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Immediate improvements in post-stroke gait biomechanics are induced with both real-time limb position and propulsive force biofeedback.
Santucci, Vincent; Alam, Zahin; Liu, Justin; Spencer, Jacob; Faust, Alec; Cobb, Aijalon; Konantz, Joshua; Eicholtz, Steven; Wolf, Steven; Kesar, Trisha M.
Affiliation
  • Santucci V; Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, USA.
  • Alam Z; Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, USA.
  • Liu J; Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, USA.
  • Spencer J; Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, USA.
  • Faust A; Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, USA.
  • Cobb A; Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, USA.
  • Konantz J; Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, USA.
  • Eicholtz S; Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, USA.
  • Wolf S; Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, USA.
  • Kesar TM; Center for Visual and Neurocognitive Rehabilitation, VA Medical Center, Atlanta, GA, USA.
J Neuroeng Rehabil ; 20(1): 37, 2023 03 31.
Article in En | MEDLINE | ID: mdl-37004111
BACKGROUND: Paretic propulsion [measured as anteriorly-directed ground reaction forces (AGRF)] and trailing limb angle (TLA) show robust inter-relationships, and represent two key modifiable post-stroke gait variables that have biomechanical and clinical relevance. Our recent work demonstrated that real-time biofeedback is a feasible paradigm for modulating AGRF and TLA in able-bodied participants. However, the effects of TLA biofeedback on gait biomechanics of post-stroke individuals are poorly understood. Thus, our objective was to investigate the effects of unilateral, real-time, audiovisual TLA versus AGRF biofeedback on gait biomechanics in post-stroke individuals. METHODS: Nine post-stroke individuals (6 males, age 63 ± 9.8 years, 44.9 months post-stroke) participated in a single session of gait analysis comprised of three types of walking trials: no biofeedback, AGRF biofeedback, and TLA biofeedback. Biofeedback unilaterally targeted deficits on the paretic limb. Dependent variables included peak AGRF, TLA, and ankle plantarflexor moment. One-way repeated measures ANOVA with Bonferroni-corrected post-hoc comparisons were conducted to detect the effect of biofeedback on gait biomechanics variables. RESULTS: Compared to no-biofeedback, both AGRF and TLA biofeedback induced unilateral increases in paretic AGRF. TLA biofeedback induced significantly larger increases in paretic TLA than AGRF biofeedback. AGRF biofeedback increased ankle moment, and both feedback conditions increased non-paretic step length. Both types of biofeedback specifically targeted the paretic limb without inducing changes in the non-paretic limb. CONCLUSIONS: By showing comparable increases in paretic limb gait biomechanics in response to both TLA and AGRF biofeedback, our novel findings provide the rationale and feasibility of paretic TLA as a gait biofeedback target for post-stroke individuals. Additionally, our results provide preliminary insights into divergent biomechanical mechanisms underlying improvements in post-stroke gait induced by these two biofeedback targets. We lay the groundwork for future investigations incorporating greater dosages and longer-term therapeutic effects of TLA biofeedback as a stroke gait rehabilitation strategy. Trial registration NCT03466372.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Stroke / Stroke Rehabilitation Limits: Aged / Humans / Male / Middle aged Language: En Journal: J Neuroeng Rehabil Journal subject: ENGENHARIA BIOMEDICA / NEUROLOGIA / REABILITACAO Year: 2023 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Stroke / Stroke Rehabilitation Limits: Aged / Humans / Male / Middle aged Language: En Journal: J Neuroeng Rehabil Journal subject: ENGENHARIA BIOMEDICA / NEUROLOGIA / REABILITACAO Year: 2023 Document type: Article Affiliation country: Country of publication: