Short-Term Effect of Prosthesis Transforming Sensory Modalities on Walking in Stroke Patients with Hemiparesis

Abstract

Sensory impairments caused by neurological or physical disorders hamper kinesthesia, making rehabilitation difficult. In order to overcome this problem, we proposed and developed a novel biofeedback prosthesis called Auditory Foot for transforming sensory modalities, in which the sensor prosthesis transforms plantar sensations to auditory feedback signals. This study investigated the short-term effect of the auditory feedback prosthesis on walking in stroke patients with hemiparesis. To evaluate the effect, we compared four conditions of auditory feedback from plantar sensors at the heel and fifth metatarsal. We found significant differences in the maximum hip extension angle and ankle plantar flexor moment on the affected side during the stance phase, between conditions with and without auditory feedback signals. These results indicate that our sensory prosthesis could enhance walking performance in stroke patients with hemiparesis, resulting in effective short-term rehabilitation.

Wearable Movement Sensors for Rehabilitation: A Focused Review of Technological and Clinical Advances

“…A single sensor attached to the heel allows detection of heel strike and heel off phases of gait, while multiple sensors within an insole enable examination of walking strategies 10 , center of pressure translations 11 , and the estimation of vertical ground reaction forces throughout the gait cycle 12 . Force-based sensors are also used to drive auditory 13 and visual 14 biofeedback during gait training 13,14 . Limitations of force-based sensors include their susceptibility to mechanical wear over time, limited direct measurements to events during stance phase 9 , and potential drift secondary to humidity and temperature inside the shoe 15 that may influence data quality.…”

Recent Advances in Quantitative Gait Analysis Using Wearable Sensors: A Review

“…Notwithstanding the studies considered in this review, several studies have demonstrated immense progress made in the wearable-based gait feedback system. The auditory feedback investigated in [118] was found to be effective in the short-term rehabilitation of stroke patients with hemiparesis. A biofeedback system for gait and balance training in PD subjects was proposed in [17], [18].…”

Two-Week Rehabilitation with Auditory Biofeedback Prosthesis Reduces Whole Body Angular Momentum Range during Walking in Stroke Patients with Hemiplegia: A Randomized Controlled Trial

“…We focused on an auditory biofeedback from cutaneous plantar sensation for the following reasons: (i) plantar sensation, that is, the trajectory of the center of pressure (COP) on the plantar region and the magnitude of load, is an essential kinesthesia in walking [ 15 , 16 ]; (ii) in stroke patients with hemiparesis, the range of COP trajectories during walking is narrowed on the affected foot through the change of gait [ 17 ]; (iii) the time required for the cognitive resolution of auditory signals in the human brain (approximately 1 ms) is shorter than that required for the resolution of visual feedback signals (approximately 50–100 ms); and (iv) visual feedback systems, that is, a display showing visual feedback signals, constrains the posture of subjects, resulting in limited rehabilitation spaces and approaches. In our previous study [ 18 ] for 1-day short-term walking rehabilitation with AF in stroke patients, we found significant differences in the maximum hip extension angle and ankle plantar flexor movement on the affected side during the stance phase, between conditions with and without auditory feedback signals, suggesting that AF brought a short-term effect of improving the dynamical properties of gait in stroke patients. In this study, we attempt to verify the effect of a two-week walking rehabilitation on auditory biofeedback in stroke patients.…”

“…As a buffer for a holiday during the two-week period, the 13th day contained normal walking training for the AF group. In a previous study, we showed a short-term effect of auditory biofeedback from two sensors, one at the heel and the other at the metatarsal, to improve walking kinematics and kinetic performance in stroke patients [ 18 ]. In the present study, we have used the same auditory feedback, wearing orthosis if patients used it.…”