Evaluation of a Vibrotactile Biofeedback System Targeting Stance Time Symmetry Ratio of Individuals With Lower-Limb Amputation: A Pilot Study

Escamilla-Nunez, Rafael; Gouda, Aliaa; Andrysek, Jan

doi:10.1109/tnsre.2023.3282216

Cited by 2 publications

(4 citation statements)

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“…Previous studies have only compared symmetry changes when inducing symmetry (in patient groups) or asymmetry (in healthy groups) using a single target level [ 11 , 12 , 14 , 23 , 30 ]. However, this study investigated multiple target levels to further understand the symmetry changes at those different targets using the same biofeedback strategy.…”

Section: Discussionmentioning

confidence: 99%

“…One of the challenges associated with other biofeedback strategies (e.g., corrective) is the adverse effect of STSR-based biofeedback on speed and cadence. Escamilla-Nunez et al compared three different corrective biofeedback strategies (sensory stimulation is provided only when an individual is out of a certain range) to induce TGA, resulting in symmetry changes of up to 0.10 and 0.05 on average for able-bodied individuals [ 30 ] and lower-limb amputees [ 14 ], respectively. However, the symmetry changes came at a cost, as the average walking speed and cadence significantly decreased by 20% and 15%, respectively [ 14 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…Escamilla-Nunez et al compared three different corrective biofeedback strategies (sensory stimulation is provided only when an individual is out of a certain range) to induce TGA, resulting in symmetry changes of up to 0.10 and 0.05 on average for able-bodied individuals [ 30 ] and lower-limb amputees [ 14 ], respectively. However, the symmetry changes came at a cost, as the average walking speed and cadence significantly decreased by 20% and 15%, respectively [ 14 , 30 ]. In contrast, in this study, cadence and speed remained unchanged while symmetry improved, thus suggesting that RAS strategies may be better suited (over, for example, corrective) for rehabilitation programs aiming to improve overall mobility.…”

Section: Discussionmentioning

confidence: 99%

“…Hence, closed-loop systems that provide progressive gait training, such as an RAS-based biofeedback (BFB) system, may be beneficial in this case. Particularly, given that RAS enables control over cadence through the generation of a metronome synchronized to a specific rhythmic pattern, the integration of RAS within a BFB system holds promise for mitigating the issues of reduced speed and cadence that are associated with other BFB methods [ 14 , 15 ]. Additionally, by providing external cues, rhythmic stimulation allows for more automatic and subconscious control of gait [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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The Development of a Wearable Biofeedback System to Elicit Temporal Gait Asymmetry using Rhythmic Auditory Stimulation and an Assessment of Immediate Effects

Gouda,

Andrysek

2024

Sensors

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Temporal gait asymmetry (TGA) is commonly observed in individuals facing mobility challenges. Rhythmic auditory stimulation (RAS) can improve temporal gait parameters by promoting synchronization with external cues. While biofeedback for gait training, providing real-time feedback based on specific gait parameters measured, has been proven to successfully elicit changes in gait patterns, RAS-based biofeedback as a treatment for TGA has not been explored. In this study, a wearable RAS-based biofeedback gait training system was developed to measure temporal gait symmetry in real time and deliver RAS accordingly. Three different RAS-based biofeedback strategies were compared: open- and closed-loop RAS at constant and variable target levels. The main objective was to assess the ability of the system to induce TGA with able-bodied (AB) participants and evaluate and compare each strategy. With all three strategies, temporal symmetry was significantly altered compared to the baseline, with the closed-loop strategy yielding the most significant changes when comparing at different target levels. Speed and cadence remained largely unchanged during RAS-based biofeedback gait training. Setting the metronome to a target beyond the intended target may potentially bring the individual closer to their symmetry target. These findings hold promise for developing personalized and effective gait training interventions to address TGA in patient populations with mobility limitations using RAS.

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