The effect of laboratory and real world gait training with vibration feedback on center of pressure during gait in people with chronic ankle instability

Abstract

BackgroundExternal feedback has can medially shift the center of pressure (COP) location in people with chronic ankle instability(CAI) during walking. However, previous modalities are restricted to controlled environments which limits motor learning. Vibration feedback during gait may maximize motor learning by allowing for training in the laboratory and real world (RW) but has not been investigated in those with CAI. Research questionDoes vibration feedback change COP location in people with CAI following laboratory and RW training? MethodsNineteen CAI participants walked for 10 min on a treadmill (lab training) and a one mile loop on a sidewalk (RW training) with vibration feedback. When pressure under the 5th metatarsal exceeded a threshold, a vibration stimulus was applied to the lateral malleolus encouraging the participant to medially shift the COP. One minute baseline, posttest, and short term retention gait assessments were taken for each environment. The stance phase of gait was divided into 10 subphases and data were averaged within each subphase. Repeated measures ANOVAs were completed for each subphase to compare COP location over time. ResultsAfter lab based training the COP was more medial at posttest for the first 90 % of stance versus baseline (Mean differences (MD): −0.57 to −5.12 mm, p < 0.023). Relative to baseline, the COP remained more medial at retention from 20 to 90% of stance (MD: −1.69 to −4.40 mm, p < 0.049). For RW training, the COP was more medial at posttest for the first 70 % of stance versus baseline (MD: −4.24 to −8.27 mm, p < 0.017) and the first 60 % of stance at retention versus baseline (MD: −4.14 to −6.42 mm, p < 0.049). SignificanceVibration feedback during laboratory and RW gait training has the ability to immediately shift the COP location medially and retain this shift for a short period in individuals with CAI.