A biofeedback cycling training to improve locomotion: a case series study based on gait pattern classification of 153 chronic stroke patients
Open Access
- 1 January 2011
- journal article
- clinical trial
- Published by Springer Science and Business Media LLC in Journal of NeuroEngineering and Rehabilitation
- Vol. 8 (1), 47
- https://doi.org/10.1186/1743-0003-8-47
Abstract
The restoration of walking ability is the main goal of post-stroke lower limb rehabilitation and different studies suggest that pedaling may have a positive effect on locomotion. The aim of this study was to explore the feasibility of a biofeedback pedaling treatment and its effects on cycling and walking ability in chronic stroke patients. A case series study was designed and participants were recruited based on a gait pattern classification of a population of 153 chronic stroke patients. In order to optimize participants selection, a k-means cluster analysis was performed to subgroup homogenous gait patterns in terms of gait speed and symmetry. The training consisted of a 2-week treatment of 6 sessions. A visual biofeedback helped the subjects in maintaining a symmetrical contribution of the two legs during pedaling. Participants were assessed before, after training and at follow-up visits (one week after treatment). Outcome measures were the unbalance during a pedaling test, and the temporal, spatial, and symmetry parameters during gait analysis. Three clusters, mainly differing in terms of gait speed, were identified and participants, representative of each cluster, were selected. An intra-subject statistical analysis (ANOVA) showed that all patients significantly decreased the pedaling unbalance after treatment and maintained significant improvements with respect to baseline at follow-up. The 2-week treatment induced some modifications in the gait pattern of two patients: one, the most impaired, significantly improved mean velocity and increased gait symmetry; the other one reduced significantly the over-compensation of the healthy limb. No benefits were produced in the gait of the last subject who maintained her slow but almost symmetrical pattern. Thus, this study might suggest that the treatment can be beneficial for patients having a very asymmetrical and inefficient gait and for those that overuse the healthy leg. The results demonstrated that the treatment is feasible and it might be effective in translating progresses from pedaling to locomotion. If these results are confirmed on a larger and controlled scale, the intervention, thanks to its safety and low price, could have a significant impact as a home- rehabilitation treatment for chronic stroke patients.Keywords
This publication has 32 references indexed in Scilit:
- Task-Oriented Biofeedback to Improve Gait in Individuals With Chronic Stroke: Motor Learning ApproachNeurorehabilitation and Neural Repair, 2010
- Rehabilitation of Gait Speed After Stroke: A Critical Review of Intervention ApproachesNeurorehabilitation and Neural Repair, 2008
- Validation of a Speed-Based Classification System Using Quantitative Measures of Walking Performance PoststrokeNeurorehabilitation and Neural Repair, 2008
- Rehabilitation of Gait Speed After Stroke: A Critical Review of Intervention ApproachesNeurorehabilitation and Neural Repair, 2008
- Kinesiological and kinematical analysis for stroke subjects with asymmetrical cycling movement patternsJournal of Electromyography and Kinesiology, 2005
- Use of cluster analysis for gait pattern classification of patients in the early and late recovery phases following strokeGait & Posture, 2003
- Reorganization of Sensory and Motor Systems in Hemiplegic Stroke PatientsStroke, 1999
- Pilot Study of Functional MRI to Assess Cerebral Activation of Motor Function After Poststroke HemiparesisStroke, 1998
- Physiological Outcomes of Aerobic Exercise Training in Hemiparetic Stroke PatientsStroke, 1995
- Silhouettes: A graphical aid to the interpretation and validation of cluster analysisJournal of Computational and Applied Mathematics, 1987