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

• 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 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 plantar-pressure 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. 

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Arbetsterapi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Occupational Therapy (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Ortopedi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Orthopaedics (hsv//eng)

Keyword

foot inversion

gait training

instant biofeedback

plantar pressure

smart wearable device

Stroke

abduction

adult

aged

Article

biofeedback

brain ischemia

cerebrovascular accident

clinical article

controlled study

disease duration

female

forefoot

gait

hemiplegia

human

kinematics

knee function

male

middle aged

stroke patient

varus deformity

walking speed

weight bearing

analysis of variance

complication

drug therapy

electronic device

foot

innervation

locomotion

neurologic gait disorder

outcome assessment

physiology

procedures

stroke rehabilitation

vibration

Biofeedback

Psychology

Gait Disorders

Neurologic

Humans

Outcome Assessment (Health Care)

Wearable Electronic Devices

Publication and Content Type

ref (subject category)

art (subject category)