Abstract
BackgroundTask-specific perturbation training is a widely studied means of fall prevention, utilizing techniques that induce slips or slip-like perturbations during gait. Though effective, these methods only simulate narrow ranges within the larger space of possible slipping conditions encountered in daily life. Here we describe and test a novel, wearable apparatus designed to address these limitations and simulate a diverse range of slipping disturbances.MethodsThe device consists of wireless triggering and detachable outsole components that provide adequate friction with the floor when secured to the wearer’s foot, but suddenly create a low-friction surface underfoot upon release. “Benchtop” tests were carried out to quantify device triggering characteristics (i.e. cutting temperature, release delay) and the resulting friction reduction. The device was also tested on six healthy young adults (3 female, age 23 ± 2.4 years), who walked with and without the device to observe how gait kinematics and spatiotemporal parameters were influenced, then performed 12 walking trials ending with a slip delivered by the device. Each participant also completed a survey to obtain opinions on device safety, device comfort, slip realism, and slip difficulty. A linear mixed effects analysis was employed to compare subject spatiotemporal parameters with and without the apparatus, as well as correlation coefficients and root mean square errors (RMSE) to assess the impact of the device on lower limb gait kinematics. Slip onset phases, distances, directions, velocities, and recovery step locations were also calculated.ResultsThis device rapidly diminishes available friction from static coefficients of 0.48 to 0.07, albeit after a substantial delay (0.482 ± 0.181 s) between signal reception and outsole release. Strong correlations (R > 0.93) and small RMSE between gait kinematics with and without the device indicate minimal effects on natural gait patterns, however some spatiotemporal parameters were significantly impacted. A diverse range of slip perturbations and recovery steps were successfully elicited by the device.ConclusionsOur results highlight the efficacy and utility of a wearable slipping device to deliver diverse slip conditions. Such an apparatus enables the study of unconstrained slips administered across the gait cycle, as well as during different locomotor behaviors like turning, negotiating slopes, and level changes.
Highlights
Task-specific perturbation training is a widely studied means of fall prevention, utilizing techniques that induce slips or slip-like perturbations during gait
The adjustments obtained from treadmill slip training in particular can be scaled to match the intensity of perturbation [14], and those from sliding platforms can be generalized to other tasks of varying context similarity [21,22,23]
If individuals could not distinguish a slip at any point in a trial, the Functional Characteristics The average static coefficients of friction (SCoF) observed between the Wearable Apparatus for Slipping Perturbations (WASP) outsole and tile floor surface was 0.54 ± 0.03 with a 75 lbs. load and 0.49 ± 0.03 under a 180 lbs. load
Summary
Task-specific perturbation training is a widely studied means of fall prevention, utilizing techniques that induce slips or slip-like perturbations during gait. Task-specific training has gained popularity in rehabilitation as an effective intervention to regain [1, 2] and reinforce [3] motor skills This methodology closely mimics the sensorimotor and environmental interactions of the target task, thereby forcing the patient or subject to repetitively execute the movements necessary to accomplish the goal of the task [4]. This paradigm is widely utilized in studies of gait stability and fall prevention by administering repeated perturbations to an individual in the form of simulated trips and slips [5,6,7]. After participating in a perturbation protocol, subjects have retained their acquired stabilization skills for months [22], and quickly readapt after periods over a year [23, 24]
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