Balance Improvement and Fall Risk Reduction in Stroke Survivors After Treatment With a Wearable Home-Use Gait Device: Single-Arm Longitudinal Study With 1-Year Follow-Up.

Background: Falls are a common and serious problem after stroke, often leading to injuries, loss of independence, and increased health care usage. Functional balance, a primary risk factor for falls, is frequently impaired in individuals with hemiparetic gait impairments. Previous research with the iStride gait device (Moterum Technologies, Inc) showed that functional balance improved immediately following 4 weeks of treatment.

Exploring the Role of Asymmetric Auditory and Tactile Stimulation on Modulating Gait Kinetics.

This study explores the influence of Auditory Rhythmic Asymmetric Cueing (A-RAC), Tactile Rhythmic Asymmetric Cueing (T-RAC), and their combination (AT) on key kinetic gait parameters in gait rehabilitation: Vertical Ground Reaction Force Asymmetry (GRF), Push-off Force Asymmetry (POF), and Braking Force Asymmetry (BRK). Utilizing the Computer-Assisted Rehabilitation Environment (CAREN) with 18 participants, this research examines these interventions' effectiveness in generating asymmetric gait. While the results during adaptation indicate that BRK was significantly affected by both A-RAC (p = 0.

Gait Response to Rhythmic Cues: Influence of Adaptation Mechanisms and Entrainment Levels.

This study categorizes the response to asymmetric rhythmic cues into distinct levels of adaptation using changes in their step velocity. Motion capture and force data were collected from healthy individuals undergoing split-belt treadmill and rhythmic cueing interventions. This allowed comparative insights into two distinct adaptation mechanisms (sensorimotor and instructional adaptation) corresponding to the interventions and integration of those findings with trade-off mechanisms within spatiotemporal and kinetic gait parameters.

Facilitation of motor adaptation using multiple gait rehabilitation interventions.

Introduction: The rate of adjustment in a movement, driven by feedback error, is referred to as the adaptation rate, and the rate of recovery of a newly adapted movement to its unperturbed condition is called the de-adaptation rate. The rates of adaptation and de-adaptation are dependent on the training mechanism and intrinsic factors such as the participant's sensorimotor abilities. This study investigated the facilitation of the motor adaptation and de-adaptation processes for spatiotemporal features of an asymmetric gait pattern by sequentially applying split-belt treadmill (SBT) and asymmetric rhythmic auditory cueing (ARAC).

One-year retention of gait speed improvement in stroke survivors after treatment with a wearable home-use gait device.

Background: Gait impairments after stroke are associated with numerous physical and psychological consequences. Treatment with the iStride gait device has been shown to facilitate improvements to gait function, including gait speed, for chronic stroke survivors with hemiparesis. This study examines the long-term gait speed changes up to 12 months after treatment with the gait device.

Gait Device Treatment Using Telehealth for Individuals With Stroke During the COVID-19 Pandemic: Nonrandomized Pilot Feasibility Study.

Background: During the COVID-19 pandemic, rehabilitation providers and consumers adopted telehealth practices at unprecedented rates. Multiple prepandemic studies demonstrate the feasibility and comparable efficacy between in-clinic and remote treatment for certain impairments caused by stroke, such as upper extremity weakness and impaired motor function. However, less guidance has been available regarding gait assessment and treatment.

Real-time feedback control of split-belt ratio to induce targeted step length asymmetry.

Introduction: Split-belt treadmill training has been used to assist with gait rehabilitation following stroke. This method modifies a patient's step length asymmetry by adjusting left and right tread speeds individually during training. However, current split-belt training approaches pay little attention to the individuality of patients by applying set tread speed ratios (e.

Time Delay Affects Thermal Discrimination.

Time order errors have been investigated in several fields, and the time delay between subsequent stimuli in discrimination tasks is one example of such errors. However, the effect of these types of errors in thermal discrimination tasks is understudied. To evaluate the effect of inter-stimulus interval (ISI) on thermal perception, we used a discrimination task with a staircase method between two non-zero thermal stimuli.

The Role of Spatial and Modality Cues on Visual and Haptic Memory.

This study investigates the ability to remember a sequence of stimuli in two basic conditions: haptic and visual. Participants rely on a combination of modal and/or spatial information to perform a memory task. For this purpose, an experimental setup was developed based on the "Simon Says" memory game.

Superposition principle applies to human walking with two simultaneous interventions.

Gait rehabilitation therapies provide adjusted sensory inputs to modify and retrain walking patterns in an impaired gait. Asymmetric walking is a common gait abnormality, especially among stroke survivors. Physical therapy interventions using adaptation techniques (such as treadmill training, auditory stimulation, visual biofeedback, etc.

Wearable gait device for stroke gait rehabilitation at home.

Background: Hemiparesis is a common disabling consequence of stroke that leads to abnormal gait patterns marked by asymmetries in step length, stance, and swing phases. Asymmetric gait patterns are correlated with decreased gait velocity and increased susceptibility to falls that can lead to serious injuries and hospitalizations.

Objective: In this single group, before and after study, treatment with the iStride gait device, designed to improve the gait patterns of individuals with hemiparesis, is adapted to the home environment.

Haptic Coupling in Dyads Improves Motor Learning in a Simple Force Field.

In dyadic motor learning, pairs of people learn the same motion while their limbs are loosely coupled together using haptic devices. Such coupled learning has been shown to outperform solo learning (including robot-guided learning) for simple one-degree-of-freedom tasks. However, results from more complex tasks are limited and sometimes conflicting.

Novel passive ankle-foot prosthesis mimics able-bodied ankle angles and ground reaction forces.

Background: During gait, the human ankle both bends with ease and provides push-off forces that facilitate forward motion. The ankle is crucial for support, stabilization, and adapting to different slopes and terrains. Individuals with lower limb amputation require an ankle-foot prosthesis for basic mobility.

Walking assistance using crutches: A state of the art review.

Crutches are one of the most common ambulatory assistive devices. Using crutches encourages more physical activity than many other assistive devices, which has long-term health benefits. Recent advances have led to improvements in performance, but using crutches remains slower than normal walking, are energetically inefficient, cause additional strain on upper extremities, and often result in abrasions on the skin.

Human Gait Analysis Metric for Gait Retraining.

The combined gait asymmetry metric (CGAM) provides a method to synthesize human gait motion. The metric is weighted to balance each parameter's effect by normalizing the data so all parameters are more equally weighted. It is designed to combine spatial, temporal, kinematic, and kinetic gait parameter asymmetries.

Relearning functional and symmetric walking after stroke using a wearable device: a feasibility study.

Background: Gait impairment is a common consequence of stroke and typically involves a hemiparetic or asymmetric walking pattern. Asymmetric gait patterns are correlated with decreased gait velocity and efficiency as well as increased susceptibility to serious falls and injuries.

Research Question: This paper presents an innovative device worn on a foot for gait rehabilitation post stroke.

Accuracy of Dynamic Force Compensation Varies With Direction and Speed.

This study investigates physical responses to force perturbations while tracking a moving target. The results show accuracy depends on the direction of a force perturbation and speed of the task, but generally not on hand. There are also differences in responses when the force is first applied and when it is removed.

Comparing Gait with Multiple Physical Asymmetries Using Consolidated Metrics.

Physical changes such as leg length discrepancy, the addition of a mass at the distal end of the leg, the use of a prosthetic, and stroke frequently result in an asymmetric gait. This paper presents a metric that can potentially serve as a benchmark to categorize and differentiate between multiple asymmetric bipedal gaits. The combined gait asymmetry metric (CGAM) is based on modified Mahalanobis distances, and it utilizes the asymmetries of gait parameters obtained from motion capture and force data recorded during human walking.

Combined effects of leg length discrepancy and the addition of distal mass on gait asymmetry.

Asymmetries in gait often arise due to some form of physical impairment. For example, a leg length discrepancy (LLD) or the change of limb mass can result in asymmetric gait patterns. Although adding mass and LLD have been studied separately, this research studies how gait patterns change as a result of asymmetrically altering both leg length and mass at a leg's distal end.

Tactile Morse Code Using Locational Stimulus Identification.

This research investigated several haptic interfaces designed to reduce mistakes in Morse code reception. Results concluded that a bimanual setup, discriminating dots/dashes by left/right location, reduced the amount of errors to only 56.6 percent of the errors compared to a unimanual setup that used temporal discrimination to distinguish dots and dashes.

Evaluation of 3D printed anatomically scalable transfemoral prosthetic knee.

This case study compares a transfemoral amputee's gait while using the existing Ossur Total Knee 2000 and our novel 3D printed anatomically scalable transfemoral prosthetic knee. The anatomically scalable transfemoral prosthetic knee is 3D printed out of a carbon-fiber and nylon composite that has a gear-mesh coupling with a hard-stop weight-actuated locking mechanism aided by a cross-linked four-bar spring mechanism. This design can be scaled using anatomical dimensions of a human femur and tibia to have a unique fit for each user.

Quantifying the benefit of the Kinetic Crutch Tip.

This research focuses on the difference between the Kinetic Crutch Tip (KCT) and a Standard Rubber Tip. Additionally, the effect of KCT stiffness on the crutch gait cycle and the reaction forces were investigated. This study also examined the maximum backward angle that a crutch is able to move forward without any external forces as well as the ratio of positive to negative horizontal forces were considered.

Assessing the role of preknowledge in force compensation during a tracking task.

Considerable research has been done looking at the asymmetries between the dominant and nondominant arms. However, one area that has received less attention is how information about a perturbation affects these upper limb asymmetries. Our study sought to determine whether foreknowledge of a perturbation can affect the compensation from each arm.

Combined gait asymmetry metric.

People with physical impairments often have asymmetric gait. To evaluate if their overall symmetry is improving during intervention, there needs to be a simple metric that can help classify gait patterns that includes multiple measures of gait asymmetry. The Combined Gait Asymmetry Metric presented here is based on the Mahalanobis distance of multiple step parameters.

Perceived Cooling Using Asymmetrically-Applied Hot and Cold Stimuli.

Temperature perception is a highly nonlinear phenomenon with faster rates of change being perceived at much lower thresholds than slower rates. This paper presents a method that takes advantage of this nonlinear characteristic to generate a perception of continuous cooling even though the average temperature is not changing. The method uses multiple thermal actuators so that a few are cooling quickly while the rest of the actuators are heating slowly.