Abstract
Sensory impairments caused by neurological or physical disorders hamper kinesthesia, making rehabilitation difficult. In order to overcome this problem, we proposed and developed a novel biofeedback prosthesis called Auditory Foot for transforming sensory modalities, in which the sensor prosthesis transforms plantar sensations to auditory feedback signals. This study investigated the short-term effect of the auditory feedback prosthesis on walking in stroke patients with hemiparesis. To evaluate the effect, we compared four conditions of auditory feedback from plantar sensors at the heel and fifth metatarsal. We found significant differences in the maximum hip extension angle and ankle plantar flexor moment on the affected side during the stance phase, between conditions with and without auditory feedback signals. These results indicate that our sensory prosthesis could enhance walking performance in stroke patients with hemiparesis, resulting in effective short-term rehabilitation.
Highlights
Rehabilitation includes physical therapy that enables longterm improvements through short-term efforts during daily interventions; it promotes mobility, improves functional ability, and improves the quality of life
We focused on an auditory feedback prosthesis that transformed plantar sensation in walking rehabilitation [1] for the following four reasons: plantar sensation, that is, the trajectory of the center of pressure (COP) on the plantar region and the magnitude of load, is an essential kinesthesia in walking [2,3,4,5,6,7]; in stroke patients with hemiparesis, the range of COP trajectories during walking is narrowed on the affected foot through the change of gait [8]; the time required for the cognitive resolution of auditory signals in the human brain is shorter than that required for the resolution of visual feedback signals; and visual feedback systems, for example, a display showing visual
Gait speed [cm/s], stride length [cm], step length [cm] of the affected side, maximum hip extensor angle [degree], and maximum ankle plantar flexor moment [Nm/kg] of the affected side for the four conditions are presented in Table 3 (7 patients)
Summary
Rehabilitation includes physical therapy that enables longterm improvements through short-term efforts during daily interventions; it promotes mobility, improves functional ability, and improves the quality of life. For the rehabilitation of sensory impairments, we proposed a novel biofeedback prosthesis [1] that transforms weak or deficient kinesthetic feedback into an alternative sensory modality. From the viewpoint of system engineering, sensory impairments in humans are considered as input failure in a system, leading to dysfunction of the entire system; the dysfunction can be corrected through repair or replacement by another input component (Figure 1). In this situation, enhancement of kinesthetic feedback or replacement with another sensory modality allows intervention for the dysfunction and enables reestablishment of motor-sensory loop in patients undergoing rehabilitation
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