The effects of vibrotactile biofeedback training on trunk sway in Parkinson's disease patients

Abstract

Background: Postural instability in Parkinson's disease (PD) can lead to falls, injuries and reduced quality of life. We investigated whether balance in PD can improve by offering patients feedback about their own trunk sway as a supplement to natural sensory inputs. Specifically, we investigated the effect of artificial vibrotactile biofeedback on trunk sway in PD. Methods: Twenty PD patients were assigned to a control group (n ¼ 10) or biofeedback group (n ¼ 10). First, all patients performed two sets of six gait tasks and six stance tasks (pre-training assessment). Subsequently, all subjects trained six selected tasks five times (balance training). During this training, the feedback group received vibrotactile feedback of trunk sway, via vibrations delivered at the head. After training, both groups repeated all twelve tasks (post-training assessment). During all tasks, trunk pitch and roll movements were measured with angular velocity sensors attached to the lower trunk. Outcomes included sway angle and sway angular velocity in the roll and pitch plane, and task duration. Results: Overall, patients in the feedback group had a significantly greater reduction in roll (P ¼ 0.005) and pitch (P < 0.001) sway angular velocity. Moreover, roll sway angle increased more in controls after training, suggesting better training effects in the feedback group (P < 0.001). Conclusions: One session of balance training in PD using a biofeedback system showed beneficial effects on trunk stability. Additional research should examine if these effects increase further after more intensive training, how long these persist after training has stopped, and if the observed effects carry over to non-trained tasks.

Effects of Wearable Sensor-Based Balance and Gait Training on Balance, Gait, and Functional Performance in Healthy and Patient Populations: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…RCTs were performed in patients with PD ( n = 2) [27,28] , stroke ( n = 1) [29] , PD/stroke ( n = 1) [30] , peripheral neuropathy, either relating to diabetes ( n = 1) [31] or chemotherapy ( n = 1) [32] , and healthy ( n = 1) [33] , or frail older adults with confirmed fall risk ( n = 1) [14] . The average age of the samples ranged from 52.1 to 84.9 years.…”

“…Types and Placements of WS Six studies used IMUs (incorporating accelerometers, gyroscopes, and magnetometers) [14,27,28,[31][32][33] , of which 3 studies used 5 IMUs (1 at the lower back, 1 at each shank, 1 at each thigh) [14,31,32] , 1 study used 2 IMUs (1 on each shoe) [27] , and 2 studies used 1 IMU at the lower back [28,33] . One study used wearable plantar pressure sensors [29] and another one combined wearable plantar pressure sensors and IMUs [30] ( Table 2 ).…”

The effect of age on postural and cognitive task performance while using vibrotactile feedback

“…Various sensory substitution devices providing auditory, vibrotactile, and multimodal biofeedback have been proposed to counter age-and disease-related imbalance and to decrease the risk of falls (Dozza et al 2007;Honegger et al 2013;Nanhoe-Mahabier et al 2012;Wall et al 2009). Vibrotactile feedback (VTF) is one feedback modality that has been developed to provide individuals with balance problems with an external cue about how their body is moving in space (Wall et al 2001).…”

A Fabric-Based Approach for Wearable Haptics

“…[5,16,18]; wrist [19,21]; arm and forearm [14,20,22,23]; tongue and mouth [24][25][26]; head [27]; torso, trunk and shoulders [28][29][30]; leg [31,32]; foot [15,33].…”