Legrand Mathilde, Grenet Florette, Hochstrasser Olivia, Luft Andreas, Gassert Roger, Lambercy Olivier, Awai Chris Easthope
Rehabilitation Engineering Laboratory, ETH Zurich, Zurich, Switzerland.
GIPSA-Lab Grenoble Images Parole Signal Automatique, University Grenoble Alpes, Centre National de la Recherche Scientifique (CNRS), Grenoble INP, Grenoble, France.
Front Bioeng Biotechnol. 2025 Aug 8;13:1645390. doi: 10.3389/fbioe.2025.1645390. eCollection 2025.
Augmented visual feedback (AVF) is a promising approach for gait rehabilitation after stroke. However, we still lack crucial knowledge about how to most efficiently use it.
How does the selection of the gait parameter targeted by the AVF signal influence the global motor response (i.e., overall gait pattern)?
24 healthy young participants (mean age 25.3 5.3 years old) performed one session of treadmill walking while receiving real-time AVF driving them towards gait asymmetry. AVF was given during 3 × 10 mins on three different gait parameters: stance time (ST), ankle plantarflexion at toe-off (APL) and push-off force (POF). We analyzed gait responses throughout, with a focus on parameter-specific (local) changes in symmetry ratio, and global gait pattern changes, quantified by correlation coefficient and Gait Deviation Index (GDI).
When using ST and POF feedback targets, participants successfully modified their local asymmetry by an average of 10%. Correlation analysis (Spearman) indicated that the modulated gait propagated across parameters, with a fair correlation between ST and APL, POF or vertical ground reaction force and between POF and ST, swing time, step length, step height or vertical ground reaction force. However, global gait pattern was only negatively influenced by ST feedback (GDI -7.9 points with ). Conversely, APL did not lead to significant local symmetry modulation.
Our results show that the efficacy of AVF is dependent on the selected target parameter. This choice also seems to affect how local symmetry changes affect global motion patterns. This work is a first step towards a more comprehensive understanding of the direct and indirect impact of AVF on gait response, which is crucial before using AVF for clinical applications.
增强视觉反馈（AVF）是一种很有前景的中风后步态康复方法。然而，我们仍然缺乏关于如何最有效使用它的关键知识。
AVF信号所针对的步态参数选择如何影响整体运动反应（即整体步态模式）？
24名健康年轻参与者（平均年龄25.3±5.3岁）在跑步机上行走一次，期间接受实时AVF，使其走向步态不对称。在三个不同的步态参数上给予3×10分钟的AVF：站立时间（ST）、离地时踝关节跖屈（APL）和蹬离力（POF）。我们分析了整个过程中的步态反应，重点关注对称比的参数特异性（局部）变化以及通过相关系数和步态偏差指数（GDI）量化的整体步态模式变化。
当使用ST和POF反馈目标时，参与者成功地将其局部不对称平均改变了10%。相关性分析（Spearman）表明，调制后的步态在参数之间传播，ST与APL、POF或垂直地面反作用力之间以及POF与ST、摆动时间、步长、步高或垂直地面反作用力之间存在适度相关性。然而，整体步态模式仅受到ST反馈的负面影响（GDI降低7.9分）。相反，APL并未导致显著的局部对称调制。
我们的结果表明，AVF的效果取决于所选的目标参数。这种选择似乎也会影响局部对称变化如何影响整体运动模式。这项工作是朝着更全面理解AVF对步态反应的直接和间接影响迈出的第一步，这在将AVF用于临床应用之前至关重要。
