A Study of Biofeedback Gait Training in Cerebral Stroke Patients in the Early Recovery Phase with Stance Phase as Target Parameter.

Dmitry V Skvortsov,Sergey N Kaurkin,Galina E Ivanova

doi:10.3390/s21217217

Abstract

Walking function disorders are typical for patients after cerebral stroke. Biofeedback technology (BFB) is currently considered effective and promising for training walking function, including in patients after cerebral stroke. Most studies recognize that BFB training is a promising tool for improving walking function; however, the data on the use of highly selective walking parameters for BFB training are very limited. The aim of our study was to investigate the feasibility of using BFB training targeting one of the basic parameters of gait symmetry—stance phase duration—in cerebral stroke patients in the early recovery period. The study included 20 hemiparetic patients in the early recovery period after the first hemispheric ischemic stroke. The control group included 20 healthy subjects. The BFB training and biomechanical analysis of walking (before and after all BFB sessions) were done using an inertial system. The mean number of BFB sessions was nine (from 8 to 11) during the three weeks in clinic. There was not a single negative response to BFB training among the study patients, either during the sessions or later. The spatiotemporal parameters of walking showed the whole syndrome complex of slow walking and typical asymmetry of temporal walking parameters, and did not change significantly as a result of the study therapy. The changes were more significant for the functioning of hip and knee joints. The contralateral hip amplitude returned to the normal range. For the knee joint, the amplitude of the first flexion increased and the value of the amplitude of hyperextension decreased in the middle of the stance phase. Concerning muscle function, the observed significant decrease in the function of m. Gastrocnemius and the hamstring muscles on the paretic side remained without change at the end of the treatment course. We obtained positive dynamics of the biomechanical parameters of walking in patients after the BFB training course. The feasibility and efficacy of their use for targeted correction need further research.

Highlights

Biofeedback technology (BFB) is currently considered effective and promising for training walking function [1,2,3], including in patients after cerebral stroke [3]
We found only one study [19] where stance phase was successfully used as the BFB parameter
The conducted study showed that gait training in the early recovery period after stroke can cause positive changes in walking function

Summary

Introduction

Biofeedback technology (BFB) is currently considered effective and promising for training walking function [1,2,3], including in patients after cerebral stroke [3]. The technology is based on capturing a physiological parameter and presenting it to the patient in a perceivable form, so that the subject can understand its changes and respond appropriately. BFB can be used independently or as part of rehabilitation therapy. BFB can activate the body’s own resources, with the patient taking active part in the process of his or her recovery. Different types of BFB rely on different technical methods and senses. The most frequently used feedback channel is vision, followed by hearing alone or in combination with vision, whereas kinesthetic feedback is much more rare [1,4]

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