling frail or prefrail elderly residents (7 men, 20 women; age range 65-85 years) were selected from a volunteer sample. Two exercises were prepared for interventions: robotic exercise moving the center of gravity by the balance exercise assist robot system; and conventional balance training combining muscle-strengthening exercise, postural strategy training and applied motion exercise. Each exercise was carried out twice a week for 6 weeks. Participants were allocated randomly to either the robotic exercise first group or the conventional balance exercise first group.
  
  
  METHODS
  preferred and maximal gait speeds, tandem gait speeds, timed up-and-go test, functional reach test, functional base of support, center of pressure, and muscle strength of the lower extremities were assessed before and after completion of each exercise program.
  
  
  RESULTS
  Robotic exercise achieved significant improvements for tandem gait speed (P = 0.012), functional reach test (P = 0.002), timed up-and-go test (P = 0.023) and muscle strength of the lower extremities (P = 0.001-0.030) compared with conventional exercise.
  
  
  CONCLUSIONS
  In frail or prefrail older adults, robotic exercise was more effective for improving dynamic balance and lower extremity muscle strength than conventional exercise. These findings suggest that postural strategy training with the balance exercise assist robot is effective to improve the gait instability and muscle weakness often seen in frail older adults. Geriatr Gerontol Int 2017; 17: 1982-1990.
authors.affiliation: Department of Rehabilitation Medicine, National Center for Geriatrics Gerontology, Obu, Aichi, Japan.
authors.forename: Kenichi
authors.identifier: http://orcid.org/0000-0001-9146-5409
authors.initials: K
authors.lastname: Ozaki
authors.affiliation: Department of Rehabilitation Medicine, National Center for Geriatrics Gerontology, Obu, Aichi, Japan.
authors.forename: Izumi
authors.initials: I
authors.lastname: Kondo
authors.affiliation: Department of Rehabilitation Medicine 1, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hirano
authors.affiliation: Department of Rehabilitation Medicine 1, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kagaya
authors.affiliation: Department of Rehabilitation Medicine 1, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Saitoh
authors.affiliation: Department of Rehabilitation Medicine, National Center for Geriatrics Gerontology, Obu, Aichi, Japan.
authors.forename: Aiko
authors.initials: A
authors.lastname: Osawa
authors.affiliation: Partner Robot Division, Toyota Motor Corporation, Toyota, Aichi, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Fujinori
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D004856:Postural Balance / Q000502:physiology*; D012371:Robotics; D016896:Treatment Outcome
keywords: assistive technology; frailty; postural balance; rehabilitation