Cortical mechanisms underlying sensorimotor enhancement promoted by walking with haptic inputs in a virtual environment.

Sensorimotor integration is a complex process in the central nervous system that produces task-specific motor output based on selective and rapid integration of sensory information from multiple sources. This chapter reviews briefly the role of haptic cues in postural control during tandem stance and locomotion, focusing on sensorimotor enhancement of locomotion post stroke. The use of mixed-reality systems incorporating both haptic cues and virtual reality technology in gait rehabilitation post stroke is discussed. Over the last decade, researchers and clinicians have shown evidence of cerebral reorganization that underlies functional recovery after stroke based on results from neuroimaging techniques such as positron emission tomography and functional magnetic resonance imaging. These imaging modalities are however limited in their capacity to measure cortical changes during extensive body motions in upright stance. Functional near-infrared spectroscopy (fNIRS) on the other hand provides a unique opportunity to measure cortical activity associated with postural control during locomotion. Evidence of cortical changes associated with sensorimotor enhancement induced by haptic touch during locomotion is revealed through fNIRS in a pilot study involving healthy individuals and a case study involving a chronic stroke patient.