WITHDRAWN: Real-Time Tactile Biofeedback Device Use for Improving Balance Control of Pediatric Patients with Cerebral Palsy

Abstract

Background. This study aimed to develop a novel tactile biofeedback device, which tracks balance continuously and provides haptic biofeedback to its user through real-time vibration stimulus. The efficacy of the device on gait parameters was investigated in pediatric patients with cerebral palsy. Twelve children diagnosed with cerebral palsy and 12 age-matched healthy control subjects used the device during walking at a self-selected speed. The two group participants' lower extremity joint kinematics and spatial-temporal parameters were recorded with Xsens MVN during “with” and “without” biofeedback conditions. Results. The device did not disturb healthy gait. The integration of the real-time balance guidance through the device brought the gait parameters of the cerebral palsy patients closer to the gait parameters of the healthy control group. Pearson Correlation Coefficient and Root Mean Square Error techniques showed that biofeedback altered each gait parameter of the CP group when “with/without biofeedback” conditions were compared. The joints that diverged the most from the healthy control group trends were the ankle and pelvic joints. The extended stance percentage (without BF: 73.91% ± 10.42, with BF: 63.53% ± 2.99), step width (without BF: 0.20m ± 0.05, with BF: 0.18m ± 0.07), and step time (without BF: 1.55s ± 1.07, with BF: 0.73s ± 0.14) parameters decreased; similarly, cadence and walking speed increased when subjects were guided with biofeedback. Conclusions. Guidance with tactile biofeedback reduced the sternum sway, additionally, spatial-temporal parameters were regulated. Obtained results indicated that this wearable device can be integrated into the physical therapy and rehabilitation process of patients with balance and postural control impairments. The present findings contribute to a better understanding of the adaptation of innovative engineering applications with rehabilitation processes, which in turn could assist patients with balance impairments and facilitate their integration into society.