Sharafian M Ehsan, Ellis Colby, Sidaway Ben, Hayes Marie, Hejrati Babak
IEEE Trans Neural Syst Rehabil Eng. 2025;33:2335-2344. doi: 10.1109/TNSRE.2025.3578865.
Gait speed is a key indicator of mobility and health in older adults, with declines often reflecting neuromotor deficits rather than musculoskeletal or cardiopulmonary limitations. This study presents a wearable smartphone-based haptic feedback system that applies feedback to the thighs to increase peak thigh extension (PTE) and, consequently, improve stride length and walking speed. Thirty community-dwelling older adults ( ${79}.{9}~ {\pm }~{6}.{5}$ years) participated in this study. Three treatment conditions were evaluated: (1) tactile feedback due to incorrect response when PTE was below the target ( ${F}{\text {IR}}$ ); (2) tactile feedback due to correct response when the target PTE was met ( ${F}{\textit {CR} }$ ); and (3) verbal instructions ( ${I}{\boldsymbol {V}}$ ) without feedback. Cognitive demand during treatment was assessed using a probe reaction time task. Walking trials comparing baseline with treatment conditions were conducted. We found significant differences for all gait parameters across walking trials ( $\mathit {p} \lt {0}.{001}$ ), but no significant difference among the three treatment conditions. The haptic feedback system significantly increased stride length by 14% and gait speed by 18%. Gains in speed and stride length were achieved using the haptic system during a single session, comparable to following verbal instructions. Although no statistical difference was found across treatments, thigh feedback employed a different mechanism than verbal instructions for attaining greater speed. Adding haptic feedback increased reaction time, but these increases were small ( ${F}{\textit {IR} }$ : 27ms, ${F}_{\textit {CR} }$ : 74ms), indicating minimal cognitive load. The observed gait improvements suggest haptic feedback is a viable option for gait training for older adults.
步速是老年人身体活动能力和健康状况的关键指标，步速下降通常反映的是神经运动功能缺陷，而非肌肉骨骼或心肺功能受限。本研究提出了一种基于可穿戴智能手机的触觉反馈系统，该系统通过向大腿施加反馈来增加大腿伸展峰值（PTE），从而提高步幅和步行速度。30名社区居住的老年人（年龄79.9±6.5岁）参与了本研究。评估了三种治疗条件：（1）当PTE低于目标值时因反应不正确而产生的触觉反馈（FIR）；（2）当达到目标PTE时因反应正确而产生的触觉反馈（FCR）；（3）无反馈的口头指令（IV）。使用探测反应时间任务评估治疗期间的认知需求。进行了比较基线与治疗条件的步行试验。我们发现步行试验中所有步态参数均存在显著差异（p<0.001），但三种治疗条件之间无显著差异。触觉反馈系统使步幅显著增加了14%，步速显著增加了18%。在单个疗程中使用触觉系统实现了速度和步幅的增加，与遵循口头指令相当。尽管各治疗组之间未发现统计学差异，但大腿反馈与口头指令采用了不同的机制来实现更快的速度。添加触觉反馈会增加反应时间，但增加幅度较小（FIR：27毫秒，FCR：74毫秒），表明认知负荷最小。观察到的步态改善表明，触觉反馈是老年人步态训练的一个可行选择。
