IEEE Trans Neural Syst Rehabil Eng. 2021;29:74-84. doi: 10.1109/TNSRE.2020.3034521. Epub 2021 Feb 25.
Gait asymmetry in lower-limb amputees can lead to several secondary conditions that can decrease general health and quality of life. Including augmented sensory feedback in rehabilitation programs can effectively mitigate spatiotemporal gait irregularities. Such benefits can be obtained with non-invasive haptic systems representing an advantageous choice for usability in overground training and every-day life. In this study, we tested a wearable tactile feedback device delivering short-lasting (100ms) vibrations around the waist syncronized to gait events, to improve the temporal gait symmetry of lower-limb amputees. Three above-knee amputees participated in the study. The device provided bilateral stimulations during a training program that involved ground-level gait training. After three training sessions, participants showed higher temporal symmetry when walking with the haptic feedback in comparison to their natural walking (resulting symmetry index increases of +2.8% for Subject IDA, +12.7% for Subject IDB and +2.9% for Subject IDC). One subject retained improved symmetry (Subject IDB,+14.9%) even when walking without the device. Gait analyses revealed that higher temporal symmetry may lead to concurrent compensation strategies in the trunk and pelvis. Overall, the results of this pilot study confirm the potential utility of sensory feedback devices to positively influence gait parameters when used in supervised settings. Future studies shall clarify more precisely the training modalities and the targets of rehabilitation programs with such devices.
下肢截肢者的步态不对称可能导致多种继发性疾病,从而降低整体健康水平和生活质量。在康复计划中加入增强的感觉反馈,可以有效地减轻时空步态不规则。非侵入性触觉系统可以提供这种益处,并且由于其在地面训练和日常生活中的可用性,是一种有利的选择。在这项研究中,我们测试了一种可穿戴的触觉反馈设备,该设备可以在腰部周围同步发送短暂(100ms)的振动,以改善下肢截肢者的时间步态对称性。三名大腿截肢者参加了这项研究。该设备在涉及地面行走训练的训练计划中提供双侧刺激。经过三个训练疗程后,与自然行走相比,参与者在使用触觉反馈行走时表现出更高的时间对称性(结果显示,受试者 IDA 的对称性指数增加了+2.8%,受试者 IDB 的对称性指数增加了+12.7%,受试者 IDC 的对称性指数增加了+2.9%)。一名受试者即使在没有设备的情况下行走,其对称性也得到了改善(受试者 IDB,+14.9%)。步态分析显示,更高的时间对称性可能会导致躯干和骨盆同时出现补偿策略。总体而言,这项初步研究的结果证实了感觉反馈设备在监督环境中积极影响步态参数的潜力。未来的研究将更准确地阐明此类设备的训练模式和康复计划的目标。