背景:生物反馈(BFB),提供实时感觉反馈的实践已被证明可以改善步态康复效果。通过节奏刺激进行BFB训练有可能改善时空步态不对称性,同时通过鼓励用户步态周期和外部节律之间的同步来最小化认知负荷。
目的:这项工作的目的是评估有节奏的刺激是否可以改善站立时间对称比(STSR),并比较振动触觉和听觉刺激。步态参数,包括速度,节奏,步幅长度,双重支持时间,和步长对称,也被检查过。
方法:开发了一种实验性节律刺激系统,和12名健康成年人(5名男性),年龄28.42±10.93岁,被招募参加步行试验。单侧踝关节重量用于诱导步态不对称性,以模拟下肢截肢和其他临床疾病患者通常表现出的不对称性。评估了四个条件:1)无踝关节重量基线,2)踝关节的重量没有节奏的刺激,3)使用交替运动的踝关节重量+有节奏的振动触觉刺激(RVS);4)踝关节重量+有节奏的听觉刺激(RAS),使用参与者自选节奏的单节拍器。
结果:如预期的那样,STSR随着踝关节重量变得更加不对称(即诱导的不对称状况)。与没有节律刺激的踝关节重量相比,使用RVS和RAS的STSR显着改善。与没有节奏刺激的踝关节重量相比,RVS和RAS的Cadence也显着改善。除了双重支持时间,其他步态参数与踝关节重量状况没有变化。RVS和RAS之间无统计学差异。
结论:这项研究发现,当诱导不对称时,有节奏的刺激可以改善STSR。此外,RVS在改善具有诱发步态不对称的健康成年人的STSR方面至少与听觉刺激一样有效。未来的工作应该扩展到行动不便的人群和实验室环境之外。
BACKGROUND: Biofeedback (BFB), the practice of providing real-time sensory feedback has been shown to improve gait rehabilitation outcomes. BFB training through rhythmic stimulation has the potential to improve spatiotemporal gait asymmetries while minimizing cognitive load by encouraging a synchronization between the user\'s gait cycle and an external rhythm.
OBJECTIVE: The purpose of this work was to evaluate if rhythmic stimulation can improve the stance time symmetry ratio (STSR) and to compare vibrotactile to auditory stimulation. Gait parameters including velocity, cadence, stride length, double support time, and step length symmetry, were also examined.
METHODS: An experimental rhythmic stimulation system was developed, and twelve healthy adults (5 males), age 28.42 ± 10.93 years, were recruited to participate in walking trials. A unilateral ankle weight was used to induce a gait asymmetry to simulate asymmetry as commonly exhibited by individuals with lower limb amputation and other clinical disorders. Four conditions were evaluated: 1) No ankle weight baseline, 2) ankle weight without rhythmic stimulation, 3) ankle weight + rhythmic vibrotactile stimulation (RVS) using alternating motors and 4) ankle weight + rhythmic auditory stimulation (RAS) using a singletone metronome at the participant\'s self-selected cadence.
RESULTS: As expected the STSR became significantly more asymmetrical with the ankle weight (i.e. induced asymmetry condition). STSR improved significantly with RVS and RAS when compared to the ankle weight without rhythmic stimulation. Cadence also significantly improved with RVS and RAS compared to ankle weight without rhythmic stimulation. With the exception of double support time, the other gait parameters were unchanged from the ankle weight condition. There were no statistically significant differences between RVS and RAS.
CONCLUSIONS: This study found that rhythmic stimulation can improve the STSR when an asymmetry is induced. Moreover, RVS is at least as effective as auditory stimulation in improving STSR in healthy adults with an induced gait asymmetry. Future work should be extended to populations with mobility impairments and outside of laboratory settings.