Development of Weight Shifting Training System using Biofeedback for Post-stroke Hemiplegic Patients with Step Length Asymmetry

2013 ◽  
Vol 30 (4) ◽  
pp. 450-458
Author(s):  
Seeun Kim ◽  
Deog Young Kim ◽  
Jung Hoon Kim ◽  
Jong Hyun Choi ◽  
So Young Joo ◽  
...  
Keyword(s):  
Step Length ◽  
Training System ◽  
Post Stroke ◽  
Weight Shifting

No. 106 Effect of Anterioposterior Weight Shifting Training With Visual Feedback on Step Length Asymmetry in Post-Stroke Hemiplegic Patients

PM&R ◽  
2014 ◽  
Vol 6 (8) ◽  
pp. S116-S117
Author(s):  
Deog Young Kim ◽  
Dae Hyun Kim ◽  
Seeun Kim ◽  
Yoon Su Baek
Keyword(s):  
Visual Feedback ◽  
Step Length ◽  
Post Stroke ◽  
Weight Shifting

scholarly journals Effect of robotic-assisted gait training on objective biomechanical measures of gait in persons post-stroke: a systematic review and meta-analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Heidi Nedergård ◽  
Ashokan Arumugam ◽  
Marlene Sandlund ◽  
Anna Bråndal ◽  
Charlotte K. Häger
Keyword(s):  
Kinetic Parameters ◽  
Step Length ◽  
Gait Training ◽  
Risk Of Bias ◽  
Current Evidence ◽  
Temporal Asymmetry ◽  
Robotic Assisted ◽  
Post Stroke ◽  
Gait Biomechanics ◽  
Affected Side

Abstract Background Robotic-Assisted Gait Training (RAGT) may enable high-intensive and task-specific gait training post-stroke. The effect of RAGT on gait movement patterns has however not been comprehensively reviewed. The purpose of this review was to summarize the evidence for potentially superior effects of RAGT on biomechanical measures of gait post-stroke when compared with non-robotic gait training alone. Methods Nine databases were searched using database-specific search terms from their inception until January 2021. We included randomized controlled trials investigating the effects of RAGT (e.g., using exoskeletons or end-effectors) on spatiotemporal, kinematic and kinetic parameters among adults suffering from any stage of stroke. Screening, data extraction and judgement of risk of bias (using the Cochrane Risk of bias 2 tool) were performed by 2–3 independent reviewers. The Grading of Recommendations Assessment Development and Evaluation (GRADE) criteria were used to evaluate the certainty of evidence for the biomechanical gait measures of interest. Results Thirteen studies including a total of 412 individuals (mean age: 52–69 years; 264 males) met eligibility criteria and were included. RAGT was employed either as monotherapy or in combination with other therapies in a subacute or chronic phase post-stroke. The included studies showed a high risk of bias (n = 6), some concerns (n = 6) or a low risk of bias (n = 1). Meta-analyses using a random-effects model for gait speed, cadence, step length (non-affected side) and spatial asymmetry revealed no significant differences between the RAGT and comparator groups, while stride length (mean difference [MD] 2.86 cm), step length (affected side; MD 2.67 cm) and temporal asymmetry calculated in ratio-values (MD 0.09) improved slightly more in the RAGT groups. There were serious weaknesses with almost all GRADE domains (risk of bias, consistency, directness, or precision of the findings) for the included outcome measures (spatiotemporal and kinematic gait parameters). Kinetic parameters were not reported at all. Conclusion There were few relevant studies and the review synthesis revealed a very low certainty in current evidence for employing RAGT to improve gait biomechanics post-stroke. Further high-quality, robust clinical trials on RAGT that complement clinical data with biomechanical data are thus warranted to disentangle the potential effects of such interventions on gait biomechanics post-stroke.

scholarly journals Disentangling the energetic costs of step time asymmetry and step length asymmetry in human walking

2021 ◽  
Author(s):  
Jan Stenum ◽  
Julia T. Choi
Keyword(s):  
Energy Cost ◽  
Metabolic Cost ◽  
Step Length ◽  
Human Walking ◽  
Metabolic Power ◽  
Healthy Human ◽  
Time Asymmetry ◽  
Double Support ◽  
Post Stroke ◽  
The Cost

The metabolic cost of walking in healthy individuals increases with spatiotemporal gait asymmetries. Pathological gait, such as post-stroke, often has asymmetry in step lengths and step times which may contribute to an increased energy cost. But paradoxically, enforcing step length symmetry does not reduce metabolic cost of post-stroke walking. The isolated and interacting costs of asymmetry in step times and step lengths remain unclear, because previous studies did not simultaneously enforce spatial and temporal gait asymmetries. Here, we delineate isolated costs of asymmetry in step times and step lengths in healthy human walking. We first show that the cost of step length asymmetry is predicted by the cost of taking two non-preferred step lengths (one short and one long), but that step time asymmetry adds an extra cost beyond the cost of non-preferred step times. The metabolic power of step time asymmetry is about 2.5 times greater than the cost of step length asymmetry. Furthermore, the costs are not additive when walking with asymmetric step times and step lengths: metabolic power of concurrent asymmetry in step lengths and step times is driven by the cost of step time asymmetry alone. The metabolic power of asymmetry is explained by positive mechanical power produced during single support phases to compensate for a net loss of center of mass power incurred during double support phases. These data may explain why metabolic cost remains invariant to step length asymmetry in post-stroke walking and suggests how effects of asymmetry on energy cost can be attenuated.

scholarly journals A Dual-Learning Paradigm Simultaneously Improves Multiple Features of Gait Post-Stroke

2018 ◽  
Vol 32 (9) ◽  
pp. 810-820 ◽  
Author(s):  
Kendra M. Cherry-Allen ◽  
Matthew A. Statton ◽  
Pablo A. Celnik ◽  
Amy J. Bastian
Keyword(s):  
Knee Flexion ◽  
Joint Angle ◽  
Step Length ◽  
Learning Task ◽  
Gait Pattern ◽  
Learning Paradigm ◽  
Post Stroke ◽  
Learning Conditions ◽  
Hip Flexion ◽  
Gait Impairments

Background. Gait impairments after stroke arise from dysfunction of one or several features of the walking pattern. Traditional rehabilitation practice focuses on improving one component at a time, which may leave certain features unaddressed or prolong rehabilitation time. Recent work shows that neurologically intact adults can learn multiple movement components simultaneously. Objective. To determine whether a dual-learning paradigm, incorporating 2 distinct motor tasks, can simultaneously improve 2 impaired components of the gait pattern in people posttroke. Methods. Twelve individuals with stroke participated. Participants completed 2 sessions during which they received visual feedback reflecting paretic knee flexion during walking. During the learning phase of the experiment, an unseen offset was applied to this feedback, promoting increased paretic knee flexion. During the first session, this task was performed while walking on a split-belt treadmill intended to improve step length asymmetry. During the second session, it was performed during tied-belt walking. Results. The dual-learning task simultaneously increased paretic knee flexion and decreased step length asymmetry in the majority of people post-stroke. Split-belt treadmill walking did not significantly interfere with joint-angle learning: participants had similar rates and magnitudes of joint-angle learning during both single and dual-learning conditions. Participants also had significant changes in the amount of paretic hip flexion in both single and dual-learning conditions. Conclusions. People with stroke can perform a dual-learning paradigm and change 2 clinically relevant gait impairments in a single session. Long-term studies are needed to determine if this strategy can be used to efficiently and permanently alter multiple gait impairments.

scholarly journals Feasibility of Using Foot–Ground Clearance Biofeedback Training in Treadmill Walking for Post-Stroke Gait Rehabilitation

2020 ◽  
Vol 10 (12) ◽  
pp. 978
Author(s):  
Hanatsu Nagano ◽  
Catherine M. Said ◽  
Lisa James ◽  
Rezaul K. Begg
Keyword(s):  
Real Time ◽  
Training Session ◽  
Step Length ◽  
Gait Training ◽  
Treadmill Walking ◽  
Biofeedback Training ◽  
Step Width ◽  
Double Support ◽  
Post Stroke ◽  
Foot Clearance

Hemiplegic stroke often impairs gait and increases falls risk during rehabilitation. Tripping is the leading cause of falls, but the risk can be reduced by increasing vertical swing foot clearance, particularly at the mid-swing phase event, minimum foot clearance (MFC). Based on previous reports, real-time biofeedback training may increase MFC. Six post-stroke individuals undertook eight biofeedback training sessions over a month, in which an infrared marker attached to the front part of the shoe was tracked in real-time, showing vertical swing foot motion on a monitor installed in front of the subject during treadmill walking. A target increased MFC range was determined, and participants were instructed to control their MFC within the safe range. Gait assessment was conducted three times: Baseline, Post-training and one month from the final biofeedback training session. In addition to MFC, step length, step width, double support time and foot contact angle were measured. After biofeedback training, increased MFC with a trend of reduced step-to-step variability was observed. Correlation analysis revealed that MFC height of the unaffected limb had interlinks with step length and ankle angle. In contrast, for the affected limb, step width variability and MFC height were positively correlated. The current pilot-study suggested that biofeedback gait training may reduce tripping falls for post-stroke individuals.

scholarly journals Persons post-stroke improve step length symmetry by walking asymmetrically

2020 ◽  
Author(s):  
Purnima Padmanabhan ◽  
Keerthana Sreekanth ◽  
Shivam Gulhar ◽  
Kendra M. Cherry-Allen ◽  
Kristan A. Leech ◽  
...  
Keyword(s):  
Center Of Mass ◽  
Metabolic Cost ◽  
Step Length ◽  
Gait Pattern ◽  
Future Research ◽  
Cost Of Transport ◽  
Post Stroke ◽  
Paretic Limb ◽  
Gait Parameters ◽  
The Many

Abstract Background Restoration of step length symmetry is a common rehabilitation goal after stroke. Persons post-stroke often retain the ability to walk with symmetric step lengths ("symmetric steps") at an elevated metabolic cost relative to healthy adults. Two key questions with direct implications for rehabilitation have emerged: 1) how do persons post-stroke generate symmetric steps, and 2) why do symmetric steps remain so effortful? Here, we aimed to understand how persons post-stroke generate symmetric steps and explored how the resulting gait pattern may relate to the metabolic cost of transport. Methods We recorded kinematic, kinetic, and metabolic data as nine persons post-stroke walked on an instrumented treadmill under two conditions: preferred walking and symmetric stepping (using visual feedback). Results Gait kinematics and kinetics remained markedly asymmetric even when persons post-stroke improved step length symmetry. Impaired paretic propulsion and abnormal movement of the center of mass were evident during both preferred walking and symmetric stepping. These deficits contributed to diminished positive work performed by the paretic limb on the center of mass in both conditions. Within each condition, decreased positive paretic work correlated with increased metabolic cost of transport and decreased walking speed across participants. Conclusions It is critical to consider the mechanics used to restore symmetric steps when designing interventions to improve walking after stroke. Future research should consider the many dimensions of asymmetry in post-stroke gait, and additional within-participant manipulations of gait parameters are needed to improve our understanding of the elevated metabolic cost of walking after stroke.

scholarly journals Persons post-stroke improve step length symmetry by walking asymmetrically

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Purnima Padmanabhan ◽  
Keerthana Sreekanth Rao ◽  
Shivam Gulhar ◽  
Kendra M. Cherry-Allen ◽  
Kristan A. Leech ◽  
...  
Keyword(s):  
Step Length ◽  
Post Stroke

Long-distance running training system based on inertial sensor network

2021 ◽  
pp. 1-9
Author(s):  
Yingjiao Xiang ◽  
Baishun Sun ◽  
Zhiqin Wang ◽  
Fatma Taher
Keyword(s):  
Gait Analysis ◽  
Sensor Network ◽  
Inertial Sensor ◽  
Step Length ◽  
Training System ◽  
Distance Running ◽  
Long Distance ◽  
Running Training ◽  
Long Distance Running ◽  
Analysis System

Long-distance running is an advantage of Chinese sports, but compared with the world level, there is still a big gap. Therefore, an advanced long-distance running training system is urgently needed to scientifically train our long-distance runners to change this situation. The purpose of this article is to study the long-distance running training system under inertial sensor network. According to the actual situation at home and abroad, a human gait analysis system based on inertial sensors is designed. Gait parameters are transformed into clinical medicine through related algorithms and software platforms. Experimental results show that although the step length calculated by the gait analysis system is different from the actual step length, the error value is small, kept below 3 cm, and the error percentage is less than 2%, which meets the accuracy requirements of gait analysis. This fully proves the feasibility of the zero-speed correction method in gait analysis.

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