Realtime Visual Feedback Diminishes Energy Consumption of Amputee Subjects During Treadmill Locomotion

Davis, Brian L.; Ortolano, Mary; Richards, Kirsten; Redhed, James; Kuznicki, Jennifer; Sahgal, Vinod

doi:10.1097/00008526-200404000-00004

Cited by 29 publications

(20 citation statements)

References 12 publications

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“…It has been suggested that spatiotemporal asymmetry is a factor in the increased energy cost of walking after stroke, 9 and improvements in gait asymmetry are associated with reduced energy cost of walking in amputees. 39 …”

Section: Discussionmentioning

confidence: 99%

Repeated Split-Belt Treadmill Training Improves Poststroke Step Length Asymmetry

Reisman

McLean

Keller

et al. 2013

Neurorehabil Neural Repair

238

286

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Background and objective Previous studies suggest that error augmentation may be used as a strategy to achieve longer-term changes in gait deficits after stroke. The purpose of this study was to determine whether longer-term improvements in step length asymmetry could be achieved with repeated split-belt treadmill walking practice using an error augmentation strategy. Methods 13 persons with chronic stroke (>6 months) participated in testing: (1) prior to 12 sessions of split-belt treadmill training, (2) after the training, and (3) in follow-up testing at 1 and 3 months. Step length asymmetry was the target of training, so belt speeds were set to augment step length asymmetry such that aftereffects resulted in reduced step length asymmetry during overground walking practice. Each individual was classified as a “responder” or “nonresponder” based on whether their reduction in step length asymmetry exceeded day-to-day variability. Results For the group and for the responders (7 individuals), step length asymmetry improved from baseline to posttesting (P < .05) through an increased step length on both legs but a relatively larger change on the shorter step side (P < .05). Other parameters that were not targeted (eg, stance time asymmetry) did not change over the intervention. Conclusions This study demonstrates that short-term adaptations can be capitalized on through repetitive practice and can lead to longer-term improvements in gait deficits poststroke. The error augmentation strategy, which promotes stride-by-stride adjustment to reduce asymmetry and results in improved asymmetry during overground walking practice, appears to be critical for obtaining the improvements observed.

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Section: Discussionmentioning

confidence: 99%

Repeated Split-Belt Treadmill Training Improves Poststroke Step Length Asymmetry

Reisman

McLean

Keller

et al. 2013

Neurorehabil Neural Repair

238

286

View full text Add to dashboard Cite

show abstract

“…The improvement represents a treatment effect at least 2 to 3 times greater than previously published for gait training interventions or changes in prosthetic devices and alignments. 19,[25][26][27] Although many factors could have contributed to the overall improvement, existing literature substantiates the influence of reduced trunk motion and a more normalized step width on oxygen consumption. 28,29 For this patient, the greatest improvements in oxygen consumption and trunk motion occurred at the same time point, suggesting training to correct trunk abnormalities may have a greater impact on the oxygen consumption than changes in step width, which were not observed until the final test.…”

Section: Discussionmentioning

confidence: 99%

“…14,16 -18 In people with an amputation, feedback on symmetry of limb push-off forces produced a reduction in the metabolic cost of nearly 6%. 19 However, it remains to be seen whether the complex motions of the pelvis and trunk can be effectively modified using VR-based feedback and whether the changes would benefit the overall gait performance of people with an amputation. The purpose of this case report is to present the effects of a novel VR-based gait training program using real-time feedback to restore normal walking kinematics, with a particular emphasis on frontal-plane pelvis and trunk motion, and consequently decrease the physiological effort required while walking in a person with a transfemoral amputation.…”

mentioning

confidence: 99%

Gait Training With Virtual Reality–Based Real-Time Feedback: Improving Gait Performance Following Transfemoral Amputation

Darter¹,

Wilken²

2011

Physical Therapy

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Although the exact contribution of the visual feedback could not be isolated, the training was effective in improving the patient's walking performance. Biomechanical data suggest correcting trunk motion and increasing hip abductor strength (force-generating capacity) may be important in facilitating improvements at the pelvis and hip. Observed improvements in oxygen consumption were significantly larger than achieved through previously reported interventions.

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“…The center of pressure shows a representation of this output display. Moreover, real-time visual feedback not only results in an immediate improvement in symmetry, but there are also concomitant reductions in heart rate and oxygen consumption while patients walk at a steady pace on a treadmill [4]. Davis then suggested that visual feedback rehabilitation may serve as a useful tool for amputee patients.…”

Section: Past Research Of Real-time Visual Feedbackmentioning

confidence: 99%

“…Based on literature [4], the visualization of the floor reaction force is important for the rehabilitation in gait with prosthesis. Therefore, the purpose of this study is the development of a rehabilitation-assist system that visualizes the floor reaction force in real time.…”

Section: Visualizing Load Weight Without Force Sensorsmentioning

confidence: 99%

Training Assist System of a Lower Limb Prosthetic Visualizing Floor-Reaction Forces Using a Color-Depth Sensing Camera

Ogata

Mita

Shimizu

et al. 2015

IEICE Trans. Inf. & Syst.

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SUMMARYSome unilateral lower-limb amputees, have through continued exertion, increase the foot reaction force of the sound leg. The asymmetric gait with a prosthetic leg may thus negatively affect the musculoskeletal health of the leg on the healthy side. Therefore, it is important for these amputees to learn how to adjust the balance of each foot load in training. The aim of this study is to develop a training support system visualizing floor-reaction forces using a color-depth sensor. The pose of the entire body of the amputee is measured by the depth sensor, and the floor reaction force is estimated based on Zero Moment Point (ZMP), which is calculated using the center of mass of the amputee. Evaluation experiments of the proposed method were performed and they confirmed the effectiveness of the estimation method and the training with the visualization of reaction force.

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Realtime Visual Feedback Diminishes Energy Consumption of Amputee Subjects During Treadmill Locomotion

Cited by 29 publications

References 12 publications

Repeated Split-Belt Treadmill Training Improves Poststroke Step Length Asymmetry

Repeated Split-Belt Treadmill Training Improves Poststroke Step Length Asymmetry

Gait Training With Virtual Reality–Based Real-Time Feedback: Improving Gait Performance Following Transfemoral Amputation

Training Assist System of a Lower Limb Prosthetic Visualizing Floor-Reaction Forces Using a Color-Depth Sensing Camera

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