Evaluation of the Effect of SPIDER System Therapy on Weight Shifting Symmetry in Chronic Stroke Patients-A Randomized Controlled Trial

Effects of Haptic Feedback Interventions in Post-Stroke Gait and Balance Disorders: A Systematic Review and Meta-Analysis

Background: Haptic feedback is an established method to provide sensory information (tactile or kinesthetic) about the performance of an activity that an individual can not consciously detect. After a stroke, hemiparesis usually leads to gait and balance disorders, where haptic feedback can be a promising approach to promote recovery. The aim of the present study is to understand its potential effects on gait and balance impairments, both after interventions and in terms of immediate effects. Methods: This research was carried out using the following scientific databases: Embase, Scopus, Web of Science, and Medline/PubMed from inception to May 2024. The Checklist for Measuring quality, PEDro scale, and the Cochrane collaboration tool were used to assess the methodological quality and risk of bias of the studies. Results: Thirteen articles were chosen for qualitative analysis, with four providing data for the meta-analysis. The findings did not yield definitive evidence on the effectiveness of haptic feedback for treating balance and gait disorders following a stroke. Conclusions: Further research is necessary in order to determine the effectiveness of haptic feedback mechanisms, with larger sample sizes and more robust methodologies. Longer interventions and pre-post design in gait training with haptic feedback are necessary.

Applying elastic resistance bands for gait training: A simulation-based study to determine how band configuration affects gait biomechanics and muscle activation

BACKGROUND

Wearable robotic exoskeletons and leg braces are desirable for gait rehabilitation because they can apply loads directly to an affected joint. Yet, they are not widely used in clinics because they are costly and complex to set up. Conversely, tethered devices, such as elastic resistance bands, are widely available in clinics, are low-cost, and are quick to set up. However, resistance bands will affect walking differently based on how they are configured to pull on the leg (e.g., pulling forward or backward).

RESEARCH QUESTION

How can a resistance band be configured to alter muscle activation and gait biomechanics based on the segment it is attached to and the angle with which it attaches?

METHODS

We used an open-source musculoskeletal modeling platform to emulate several configurations of an elastic band pulling on the ankle, calf, and thigh at various angles during non-pathological walking. We evaluated gait biomechanics and simulated muscle activation using computed muscle control (CMC) and identified a subset of four configurations with potential applications for gait training. Eight non-pathological participants then walked on a treadmill under these configurations to verify how these configurations altered muscle activation.

RESULTS

We found that muscle activity greatly varied based on the location where the elastic band is attached and the angle with which the elastic band pulls on the leg. Notably, specific angles can be used to pull on the legs to elicit an increase or decrease in muscle activation.

SIGNIFICANCE

This study provides insight into how tethered devices can be configured to provide assistance or resistance during gait training. This information can be applied when developing low-cost gait training solutions for addressing individuals' impairments.