Background: Walking disabilities negatively affect inclusion in society and quality of life and increase the risk for secondary complications. It has been shown that external feedback applied by therapists and/or robotic training devices enables individuals with gait abnormalities to consciously normalize their gait pattern. However, little is known about the effects of a technically-assisted over ground feedback therapy. The aim of this study was to assess whether automatic real-time feedback provided by a shoe-mounted inertial-sensor-based gait therapy system is feasible in individuals with gait impairments after incomplete spinal cord injury (iSCI), stroke and in the elderly. Methods: In a non-controlled proof-of-concept study, feedback by tablet computer-generated verbalized instructions was given to individuals with iSCI, stroke and old age for normalization of an individually selected gait parameter (stride length, stance or swing duration, or foot-to-ground angle). The training phase consisted of 3 consecutive visits. Four weeks post training a follow-up visit was performed. Visits started with an initial gait analysis (iGA) without feedback, followed by 5 feedback training sessions of 2–3 min and a gait analysis at the end. A universal evaluation and FB scheme based on equidistant levels of deviations from the mean normal value (1 level = 1 standard deviation (SD) of the physiological reference for the feedback parameter) was used for assessment of gait quality as well as for automated adaptation of training difficulty. Overall changes in level over iGAs were detected using a Friedman’s Test. Post-hoc testing was achieved with paired Wilcoxon Tests. The users’ satisfaction was assessed by a customized questionnaire. Results: Fifteen individuals with iSCI, 11 after stroke and 15 elderly completed the training. The average level at iGA significantly decreased over the visits in all groups (Friedman’s test, p < 0.0001), with the biggest decrease between the first and second training visit (4.78 ± 2.84 to 3.02 ± 2.43, p < 0.0001, paired Wilcoxon test). Overall, users rated the system’s usability and its therapeutic effect as positive. Conclusions: Mobile, real-time, verbalized feedback is feasible and results in a normalization of the feedback gait parameter. The results form a first basis for using real-time feedback in task-specific motor rehabilitation programs. Trial registration: DRKS00011853 , retrospectively registered on 2017/03/23.


    Zugriff

    Download


    Exportieren, teilen und zitieren



    Titel :

    Trainer in a pocket - proof-of-concept of mobile, real-time, foot kinematics feedback for gait pattern normalization in individuals after stroke, incomplete spinal cord injury and elderly patients


    Beteiligte:
    Schließmann, Daniel (Autor:in) / Nisser, Maria (Autor:in) / Schuld, Christian (Autor:in) / Gladow, Till (Autor:in) / Derlien, Steffen (Autor:in) / Heutehaus, Laura (Autor:in) / Weidner, Norbert (Autor:in) / Smolenski, Ulrich (Autor:in) / Rupp, Rüdiger (Autor:in)

    Erscheinungsdatum :

    2018-01-01


    Anmerkungen:

    Rupp, Rüdiger (2018) Trainer in a pocket - proof-of-concept of mobile, real-time, foot kinematics feedback for gait pattern normalization in individuals after stroke, incomplete spinal cord injury and elderly patients. Journal of neuroEngineering and rehabilitation: JNER, 15 (44). pp. 1-15. ISSN 1743-0003



    Medientyp :

    Aufsatz (Zeitschrift)


    Format :

    Elektronische Ressource


    Sprache :

    Englisch



    Klassifikation :

    DDC:    610 / 629 / 796



    Mind your step: Target walking task reveals gait disturbance in individuals with incomplete spinal cord injury

    Mohammadzada, Freschta / Zipser, Carl Moritz / Easthope, Chris A et al. | BASE | 2022

    Freier Zugriff

    Volition-adaptive control for gait training using wearable exoskeleton: preliminary tests with incomplete spinal cord injury individuals

    Rajasekaran, Vijaykumar / López Larraz, Eduardo / Trincado Alonso, Fernando et al. | BASE | 2018

    Freier Zugriff

    Validation of Non-Restrictive Inertial Gait Analysis of Individuals with Incomplete Spinal Cord Injury in Clinical Settings

    Haji Hassani, Roushanak / Willi, Romina / Rauter, Georg et al. | BASE | 2022

    Freier Zugriff


    Targeted walking in incomplete spinal cord injury: Role of corticospinal control

    Meyer, Christian / Filli, Linard / Stalder, Stephanie Anja et al. | BASE | 2020

    Freier Zugriff