Abstract
Gait asymmetry in lower-limb amputees can lead to several secondary conditions that can decrease general health and quality of life. Including augmented sensory feedback in rehabilitation programs can effectively mitigate spatiotemporal gait irregularities. Such benefits can be obtained with non-invasive haptic systems representing an advantageous choice for usability in overground training and every-day life. In this study, we tested a wearable tactile feedback device delivering short-lasting (100ms) vibrations around the waist syncronized to gait events, to improve the temporal gait symmetry of lower-limb amputees. Three above-knee amputees participated in the study. The device provided bilateral stimulations during a training program that involved ground-level gait training. After three training sessions, participants showed higher temporal symmetry when walking with the haptic feedback in comparison to their natural walking (resulting symmetry index increases of +2.8% for Subject IDA, +12.7% for Subject IDB and +2.9% for Subject IDC). One subject retained improved symmetry (Subject IDB,+14.9%) even when walking without the device. Gait analyses revealed that higher temporal symmetry may lead to concurrent compensation strategies in the trunk and pelvis. Overall, the results of this pilot study confirm the potential utility of sensory feedback devices to positively influence gait parameters when used in supervised settings. Future studies shall clarify more precisely the training modalities and the targets of rehabilitation programs with such devices.
Highlights
G AIT asymmetries are common in transfemoral amputees [1]
In the post-assessment, all subjects achieved increased temporal symmetry when walking with the sensory feedback (SF) compared to their natural walking (NW) (Fig. 2)
Vibrotactile feedback intended to improve gait symmetry of transfemoral amputees was provided for the first time during an overground gait training program and implementing a novel, bilateral stimulation strategy
Summary
G AIT asymmetries are common in transfemoral amputees [1] In these individuals, pain at the stump-socket interface, decreased muscle volume and force [2], [3], and limited confidence in the prosthesis [4] cause them to shift more weight and for a longer period of time on their sound limb compared to the prosthesis. Augmented sensory feedback systems may present an effective supplement to conventional physiotherapy in the rehabilitation of gait asymmetries [10] These systems are equipped with sensors measuring spatiotemporal gait parameters such as the stance times and stride periods or biomechanical variables such as ground reaction forces and the position of the center of pressure (CoP) under the foot.
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