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

Federica Tamburella,Marco Ghidelli,Alessandra Bigioni,Simone Pasinetti,Francesca Bentivoglio,Matteo Lorusso,Iolanda Pisotta,Vincenzo Maria Saraceni,Matteo Lancini,Marcella Masciullo,Nevio Luigi Tagliamonte,Marco Molinari

doi:10.3389/fneur.2021.700472

Federica Tamburella, Marco Ghidelli + Show 10 more

Open Access

https://doi.org/10.3389/fneur.2021.700472

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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.

Highlights

Walking is a fundamental human activity [1]; when it is affected by illness or injury, people prioritize regaining the ability to walk as a goal of treatment [2]
The aids used by the participants for routine gait are reported in Table 1, as well as the details of the experimental conditions, such as the FB source, number of crutches used and crutch gait pattern during testing
There are multiple ways to walk with crutches, depending on the specific injury or disability

Summary

Introduction

Walking is a fundamental human activity [1]; when it is affected by illness or injury, people prioritize regaining the ability to walk as a goal of treatment [2]. Up to 10% of adults suffer from reduced mobility or balance as a result of conditions, such as a central nervous system (CNS) lesions, which affect balance and gait. Clinicians guide the usage of crutches according to patients’ functional and recovery states. They ask the user to progressively decrease the load on crutches as they improve motor performance or become more acquainted with a new prosthesis/overground exoskeleton. 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)

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