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Author Notes:

Contact: Trisha M. Kesar, tkesar@emory.edu

Subjects:

Research Funding:

This work was supported by National Institute of Child Health and Human Development [grant number K01 HD079584]; and National Institutes of Health [grant numbers U10NS086607, U01 NS091951, R03 HD083727].

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Rehabilitation
  • Feedback
  • locomotor training
  • motor learning
  • walking
  • push-off
  • gait biomechanics
  • hemiparesis
  • GROUND REACTION FORCES
  • STEP LENGTH ASYMMETRY
  • TRAILING LIMB ANGLE
  • CHRONIC STROKE
  • WALKING SPEED
  • HEMIPARETIC WALKING
  • HEMIPLEGIC PATIENT
  • FUNCTIONAL STATUS
  • ANKLE MOMENT
  • IMPROVE GAIT

Effects of real-time gait biofeedback on paretic propulsion and gait biomechanics in individuals post-stroke

Tools:

Journal Title:

Topics in Stroke Rehabilitation

Volume:

Volume 25, Number 3

Publisher:

, Pages 186-193

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Objectives: Gait training interventions that target paretic propulsion induce improvements in walking speed and function in individuals post-stroke. Previously, we demonstrated that able-bodied individuals increase propulsion unilaterally when provided real-time biofeedback targeting anterior ground reaction forces (AGRF). The purpose of this study was to, for the first time, investigate short-term effects of real-time AGRF gait biofeedback training on post-stroke gait. Methods: Nine individuals with post-stroke hemiparesis (6 females, age = 54 ± 12.4 years 39.2 ± 24.4 months post-stroke) completed three 6-minute training bouts on an instrumented treadmill. During training, visual and auditory biofeedback were provided to increase paretic AGRF during terminal stance. Gait biomechanics were evaluated before training, and during retention tests conducted 2, 15, and 30 minutes post-training. Primary dependent variables were paretic and non-paretic peak AGRF; secondary variables included paretic and non-paretic peak trailing limb angle, plantarflexor moment, and step length. In addition to evaluating the effects of biofeedback training on these dependent variables, we compared effects of a 6-minute biofeedback training bout to a non-biofeedback control condition. Results: Compared to pre-training, significantly greater paretic peak AGRFs were generated during the 2, 15, and 30-minute retention tests conducted after the 18-minute biofeedback training session. Biofeedback training induced no significant effects on the non-paretic leg. Comparison of a 6-minute biofeedback training bout with a speed-matched control bout without biofeedback demonstrated a main effect for training type, with greater peak AGRF generation during biofeedback. Discussion: Our results suggest that AGRF biofeedback may be a feasible and promising gait training strategy to target propulsive deficits in individuals post-stroke.

Copyright information:

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