Changes in gait and plantar foot loading upon using vibrotactile wearable biofeedback system in patients with stroke

Christina Zong-Hao Ma, Yong-Ping Zheng, Winson Chiu-Chun Lee
2017 Topics in Stroke Rehabilitation  
Lee, W. (2018) . Changes in gait and plantar foot loading upon using vibrotactile wearable biofeedback system in patients with stroke. Topics in Stroke Rehabilitation, 25 (1), 20-27. Changes in gait and plantar foot loading upon using vibrotactile wearable biofeedback system in patients with stroke Abstract Background: Patients with stroke walk with excessive foot inversion at the affected side, which may disturb their balance and gait. Objectives: This study aimed to investigate the effects of
more » ... instant biofeedback of plantar force at the medial and lateral forefoot regions on gait and plantar foot loading in patients with stroke. Methods: A total of eight patients with hemiplegic stroke, who had flexible rearfoot varus deformity at the affected side, participated in this study. A vibrotactile biofeedback system was developed and evaluated. It analyzed forces at the medial and lateral forefeet, and instantly provided vibration clues when the plantar force at medial forefoot was less than a threshold. Each subject's three-dimensional gait parameters and plantarpressure distribution during walking were measured under two experimental conditions (sequence randomized): with and without the device turned on (Trial-registration number: ChiCTR-IPB-15006530 and HKCTR-1853). Results: Providing biofeedback significantly reduced the foot inversion and increased the mid-stance foot-floor contact area and medial midfoot plantar pressure of the affected limb, bringing the values of these parameters closer to those of the unaffected side. The biofeedback also significantly reduced the unaffected side's excessive knee flexion and hip abduction. Conclusions: There were signs of improved foot loading characteristics and gait upon provision of instant vibrotactile biofeedback of plantar force. The positive results of this study further support the development of wearable biofeedback devices for improving gait of patients with stroke. Abstract: Background: Patients with stroke walk with excessive foot inversion 4 at the affected side, which may disturb their balance and gait. Objectives: This 5 study aimed to investigate the effects of instant biofeedback of plantar force at 6 the medial and lateral forefoot regions on gait and plantar foot loading in patients 7 with stroke. Methods: A total of eight patients with hemiplegic stroke, who had 8 flexible rearfoot varus deformity at the affected side, participated in this study. A 9 vibrotactile biofeedback system was developed and evaluated. It analysed forces 10 at the medial and lateral forefeet, and instantly provided vibration clues when the 11 plantar force at medial forefoot was less than a threshold. Each subject's three-12 dimensional gait parameters and plantar-pressure distribution during walking 13 were measured under two experimental conditions (sequence randomized): with 14 and without the device turned-on (Trial-registration number: ChiCTR-IPB-15 15006530& HKCTR-1853). Results: Providing biofeedback significantly 16 reduced the foot inversion and increased the mid-stance foot-floor contact area 17 and medial midfoot plantar pressure of the affected limb, bringing the values of 18 these parameters closer to those of the unaffected-side. The biofeedback also 19 significantly reduced the unaffected-side's excessive knee flexion and hip 20 abduction. Conclusions: There were signs of improved foot loading 21 characteristics and gait upon provision of instant vibrotactile biofeedback of 22 plantar force. The positive results of this study further support the development 23 of wearable biofeedback devices for improving gait of patients with stroke. 24
doi:10.1080/10749357.2017.1380339 pmid:28950803 fatcat:oamgmbe2nbhyvbjivqf2ezci24