Center for Brain and Neurotechnology, Moscow 117513, Russia.
Research and Clinical Centre, Moscow 107031, Russia.
Sensors (Basel). 2024 Nov 11;24(22):7212. doi: 10.3390/s24227212.
Biofeedback (BFB) is a rehabilitation method, which, among other things, is used for the restitution of motor and gait function. As of now, it has become technically feasible to use BFB training based on target gait parameters to improve the gait function in stroke patients. The walking patterns of stroke patients are generally characterized by significant gait phase asymmetries, mostly of the stance phase and the single stance phase. The aim of the study was to investigate the restoration of gait function using BFB training with gait phases as feedback targets. The study included two patient groups, each of 20 hemiparetic patients in the subacute stage of stroke and a control group of 20 healthy subjects. Each patient group received BFB training with either stance phase or single stance phase as the feedback target, respectively. The patients received a total of 8 to 11 training sessions. Assessments based on clinical scales and gait analysis data (spatiotemporal, kinematic, and EMG parameters) were performed before and after the training course. The score-based clinical assessments showed a significant improvement in both patient groups. According to the assessments of gait biomechanics, the subjects in the Single Stance Phase group had significantly more severe dysfunctions. In both patient groups, the unaffected limb responded to the BFB training, while the stance phase significantly changed after training in the unaffected limb only. The other patient group, trained using the single stance phase as the feedback target, showed no changes in the target parameter either in the affected or in the contralateral limb. The clinical and instrumental assessments showed different, non-equivalent sensitivity. The results of the study demonstrated the possibility to use targeted BFB training to improve walking function. However, a significant effect of such training was only observed with stance phase as the target parameter. A response to training was observed predominantly in the unaffected limb and facilitated the desired increase in the functional ability of the paretic limb. Training based on stance phase as the target parameter is probably preferable for the patient population under study.
生物反馈（BFB）是一种康复方法，除其他外，还用于恢复运动和步态功能。目前，基于目标步态参数使用 BFB 训练来改善中风患者的步态功能在技术上已经成为可能。中风患者的行走模式通常表现为明显的步态相位不对称，主要是站立相和单足支撑相。本研究的目的是通过将步态相位作为反馈目标的 BFB 训练来研究步态功能的恢复。该研究包括两个患者组，每组 20 名亚急性期中风偏瘫患者和 20 名健康对照组。每个患者组分别接受以站立相或单足支撑相为反馈目标的 BFB 训练，患者共接受 8 至 11 次训练课程。在训练前后，分别通过临床量表和步态分析数据（时空、运动学和肌电图参数）进行评估。基于评分的临床评估显示两个患者组均有显著改善。根据步态生物力学评估，单足支撑相组的受试者功能障碍更为严重。在两个患者组中，健侧肢体对 BFB 训练有反应，而仅在健侧肢体训练后站立相明显改变。另一组患者以单足支撑相作为反馈目标进行训练，在患侧和对侧肢体中均未观察到目标参数的变化。临床和仪器评估显示出不同的、非等效的敏感性。研究结果表明，使用有针对性的 BFB 训练来改善行走功能是可能的。然而，只有将站立相作为目标参数时，这种训练才会产生显著效果。训练观察到的反应主要发生在未受影响的肢体上，并促进了偏瘫肢体功能能力的期望增加。对于研究中的患者群体，基于站立相作为目标参数的训练可能更可取。
