Interactive cueing with walk-Mate for Hemiparetic Stroke Rehabilitation

Abstract

BackgroundMany techniques that compensate for locomotion problems in daily life using externally controlled stimulation have recently been reported. These techniques are beneficial for effortlessly supporting patients’ locomotive functions, but the users of such devices must necessarily remain dependent on them. It is possible that some individuals with gait impairment may be prevented recovering locomotive function. From a rehabilitation viewpoint, it may therefore be supposed that ideally, devices that can be used in daily life to improve the locomotive functions of the body itself should be proposed.MethodsWe evaluate the effectiveness of Walk-Mate, which has been used mainly as a gait compensation device, as a gait rehabilitation training device by analyzing improvement in locomotion before, during and after rehabilitation in hemiparetic patients and comparing it with a previous gait training method. Walk-Mate generates a model walking rhythm in response to a user’s locomotion in real time, and by indicating this rhythm using auditory stimuli, provides a technology that supports walking by reducing asymmetries and fluctuations in foot contact rhythm. If patients can use the system to learn a regulated walking rhythm, then it may also be expected to fulfil the functions of a gait rehabilitation training device for daily life.ResultsWith regard to asymmetry, significantly improvements were seen for compensatory movement during training using Walk-Mate, but improvements were not retained as rehabilitative results. Regarding fluctuations in the foot contact period, significant improvement was observed for compensatory movement during training and these significant improvements were retained as rehabilitative results. In addition, it became clear that such improvement could not be adequately obtained by the previously proposed training technique utilizing constant rhythmic auditory stimulation.ConclusionsWalk-Mate effectively compensated for locomotion problems of hemiparetic patients by improving gait rhythm both during and after training, suggesting that locomotive function can be effectively recovered in some patients. The interactive mechanism of Walk-Mate may be capable of simultaneously achieving the aims of gait compensation and gait rehabilitation training methods previously developed under individual frameworks. Walk-Mate is a promising technology for assisting the reintegration of disabled persons into society.

Gait Training in Chronic Stroke Using Walk-Even Feedback Device: A Pilot Study

“…The present study differs from earlier studies [12, 16–20] that used external feedback devices in two aspects: (1) auditory and/or somatosensory feedback used during real-time overground gait training and/or (2) outcome measures studied that included not only the temporal and clinical measures but also the spatial measures such as the COP trajectory and the peak pressure of the affected foot during gait. In addition, the modest improvement on clinical measures, TUG, FMA, and ABC strengthens our postulate that an intervention protocol aimed at increasing stance time and load on the affected side in stroke survivors ultimately results in better gait performance.…”

“…For example, Muto et al used Walk-Mate device which is an acceleration sensor device that was worn on both ankles in individuals with stroke. It was capable of providing auditory feedback information on foot-ground contact [20]. Despite showing improvements in gait symmetry during the duration of training in stroke survivors, the improvements were not maintained immediately after training.…”

“…Despite showing improvements in gait symmetry during the duration of training in stroke survivors, the improvements were not maintained immediately after training. This could be attributed to the inadequacy of either the auditory feedback provided by the Walk-Mate or the intensity of gait training, which consisted of walking around a 20-meter circular track twice a day for five consecutive days [20]. Another study used an insole device (I-ShoWS) that consisted of a lateral wedge on the healthy limb, a pressure sensor embedded in the shoe insole of the paretic limb, and a footswitch attached to the shoe of the healthy limb [12].…”

Effect of Exercise with Rhythmic Auditory Stimulation on Muscle Coordination and Gait Stability in Patients with Diabetic Peripheral Neuropathy: A Randomized Controlled Trial

“…Previous studies using RAS showed increased gait speed and step length [27], and improved gait rhythm [28], but these studies focused on patients with hemiplegia and Parkinson's disease. To the best of our knowledge, the present study is the first to show the effect of RAS on the gait function of DPN patients.…”

A wearable projector-based gait assistance system and its application for elderly people

“…However, a decline in muscular power, balancing ability or cognitive function of aging humans decreases their walking ability. Some health problems, such as Parkinson's disease and unilateral paralysis from a stroke [23], can also cause a disorder that affects walking. These declines of walking ability increase the risk of falls and subsequently result in fall-related injuries [5].…”