Federal State Budgetary Institution «Federal Center of Brain Research and Neurotechnologies» of the Federal Medical Biological Agency, 117997 Moscow, Russia.
Pirogov Russian National Research Medical University, 117997 Moscow, Russia.
Sensors (Basel). 2021 Oct 29;21(21):7217. doi: 10.3390/s21217217.
Walking function disorders are typical for patients after cerebral stroke. Biofeedback technology (BFB) is currently considered effective and promising for training walking function, including in patients after cerebral stroke. Most studies recognize that BFB training is a promising tool for improving walking function; however, the data on the use of highly selective walking parameters for BFB training are very limited. The aim of our study was to investigate the feasibility of using BFB training targeting one of the basic parameters of gait symmetry-stance phase duration-in cerebral stroke patients in the early recovery period. The study included 20 hemiparetic patients in the early recovery period after the first hemispheric ischemic stroke. The control group included 20 healthy subjects. The BFB training and biomechanical analysis of walking (before and after all BFB sessions) were done using an inertial system. The mean number of BFB sessions was nine (from 8 to 11) during the three weeks in clinic. There was not a single negative response to BFB training among the study patients, either during the sessions or later. The spatiotemporal parameters of walking showed the whole syndrome complex of slow walking and typical asymmetry of temporal walking parameters, and did not change significantly as a result of the study therapy. The changes were more significant for the functioning of hip and knee joints. The contralateral hip amplitude returned to the normal range. For the knee joint, the amplitude of the first flexion increased and the value of the amplitude of hyperextension decreased in the middle of the stance phase. Concerning muscle function, the observed significant decrease in the function of m. Gastrocnemius and the hamstring muscles on the paretic side remained without change at the end of the treatment course. We obtained positive dynamics of the biomechanical parameters of walking in patients after the BFB training course. The feasibility and efficacy of their use for targeted correction need further research.
步行功能障碍是脑卒后患者的典型表现。生物反馈技术（BFB）目前被认为是一种有效的、有前途的训练步行功能的方法，包括在脑卒后患者中。大多数研究认为 BFB 训练是改善步行功能的有前途的工具；然而，关于使用高度选择性的步行参数进行 BFB 训练的数据非常有限。我们的研究目的是调查针对脑卒中后早期恢复期患者步态对称性支撑相持续时间这一基本参数之一进行 BFB 训练的可行性。该研究纳入了 20 例首次半球性缺血性脑卒中后早期恢复期的偏瘫患者。对照组包括 20 名健康受试者。使用惯性系统进行 BFB 训练和步行的生物力学分析（在所有 BFB 疗程前后）。在三周的临床治疗中，BFB 疗程的平均次数为九次（8 至 11 次）。在治疗过程中，研究患者在治疗过程中或之后均未出现对 BFB 训练的任何负面反应。步行的时空参数显示出缓慢行走和典型的时间性步行参数不对称的整个综合征复杂表现，并且由于研究治疗并未发生显著变化。髋关节和膝关节的功能变化更为明显。对侧髋关节的振幅恢复到正常范围。对于膝关节，第一屈曲的振幅增加，支撑相中期过伸的振幅值减小。就肌肉功能而言，观察到患侧的腓肠肌和比目鱼肌的功能明显下降，但在治疗过程结束时仍无变化。我们在 BFB 训练疗程后获得了患者步行生物力学参数的积极动态。它们用于有针对性的纠正的可行性和疗效需要进一步研究。
