Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, 1441 Clifton Rd NE, Atlanta, GA, 30322, United States.
Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, 1441 Clifton Rd NE, Atlanta, GA, 30322, United States.
Gait Posture. 2021 Jan;83:107-113. doi: 10.1016/j.gaitpost.2020.10.014. Epub 2020 Oct 16.
Reduced forward propulsion during gait, measured as the anterior component of the ground reaction force (AGRF), may contribute to slower walking speeds in older adults and gait dysfunction in individuals with neurological impairments. Trailing limb angle (TLA) is a clinically important gait parameter that is associated with AGRF generation. Real-time gait biofeedback can induce modifications in targeted gait parameters, with potential to modulate AGRF and TLA. However, the effects of real-time TLA biofeedback on gait biomechanics have not been studied thus far.
What are the effects of unilateral, real-time, audiovisual trailing limb angle biofeedback on gait biomechanics in able-bodied individuals?
Ten able-bodied adults participated in one session of treadmill-based gait analyses comprising 60-second walking trials under three conditions: no biofeedback, AGRF biofeedback, and TLA biofeedback. Biofeedback was provided unilaterally to the right leg. Dependent variables included AGRF, TLA, ankle moment, and ankle power. One-way repeated measures ANOVA with post-hoc tests were conducted to determine the effect of the biofeedback conditions on gait parameters.
Compared to no biofeedback, both AGRF and TLA biofeedback induced significant increases in targeted leg AGRF without concomitant changes to the non-targeted leg AGRF. Targeted leg TLA was significantly larger during TLA biofeedback compared to AGRF biofeedback. Only AGRF biofeedback induced significant increases in ankle power; and only the TLA biofeedback condition induced increases in the non-targeted leg TLA.
Our novel findings provide support for the feasibility and promise of TLA as a gait biofeedback target. Our study demonstrates that comparable magnitudes of feedback-induced increases in AGRF in response to AGRF and TLA biofeedback may be achieved through divergent biomechanical strategies. Further investigation is needed to uncover the effects of TLA biofeedback on gait parameters in individuals with neuro-pathologies such as spinal cord injury or stroke.
步态中向前推进力的减小，表现为地面反作用力（GRF）的前向分量，可能导致老年人行走速度变慢和神经功能障碍患者步态功能障碍。拖曳肢体角度（TLA）是一个与 GRF 产生相关的重要临床步态参数。实时步态生物反馈可以对目标步态参数进行修改，从而有可能调节 GRF 和 TLA。然而，到目前为止，还没有研究实时 TLA 生物反馈对步态生物力学的影响。
单侧实时视听拖曳肢体角度生物反馈对健康个体步态生物力学有什么影响？
10 名健康成年人参与了一次基于跑步机的步态分析，包括在 3 种条件下进行的 60 秒步行试验：无生物反馈、GRF 生物反馈和 TLA 生物反馈。生物反馈仅提供给右腿。依赖变量包括 GRF、TLA、踝关节力矩和踝关节功率。采用单向重复测量方差分析和事后检验，确定生物反馈条件对步态参数的影响。
与无生物反馈相比，GRF 和 TLA 生物反馈都显著增加了目标腿的 GRF，而不影响非目标腿的 GRF。与 GRF 生物反馈相比，TLA 生物反馈时目标腿的 TLA 显著增大。只有 GRF 生物反馈显著增加了踝关节功率；只有 TLA 生物反馈条件增加了非目标腿的 TLA。
我们的新发现为 TLA 作为步态生物反馈目标的可行性和潜力提供了支持。我们的研究表明，通过不同的生物力学策略，可以实现 GRF 和 TLA 生物反馈对 GRF 反馈诱导增加的相似幅度。需要进一步研究 TLA 生物反馈对脊髓损伤或中风等神经病理患者步态参数的影响。
