Comparison of the Immediate Effects of Audio, Visual, or Audiovisual Gait Biofeedback on Propulsive Force Generation in Able-Bodied and Post-stroke Individuals
Comparison of the Immediate Effects of Audio, Visual, or Audiovisual Gait Biofeedback on Propulsive Force Generation in Able-Bodied and Post-stroke Individuals
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DOI：
10.1007/s10484-020-09464-1
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发表时间：
2020-04-29
影响因子：
3
通讯作者：
Kesar, Trisha M.
中科院分区：
文献类型：
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作者：
Liu, Justin;Kim, Hyun Bin;Kesar, Trisha M.
实时生物反馈是一种很有前途的卒中后步态康复策略，它可以优先针对瘫痪腿的特定步态缺陷。我们以前的工作表明，使用旨在增加瘫痪腿推进力的视听生物反馈接口的使用，通过在步态后期站立阶段产生前地面反作用力(AGRF)来测量，可以分别诱导健全和中风后个体靶向和瘫痪肢体的AGRF峰值产生的改善。然而，不同的生物反馈模式，如视觉、听觉或两者的组合，对AGRF的产生是否有不同的影响尚不清楚。本研究调查了仅听、仅视或视听AGRF生物反馈对健全和卒中后个体的影响。7名健康人(6名女性，27+/-2岁)和9名卒中后个体(6名女性，54+/-12岁，卒中后42+/-26个月)在跑步机上完成了4种条件下的30名S步行试验：无生物反馈、听觉生物反馈、视觉生物反馈和视听生物反馈。与没有生物反馈的步行相比，所有三种生物反馈模式都显著增加了靶向腿和瘫痪腿的AGRF峰值。三种生物反馈模式的峰值AGRF无显著差异。与视觉生物反馈相比，身体健全的个体在音频生物反馈过程中表现出更大的反馈诱导的AGRF产生步幅到步幅变化的增加；然而，在中风后组中没有观察到类似的结果。目前的发现可能会为临床或社区环境中使用的实时步态生物反馈接口的未来发展提供参考。
Real-time biofeedback is a promising post-stroke gait rehabilitation strategy that can target specific gait deficits preferentially in the paretic leg. Our previous work demonstrated that the use of an audiovisual biofeedback interface designed to increase paretic leg propulsion, measured via anterior ground reaction force (AGRF) generation during late stance phase of gait, can induce improvements in peak AGRF production of the targeted and paretic limb of able-bodied and post-stroke individuals, respectively. However, whether different modes of biofeedback, such as visual, auditory, or a combination of both, have differential effects on AGRF generation is unknown. The present study investigated the effects of audio only, visual only, or audiovisual AGRF biofeedback in able-bodied and post-stroke individuals. Seven able-bodied (6 females, 27 +/- 2 years) and nine post-stroke individuals (6 females, 54 +/- 12 years, 42 +/- 26 months post-stroke) completed four 30-s walking trials on a treadmill under 4 conditions: no biofeedback, audio biofeedback, visual biofeedback, or audiovisual biofeedback. Compared to walking without biofeedback, all three biofeedback modes significantly increased peak AGRF in the targeted and paretic leg. There was no significant difference in peak AGRF between the three biofeedback modes. Able-bodied individuals demonstrated greater feedback-induced increase in stride-to-stride variation of AGRF generation during audio biofeedback compared to visual biofeedback; however, similar results were not observed in the post-stroke group. The present findings may inform future development of real-time gait biofeedback interfaces for use in clinical or community environments.