Department of Rehabilitation Medicine, Amsterdam UMC, VU University Medical Center, Amsterdam Movement Sciences, the Netherlands; Department of Clinical Applications and Research, Motek Medical BV, Amsterdam, the Netherlands.
Department of Rehabilitation Medicine, Amsterdam UMC, VU University Medical Center, Amsterdam Movement Sciences, the Netherlands.
Arch Phys Med Rehabil. 2019 Apr;100(4):598-605. doi: 10.1016/j.apmr.2018.10.013. Epub 2018 Nov 14.
To investigate the immediate response to avatar-based biofeedback on 3 clinically important gait parameters: step length, knee extension, and ankle power in children with cerebral palsy (CP).
Repeated measures design.
Rehabilitation clinic.
Children with spastic paresis (N=22; 10.5±3.1y), able to walk without assistive devices.
Children walked on a treadmill with a virtual reality environment. Following baseline gait analysis, they were challenged to improve aspects of gait. Children visualized themselves as an avatar, representing movement in real time. They underwent a series of 2-minute trials receiving avatar-based biofeedback on step length, knee extension, and ankle power. To investigate optimization of biofeedback visualization, additional trials in which knee extension was visualized as a simple bar with no avatar; and avatar alone with no specific biofeedback were carried out.
Gait pattern, as measured by joint angles, powers, and spatiotemporal parameters, were compared between baseline and biofeedback trials.
Participants were able to adapt gait pattern with biofeedback, in an immediate response, reaching large increases in ankle power generation at push-off (37.7%) and clinically important improvements in knee extension (7.4) and step length (12.7%). Biofeedback on one parameter had indirect influence on other aspects of gait.
Children with CP show capacity in motor function to achieve improvements in clinically important aspects of gait. Visualizing biofeedback with an avatar was subjectively preferential compared to a simplified bar presentation of knee angle. Future studies are required to investigate if observed transient effects of biofeedback can be retained with prolonged training to test whether biofeedback-based gait training may be implemented as a therapy tool.
研究基于化身的生物反馈对 3 项临床重要步态参数（步长、膝关节伸展和踝关节功率）的即时反应在脑瘫儿童中的作用。
重复测量设计。
康复诊所。
痉挛性瘫痪的儿童（N=22；10.5±3.1 岁），能够在没有辅助设备的情况下行走。
儿童在带有虚拟现实环境的跑步机上行走。在基线步态分析后，他们接受挑战以改善步态的各个方面。儿童将自己视为化身，实时代表运动。他们进行了一系列 2 分钟的试验，接受了基于化身的生物反馈，以改善步长、膝关节伸展和踝关节功率。为了研究生物反馈可视化的优化，还进行了额外的试验，其中膝关节伸展被可视化成一个没有化身的简单棒，或者只有化身而没有特定的生物反馈。
通过关节角度、功率和时空参数来比较基线和生物反馈试验之间的步态模式。
参与者能够通过生物反馈立即适应步态模式，在蹬离时踝关节功率产生显著增加（37.7%），膝关节伸展（7.4%）和步长（12.7%）有临床意义的改善。对一个参数的生物反馈会对步态的其他方面产生间接影响。
脑瘫儿童在运动功能方面表现出能够实现临床重要的步态方面的改善。与膝关节角度的简化棒呈现相比，使用化身呈现生物反馈在主观上更受欢迎。需要进一步的研究来调查生物反馈的短暂效果是否可以通过长期训练保留，以测试基于生物反馈的步态训练是否可以作为一种治疗工具。
