Load Auditory Feedback Boosts Crutch Usage in Subjects With Central Nervous System Lesions: A Pilot Study

Abstract

Background: Crutches are the most common walking aids prescribed to improve mobility in subjects with central nervous system (CNS) lesions. To increase adherence to the appropriate level of crutch usage, providing load-related auditory feedback (aFB) may be a useful approach. We sensorized forearm crutches and developed a custom software to provide aFB information to both user and physical therapist (PhT).Aim: Evaluate aFB effects on load control during gait by a self-controlled case series trial.Methods: A single experimental session was conducted enrolling 12 CNS lesioned participants. Load on crutch was recorded during 10 Meter Walk Test performed with and without aFB. In both cases, crutch load data, and gait speed were recorded. Usability and satisfaction questionnaires were administered to participants and PhTs involved.Results: Reliable data were obtained from eight participants. Results showed that compared to the no FB condition, aFB yielded a significant reduction in the mean load on the crutches during gait (p = 0.001). The FB did not influence gait speed or fatigue (p > 0.05). The experience questionnaire data indicated a positive experience regarding the use of aFB from both participants' and PhTs' perspectives.Conclusion: aFB significantly improves compliance with crutch use and does not affect gait speed or fatigue by improving the load placed on crutches. The FB is perceived by users as helpful, safe, and easy to learn, and does not interfere with attention or concentration while walking. Furthermore, the PhTs consider the system to be useful, easy to learn and reliable.

Does Music Therapy Improve Gait after Traumatic Brain Injury and Spinal Cord Injury? A Mini Systematic Review and Meta-Analysis

“…Of the ten included studies, one was a randomized controlled trial [ 61 ], six were quasi-experimental studies [ 16 , 60 , 62 , 63 , 64 , 66 ], two were case studies [ 65 , 77 ], and one was a case study [ 76 ].…”

“…Six of the included studies were conducted in the USA [ 16 , 62 , 63 , 65 , 66 , 76 ], and one each was conducted in India [ 61 ], Italy [ 64 ], South Korea [ 77 ], and Thailand [ 60 ].…”

“…The individual PEDro scoring of each included study is presented in Figure 2 and Table 3 . In the included studies, two studies scored 6 [ 61 , 66 ], five studies scored 5 [ 16 , 60 , 62 , 63 , 64 ], and three studies scored 4 [ 64 , 76 , 77 ]. The included studies had an average PEDro score of 4.9 ± 0.7, indicating a “fair” overall quality of the studies.…”

“…Seven studies had reported the information concerning years since injury for individuals with TBI [ 16 , 63 , 76 , 77 ] and SCI [ 60 , 64 , 66 ]. Three studies had not reported the information concerning the years since injury [ 61 , 62 , 65 ].…”

“…This lack of agreement is particularly evident at the level of individual clinical trials. For example, some trials have reported improvements in spatiotemporal outcomes of gait in TBI and SCI with the use of MT [ 16 , 60 , 61 , 62 , 63 ], whereas others have suggested that MT has either no effect [ 64 , 65 ], or that it can even adversely impact the gait parameters [ 66 ]. With respect to evidence-based synthesis, to date, only one meta-analysis study has assessed the influence of MT on gait performance in individuals with TBI [ 12 ], whereas one recent scoping review evaluated the influence of MT on SCI [ 13 ].…”