Intensity control of robot-assisted gait training based on biometric data: Preliminary study.

OBJECTIVE: This study is aimed to compare the effect of robot-assisted gait training when the intensity is controlled using patients' biometric data to when controlled by therapist's subjective judgment. DESIGN: This is non-blinded, prospective, randomized controlled study. Patients were randomly assigned to one of two groups. In biometric data control group, exercise intensity was controlled through the patient's heart rate or rating of perceived exertion (RPE). The intensity was raised to the next level when the patient's heart rate reserve was less than 40 percent or the RPE was less than 12 points. The exercise intensity of the therapist control group was adjusted according to the judgement of a therapist. All patients were instructed to perform robot (Morning Walk®)-assisted 20-minute gait training session five times a week during 3 weeks. The primary outcome was functional ambulation category (FAC). The secondary outcomes were modified Barthel index (MBI), Berg balance scale (BBS), timed up and go test (TUG) and 10-meter walk test (10MWT) The outcomes were evaluated at baseline and after 3-week gait training. RESULTS: A total of 55 patients with stroke were enrolled. After robotic rehabilitation, the primary outcome, FAC improved significantly (P < .05) in both groups. Also, secondary outcomes, including MBI, BBS, TUG, 10MWT, showed significant improvement (P < .05) in all groups. In addition, when comparing the functional change from baseline to week 3 between the two groups, there was no statistically significant difference in FAC (P > .05). The difference of baseline and week 3 of secondary outcome measure, MBI, BBS, TUG, 10MWT, showed no significant difference (P > .05). CONCLUSION: In conclusion, when the robot intensity was adjusted using the patient's heart rate or RPE, the treatment effect has no significant difference to when adjusting the intensity according to the know-how of the therapist.

Relationship between Traumatic Events, Stress Coping Strategies and Post-Traumatic Stress Symptoms among Social Workers in Public Sector

OBJECTIVES: Social workers can suffer from occupational stress resulting from dealing with clients, which might lead to metal health problems. We aimed to investigate the association of duty-related traumatic experiences and stress coping strategies with posttraumatic stress symptoms among social workers in public sector. METHODS: A total of 110 social workers in public sector (men 30.9%, 36.5 +/- 7.6 yrs) participated in this study. All subjects were evaluated the frequency and the impact of duty-related traumatic events. Additionally, they completed questionnaires including the Impact of Event Scale-Revised for post-traumatic stress symptoms, the Beck Depression Inventory-II for depressive symptoms, the Scale for Suicidal Ideation for suicide symptoms and the Ways of Coping Checklist for stress coping strategies. RESULTS: The most frequent traumatic events were "Violent or abusive language from a client" (95.0%) and "Client made a fuss" (94.5%). The most distressing traumatic event was "Seeing a dead body on duty" (7.6 out of 10), which predicted post-traumatic stress symptoms (odds ratio 4.04 ; 95% confidence interval, 1.79-9.11). Among 4 types of stress coping strategies, the emotion-focused coping was positively correlated with post-traumatic stress symptoms after controlling age and sex (beta = 0.50, p < 0.001). CONCLUSIONS: Social workers in public sector showed high level of post-traumatic stress symptoms. Duty-related traumatic events and the emotional-focused coping strategies were associated with the severity of post-traumatic stress symptoms. The modification of stress coping strategies would alleviate post-traumatic stress symptoms in social workers in public sector.