BackgroundDeveloping rehabilitation strategies to improve functional walking and postural control in patients is a priority for rehabilitation clinicians and researchers alike. One possible strategy is the use of sensory modalities to elicit adaptive locomotor gait patterns. This study aimed to explore to what extent haptic inputs, in the form of forward-leading tensile forces delivered to the hand, compared to no force, may lead to adaptation and post-adaptation effects on gait parameters, during and after the haptic exposure, respectively.MethodsThirteen healthy young individuals were recruited for this study. We developed an innovative system combining virtual reality and haptic tensile forces in the direction of locomotion to simulate walking with a dog. A robotic arm generated forces via an adapted leash to the participant’s hand while they walked on a self-paced treadmill immersed in a virtual environment with scene progression synchronized to the treadmill.ResultsAll participants showed significant increases in instantaneous gait velocity and stride length, with accompanying decreases in double-limb support time (p < 0.05) when walking with a haptic tensile force of either 10 or 20 N, relative to pre-force epoch levels, indicating an adaptation effect. When the 10 or 20 N force was removed, gait measures generally remained changed relative to baseline pre-force levels (p < 0.05), providing evidence of a post-adaptation effect.ConclusionsChanges in spatiotemporal outcomes provide evidence that both adaptation and post-adaptation effects were present in response to the application and removal of a haptic force. Future studies will investigate whether similar changes in elderly and post-stroke populations can be actualized during steady-state walking.

BackgroundPowered wheelchairs are essential for many individuals who have mobility impairments. Nevertheless, if operated improperly, the powered wheelchair poses dangers to both the user and to those in its vicinity. Thus, operating a powered wheelchair with some degree of proficiency is important for safety, and measuring driving skills becomes an important issue to address. The objective of this study was to explore the discriminate validity of outcome measures of driving skills based on joystick control strategies and performance recorded using a data logging system.MethodsWe compared joystick control strategies and performance during standardized driving tasks between a group of 10 expert and 13 novice powered wheelchair users. Driving tasks were drawn from the Wheelchair Skills Test (v. 4.1). Data from the joystick controller were collected on a data logging system. Joystick control strategies and performance outcome measures included the mean number of joystick movements, time required to complete tasks, as well as variability of joystick direction.ResultsIn simpler tasks, the expert group's driving skills were comparable to those of the novice group. Yet, in more difficult and spatially confined tasks, the expert group required fewer joystick movements for task completion. In some cases, experts also completed tasks in approximately half the time with respect to the novice group.ConclusionsThe analysis of joystick control made it possible to discriminate between novice and expert powered wheelchair users in a variety of driving tasks. These results imply that in spatially confined areas, a greater powered wheelchair driving skill level is required to complete tasks efficiently. Based on these findings, it would appear that the use of joystick signal analysis constitutes an objective tool for the measurement of powered wheelchair driving skills. This tool may be useful for the clinical assessment and training of powered wheelchair skills.