Yasuda K1, Hayashi Y2, Iwata H2
1Waseda University, Research Institute for Science and Engineering, Tokyo, Japan, 2Waseda University, Graduate School of Creative Science and Engineering, Tokyo, Japan
Background: Maintaining gait performance is important for promoting health and preventing falls in older adults. Various devices have been developed, which provide biofeedback (BF) on body fluctuation in older adults during stance or gait tasks, and most of the previous studies focused on trunk or head position as a representation of overall body motion. However, appropriate foot motion is also important for the body to advance over the supporting foot during stance. This complex structure must distribute enough pressure evenly on the plantar surface and absorb shock. Thus, the present study introduces a haptic-based BF system, which provides information regarding a trainee´s foot pressure pattern to enhance gait performance.
Purpose: In this study, we evaluated the influence of the proposed BF system on gait pattern in healthy older adults and attempted to determine its effect on cognitive load during gait, which are essential for clarifying the device's feasibility in real-life settings.
Methods: Our system consists of a shoe insole with foot pressure sensor and vibrotactile BF device (pelvic belt), which enhances the foot pressure pattern (heel contact and push off) using the vibratory belt attached to the pelvis. Ten healthy older adults (mean age 73 ± 4.5 years) participated in the study. The primary task of the validation study was evaluating gait along with a cognitively demanding activity. In the BF condition, the participant walked and corrected the gait pattern using vibrotactile stimulation while subtracting. In the no-BF condition, participants only walked while subtracting. An inertial sensor and a force plate were used to measure the ankle joint angle at the heel contact phase, maximum foot pressure at push off, stride length, and walking speed. Cognitive performance was determined by the number of correct arithmetic calculations verbalized. Student's t-test was used to compare the BF and no-BF condition, with a p-value of 0.05 considered statistically significant.
Results: Regarding walking ability in the BF condition, participants extended their stride length (p=0.004), which was sustained by increasing the ankle joint angle at the heel contact phase (p=0.016) and foot pressure at the toe off (p=0.027). However, these kinematic changes did not contribute to increased walking speed (p=0.177). In addition, cognitive performance clearly decreased in participants during gait in the BF condition (p=0.014).
Conclusion(s): The system had the potential to modify the kinematic pattern, but not the walking speed, (comprehensive evaluation of walking) in older adults. Moreover, it is likely that the device placed cognitive load on older adults, an aspect that should be considered in a clinical setting. This study provides essential preliminary data for designing a successful BF system and future trials with BF devices.
Implications: Because foot pressure BF directly modified characteristics of the foot movement pattern, the proposed BF system may effectively induce positive kinematic changes in gait training. Using BF could affect the personal capacity of working memory in older adults. Thus, clinicians should consider the age and cognitive capacity of the trainee.
Keywords: Vibrotactile biofeedback system, Gait training, Older adults
Funding acknowledgements: This study was supported by Research Institute for Science and Engineering, Waseda University, Grant-in-Aid for Junior Researchers.
Purpose: In this study, we evaluated the influence of the proposed BF system on gait pattern in healthy older adults and attempted to determine its effect on cognitive load during gait, which are essential for clarifying the device's feasibility in real-life settings.
Methods: Our system consists of a shoe insole with foot pressure sensor and vibrotactile BF device (pelvic belt), which enhances the foot pressure pattern (heel contact and push off) using the vibratory belt attached to the pelvis. Ten healthy older adults (mean age 73 ± 4.5 years) participated in the study. The primary task of the validation study was evaluating gait along with a cognitively demanding activity. In the BF condition, the participant walked and corrected the gait pattern using vibrotactile stimulation while subtracting. In the no-BF condition, participants only walked while subtracting. An inertial sensor and a force plate were used to measure the ankle joint angle at the heel contact phase, maximum foot pressure at push off, stride length, and walking speed. Cognitive performance was determined by the number of correct arithmetic calculations verbalized. Student's t-test was used to compare the BF and no-BF condition, with a p-value of 0.05 considered statistically significant.
Results: Regarding walking ability in the BF condition, participants extended their stride length (p=0.004), which was sustained by increasing the ankle joint angle at the heel contact phase (p=0.016) and foot pressure at the toe off (p=0.027). However, these kinematic changes did not contribute to increased walking speed (p=0.177). In addition, cognitive performance clearly decreased in participants during gait in the BF condition (p=0.014).
Conclusion(s): The system had the potential to modify the kinematic pattern, but not the walking speed, (comprehensive evaluation of walking) in older adults. Moreover, it is likely that the device placed cognitive load on older adults, an aspect that should be considered in a clinical setting. This study provides essential preliminary data for designing a successful BF system and future trials with BF devices.
Implications: Because foot pressure BF directly modified characteristics of the foot movement pattern, the proposed BF system may effectively induce positive kinematic changes in gait training. Using BF could affect the personal capacity of working memory in older adults. Thus, clinicians should consider the age and cognitive capacity of the trainee.
Keywords: Vibrotactile biofeedback system, Gait training, Older adults
Funding acknowledgements: This study was supported by Research Institute for Science and Engineering, Waseda University, Grant-in-Aid for Junior Researchers.
Topic: Robotics & technology; Health promotion & wellbeing/healthy ageing; Older people
Ethics approval required: Yes
Institution: Waseda University
Ethics committee: Waseda University’s Ethics Committee for Human Research
Ethics number: 2015-087
All authors, affiliations and abstracts have been published as submitted.
