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Vinolo-Gil MJ, Casado-Fernández E, Perez-Cabezas V, Gonzalez-Medina G, Martín-Vega FJ, Martín-Valero R. Effects of the Combination of Music Therapy and Physiotherapy in the Improvement of Motor Function in Cerebral Palsy: A Challenge for Research. CHILDREN (BASEL, SWITZERLAND) 2021; 8:868. [PMID: 34682132 PMCID: PMC8534581 DOI: 10.3390/children8100868] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 09/22/2021] [Accepted: 09/26/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND There are different therapeutic strategies such as physiotherapy and music therapy for the treatment of cerebral palsy. Intervention protocols using both therapies to unify the measurement of motor function have not been investigated. Aims and scope: To summarize the effects of the treatment of cerebral palsy through the use of both for the improvement of motor function, analyse the challenges encountered, and submit proposals for improving them. METHODS The systematic review was conducted following PRISMA guidelines and registered in the PROSPERO database (CRD42020162493). Clinical trials that described the results obtained in terms of motor function through physiotherapy and music therapy were included. RESULTS Eight clinical trials with 234 participants were considered with a significant improvement in motor function. Results of meta-analysis suggested improvements in gait velocity in favour of the control group for cerebral palsy (mean differences = 0.03; 95% confidence interval = 0.01, 0.04, p = 0.001; I2 = 97%). However, high heterogeneity was identified in the meta-analysis due to the small number of studies included. CONCLUSIONS The combination can be effective in subjects with cerebral palsy to improve motor function, although due to the diversity of studies analysed, it is complex to extrapolate results.
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Affiliation(s)
- Maria Jesus Vinolo-Gil
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, Spain; (M.J.V.-G.); (E.C.-F.); (V.P.-C.); (G.G.-M.); (F.J.M.-V.)
| | - Esteban Casado-Fernández
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, Spain; (M.J.V.-G.); (E.C.-F.); (V.P.-C.); (G.G.-M.); (F.J.M.-V.)
| | - Veronica Perez-Cabezas
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, Spain; (M.J.V.-G.); (E.C.-F.); (V.P.-C.); (G.G.-M.); (F.J.M.-V.)
| | - Gloria Gonzalez-Medina
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, Spain; (M.J.V.-G.); (E.C.-F.); (V.P.-C.); (G.G.-M.); (F.J.M.-V.)
| | - Francisco Javier Martín-Vega
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cádiz, Spain; (M.J.V.-G.); (E.C.-F.); (V.P.-C.); (G.G.-M.); (F.J.M.-V.)
| | - Rocío Martín-Valero
- Department of Physiotherapy, Faculty of Health Sciences, University of Málaga, 29071 Málaga, Spain
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Prasanth H, Caban M, Keller U, Courtine G, Ijspeert A, Vallery H, von Zitzewitz J. Wearable Sensor-Based Real-Time Gait Detection: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2021; 21:2727. [PMID: 33924403 PMCID: PMC8069962 DOI: 10.3390/s21082727] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/26/2021] [Accepted: 04/08/2021] [Indexed: 11/16/2022]
Abstract
Gait analysis has traditionally been carried out in a laboratory environment using expensive equipment, but, recently, reliable, affordable, and wearable sensors have enabled integration into clinical applications as well as use during activities of daily living. Real-time gait analysis is key to the development of gait rehabilitation techniques and assistive devices such as neuroprostheses. This article presents a systematic review of wearable sensors and techniques used in real-time gait analysis, and their application to pathological gait. From four major scientific databases, we identified 1262 articles of which 113 were analyzed in full-text. We found that heel strike and toe off are the most sought-after gait events. Inertial measurement units (IMU) are the most widely used wearable sensors and the shank and foot are the preferred placements. Insole pressure sensors are the most common sensors for ground-truth validation for IMU-based gait detection. Rule-based techniques relying on threshold or peak detection are the most widely used gait detection method. The heterogeneity of evaluation criteria prevented quantitative performance comparison of all methods. Although most studies predicted that the proposed methods would work on pathological gait, less than one third were validated on such data. Clinical applications of gait detection algorithms were considered, and we recommend a combination of IMU and rule-based methods as an optimal solution.
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Affiliation(s)
- Hari Prasanth
- ONWARD, Building 32, Hightech Campus, 5656 AE Eindhoven, The Netherlands;
- Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
| | - Miroslav Caban
- Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland; (M.C.); (A.I.)
- ONWARD, EPFL Innovation Park Building C, 1015 Lausanne, Switzerland; (U.K.); (J.v.Z.)
| | - Urs Keller
- ONWARD, EPFL Innovation Park Building C, 1015 Lausanne, Switzerland; (U.K.); (J.v.Z.)
| | - Grégoire Courtine
- Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), 1015 Lausanne, Switzerland;
- Department of Neurosurgery, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), 1011 Lausanne, Switzerland
- Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), 1011 Lausanne, Switzerland
- Defitech Center for Interventional Neurotherapies (.NeuroRestore), CHUV/UNIL/EPFL, 1011 Lausanne, Switzerland
| | - Auke Ijspeert
- Institute of Bioengineering, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland; (M.C.); (A.I.)
| | - Heike Vallery
- Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands
- Department of Rehabilitation Medicine, Erasmus MC, 3000 CA Rotterdam, The Netherlands
| | - Joachim von Zitzewitz
- ONWARD, EPFL Innovation Park Building C, 1015 Lausanne, Switzerland; (U.K.); (J.v.Z.)
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Pitale JT, Bolte JH. Efficacy of dance-based paradigms, wearable sensors, and auditory feedback for gait retraining in children: A feasibility study. J Bodyw Mov Ther 2020; 24:57-62. [PMID: 32507153 DOI: 10.1016/j.jbmt.2019.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 06/04/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Different feedback modes such as auditory, visual and haptic have been used in the past for gait retraining or learning movement patterns. The primary goal of this study was to investigate whether real time auditory feedback would be effective in children learning novel, dance-based movement patterns. For this purpose, a prototype wearable sensor was developed to provide auditory feedback whenever a child touches their heel to the ground. METHODS To test the effectiveness of the auditory feedback in learning new patterns, typically developing children were taught simple Indian dance protocols consisting of four counts of foot-work which involved alternating heel-toe movements. The effect of wearing the sensor was assessed by the maximum vertical force with which the subjects struck their foot on the plate. RESULTS Auditory feedback reduced the learning time and increased the number of correct movement patterns for trial duration of 2 min. The prototype device did not alter the maximum force with which the subject placed the foot on the ground. CONCLUSIONS Real time auditory feedback can be reliably used to learn novel movement patterns.
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Affiliation(s)
| | - John H Bolte
- Director of the Injury Biomechanics Research Center at The Ohio State University, Columbus, OH, 43210, USA.
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Gomez-Andres A, Grau-Sánchez J, Duarte E, Rodriguez-Fornells A, Tajadura-Jiménez A. Enriching footsteps sounds in gait rehabilitation in chronic stroke patients: a pilot study. Ann N Y Acad Sci 2019; 1467:48-59. [PMID: 31799738 DOI: 10.1111/nyas.14276] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/18/2019] [Accepted: 10/25/2019] [Indexed: 12/22/2022]
Abstract
In the context of neurorehabilitation, sound is being increasingly applied for facilitating sensorimotor learning. In this study, we aimed to test the potential value of auditory stimulation for improving gait in chronic stroke patients by inducing alterations of the frequency spectra of walking sounds via a sound system that selectively amplifies and equalizes the signal in order to produce distorted auditory feedback. Twenty-two patients with lower extremity paresis were exposed to real-time alterations of their footstep sounds while walking. Changes in body perception, emotion, and gait were quantified. Our results suggest that by altering footsteps sounds, several gait parameters can be modified in terms of left-right foot asymmetry. We observed that augmenting low-frequency bands or amplifying the natural walking sounds led to a reduction in the asymmetry index of stance and stride times, whereas it inverted the asymmetry pattern in heel-ground exerted force. By contrast, augmenting high-frequency bands led to opposite results. These gait changes might be related to updating of internal forward models, signaling the need for adjustment of the motor system to reduce the perceived discrepancies between predicted-actual sensory feedbacks. Our findings may have the potential to enhance gait awareness in stroke patients and other clinical conditions, supporting gait rehabilitation.
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Affiliation(s)
- Alba Gomez-Andres
- Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain.,Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Jennifer Grau-Sánchez
- Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain.,Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain.,Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa (EUIT), Universitat Autònoma de Barcelona, Terrassa, Catalonia, Spain
| | - Esther Duarte
- Department of Physical Medicine and Rehabilitation, Hospitals del Mar i l'Esperança, Parc de Salut Mar, Barcelona, Spain
| | - Antoni Rodriguez-Fornells
- Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain.,Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain.,Institute of Neurosciences (UBNeuro), University of Barcelona, Barcelona, Spain.,Catalan Institution for Research and Advanced Studies, ICREA, Barcelona, Spain
| | - Ana Tajadura-Jiménez
- DEI Interactive Systems Group, Computer Science Department, Universidad Carlos III de Madrid, Leganés, Spain.,UCL Interaction Centre (UCLIC), University College London, London, United Kingdom
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