Real-time biofeedback device for gait rehabilitation of post-stroke patients
- 139 Downloads
In this work, we develop a device, called ‘Walk-Even’, that can provide real-time feedback to correct gait asymmetry commonly exhibited in post-stroke survivors and persons with certain neurological disorders. The device computes gait parameters, including gait time, swing time, and stance time of each leg, to detect gait asymmetry and provide corresponding real-time biofeedback by means of auditory and electrotactile stimulation to actively correct the user’s gait. The system consists of customized force-sensor-embedded insoles adjustable to fit any shoe size, electrotactile and auditory feedback circuits, microcontroller, and wireless XBee transceivers. The device also offers data saving capability. To validate its accuracy and reliability, we compared the gait measurements from our device with a commercial gait and balance assessment device, Zeno Walkway. The results show good correlation and agreement in a validity study with six healthy subjects and reliability study with seventeen healthy subjects. In addition, preliminary testing on six post-stroke patients after an 8-week training shows that the Walk-Even device helps to improve gait symmetry, foot pressure and forefoot loading of the affected side. Thus, initial testing indicates that the device is accurate in measuring the gait parameters and effective in improving gait symmetry using real-time feedback. The device is portable and low cost and has the potential for use in a non-clinical setting for patients that can walk independently without assistance. A more extensive testing with stroke patients is still ongoing.
KeywordsBiofeedback Gait asymmetry Rehabilitation Stroke
The authors thank Kristin DeMars, Amber Duong, Alyssa Matheson, Rae Rivera, and Javier Plazola for their help with the data collection and Gerardo Bocanegra and Kristi Yoshikawa for initial device development. We also acknowledge the internal grant support from CSU Long Beach Multidisciplinary grant.
Compliance with ethical standards
Conflict of interest
The authors (I-Hung Khoo, Panadda Marayong, Vennila Krishnan, Michael Balagtas, Omar Rojas, Katherine Leyba) declare that they have no conflict of interests in relation to the work in this article.
Human and animal rights
Approval was obtained from the CSULB Institutional Review Board for the experiment involving human subjects.
- 5.Kim SY, Yang L, Park IJ, Kim EJ, Park MS, You SH, Kim YH, Ko HY, Shin YI. Correction to “Effects of Innovative WALKBOT Robotic-Assisted Locomotor Training on Balance and Gait Recovery in Hemiparetic Stroke: a Prospective, Randomized, Experimenter Blinded Case Control Study With a Four-Week Follow-Up”. IEEE Trans Neural Syst Rehabil Eng. 2015;23:1128.CrossRefGoogle Scholar
- 6.Murray SA, Ha KH, Hartigan C, Goldfarb M. An assistive control approach for a lower-limb exoskeleton to facilitate recovery of walking following stroke. IEEE Trans Neural Syst Rehabil Eng. 2015;23:441–9.Google Scholar
- 11.Redd CB, Bamberg SJM. A wireless sensory feedback system for real-time gait modification. In: 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society. 2011. p. 1507–10.Google Scholar
- 19.Klose KJ, Jacobs PL, Broton JG, Guest RS, Needham-Shropshire B, Lebwohl N, Nash MS, Green BA. Evaluation of a training program for persons with SCI paraplegia using the ParastepÂ® 1 ambulation system: part 1. Ambulation performance and anthropometric measures. Arch Phys Med Rehabil. 1997;78:789–93.CrossRefGoogle Scholar
- 21.Khoo IH, Marayong P, Krishnan V, Balagtas MN, Rojas O. Design of a biofeedback device for gait rehabilitation in post-stroke patients. In: 2015 IEEE 58th international midwest symposium on circuits and systems (MWSCAS). 2015. p. 1–4.Google Scholar
- 22.American Imex. BioTENS 2 datasheet. http://www.americanimex.com.
- 23.Krishnan V, Khoo I, Marayong P, DeMars K, Cormack J. Gait training in chronic stroke using Walk-Even feedback device: a pilot study. Neurosci J. 2016; 2016.Google Scholar