[NEWS] AI: Stroke patient helped to walk by high-tech trousers

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Julie Lloyd is taking part in the first UK trial of the new AI-powered trousers.

By Paul Pigott

BBC News

A stroke survivor is learning to walk independently again thanks to high-tech trousers powered by AI.

Julie Lloyd, 65, is part of the UK’s first trial of the “smart garment” that she described as a breakthrough for fellow stroke patients.

The “NeuroSkin” trousers stimulate her paralysed leg using electrodes controlled by artificial intelligence.

The Stroke Association said new technologies are giving hope to the UK’s 1.3 million stroke survivors.

The developers of NeuroSkin said the invention is already revolutionising stroke care in France, but Ms Lloyd is one of the first involved in the UK’s own trial.

“My leg is almost feeling as if it’s being guided,” she said.

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Ms Lloyd took part in the UK trial at her physiotherapy clinic in Newport.

After first experiencing an uncomfortable “tingling feeling”, she said that within a few minutes she was walking unaided for the first time in six months.

“[My leg] was suddenly propelled up from the floor and made me feel safe walking, and that’s the part that I’ve honestly not felt at all with all the physio I’ve had,” she said.

Image caption,Julie needs a cane to walk her dogs near her home in Penarth

“I’ve never felt since my stroke as elated as I feel this moment.”

The businesswoman, from Penarth in Vale of Glamorgan, had a minor stroke in January which resulted in her left arm and left leg being partially paralysed. She currently relies on a cane to walk.

“Life before was very energetic, very active,” she said, explaining how she ran the Cardiff half marathon before her stroke. “It has taken away a lifestyle I had and that’s been terribly tragic.”

Her rehabilitation involves hours of repetitive exercises aimed at “teaching” her brain to work around the area damaged by the stroke and make new connections to control her left side.

The progress has been slow and gruelling. But when she got to about 3,000 steps a day with a cane, her physiotherapist recommended she enter the trial of the AI-powered tech.

Image caption,One side of the “smart garment” monitors the electrical impulses of Ms Lloyd’s healthy leg, then recreates those impulses on her weakened leg

Electrical muscle stimulation (EMS) has been used in stroke care for decades, “zapping” weak and atrophied muscles back to life.

But it is a blunt approach, said Rudi Gombauld, the CEO of Lyon-based firm Kurage which is developing wearable devices that deliver EMS pulses controlled by artificial intelligence.

NeuroSkin includes wired trousers and shoes with electrodes above the six main muscle groups in each leg.

Image caption,Julie Lloyd walking unaided for the first time in the six months since her stroke

“The smart garment is like a second skin which means that you have sensors that can feel how the brain works and have all the sensory information to send to an artificial intelligence system,” Mr Gombauld said.

The AI is connected to the electrodes and worn in a vest.

With each step it gathers information about the impulses being sent by the brain to the healthy leg, and then sends a mirror impulse to the patient’s weakened leg to recreate their natural stride.

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NeuroSkin is not for home or everyday use, but has been developed to help patients complete the number of repetitions necessary to help regain their walking ability.

It currently costs about £5,000 a month to lease, with the Morrello Clinic in Newport set to offer the treatment for the first time in Wales in October, starting with three stroke survivors including Ms Lloyd.

Image caption,Kurage CEO Rudi Gombauld described the trousers as a “second skin”

“I really feel this is the breakthrough for stroke victims that has been much and long awaited for,” Ms Lloyd said.

Clare Jonas, from the Stroke Association, said NeuroSkin was an “exciting” prospect for the 70,000 stroke survivors in Wales, around three-quarters of whom have some paralysis.

“It feels like there’s probably going to be a big shift in how we treat stroke and how we offer rehab for stroke in the next five to 10 years,” she said.

But she warned that new treatments will “take time to get from the lab into clinical practice”.

Source: https://www.bbc.com/news/uk-wales-66311632

[WEB] Exoskeleton for stroke rehab cleared by U.S. regulators

A self-balancing exoskeleton that enables users to move in multiple directions hands-free has been cleared by the US Food and Drug Administration (FDA) for stroke rehabilitation.

Since 2020, French developers Wandercraft has deployed 22 copies of their gait-training ‘Atalante’ exoskeleton in clinical settings. With FDA backing, they hope to deliver the first Atalante exoskeletons in the United States during the first quarter of 2023.

According to the Centers for Disease Control and Prevention (CDC), every year, more than 795,000 people in the United States have a stroke. It is a leading cause of serious long-term disability.

In 2021, Reuters was given a first-hand demonstration of the possibilities wearable exoskeletons can have for people with disabilities.

Oscar Constanza, then 16, gave a voice command to the exoskeleton he was wearing. Slowly but surely, the large frame strapped to his body lifted him up and he started walking.

Fastened to his shoulders, chest, waist, knees, and feet, the exoskeleton allowed Oscar – who has a genetic neurological condition that means his nerves do not send enough signals to his legs – to walk across the room and turn around.

“Before, I needed someone to help me walk … this makes me feel independent,” said Oscar, as his father Jean-Louis Constanza, one of the co-founders of Wandercraft, looked on.

“One day Oscar said to me, ‘Dad, you’re a robotics engineer, why don’t you make a robot that would allow us to walk?’” his father recalled, speaking at the company headquarters in Paris.

“Ten years from now, there will be no, or far fewer, wheelchairs,” he said.

Other companies across the world are also manufacturing exoskeletons, competing to make them as light and usable as possible. Some are focused on helping disabled people walk, others on a series of applications, including making standing less tiring for factory workers.

Since 2020, Wandercraft’s exoskeleton has already deployed 22 copies of it in clinical settings, and 5 in other research settings. It has been sold to hospitals in France, Luxembourg, and the United States, for about 150,000 euros ($176,000) apiece, Constanza said.

It cannot yet be bought by private individuals for everyday use – that is the next stage the company is working on. A personal exoskeleton would need to be much lighter, Wandercraft engineers said.

Just outside Paris, Kevin Piette, then 33, who lost the ability to walk in a bike accident 10 years ago, tried one on, walking around his flat, remote controller in hand.

“In the end, it’s quite similar: instead of having the information going from the brain to the legs, it goes from the remote controller to the legs,” he said, before making his dinner and walking with it from the kitchen to the living room.

By Yiming Woo and Matt Stock Reuters

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[VIDEO] Foot Drop Solutions – YouTube

PhysioFunction team discuss the benefits of Foot Drop Solutions at their clinic in Northampton

[WEB] New remote PT and AI wearable helps stroke patients to walk more easily

ByDr. Tim Sandle

People who have experienced neurological conditions such as strokes, multiple sclerosis, or Parkinson’s disease, tend to drag their affected foot. These are termed functional gait disorders.

To help address this, a new wearable device, called the EvoWalk, which is used in conjunction with a remote physical therapy platform, has been developed by Evolution Devices. The company was founded by Pier Mantovani.

The objective of the new technology is to make an improvement with a person’s mobility. The device uses machine learning to bypass the leg nerve. The foot can be lifted at just the right time to help users avoid falls and walk more freely.

Inspiration for the device came about when the founder’s father was diagnosed with multiple sclerosis and he struggled to walk. Physical therapy was critical for addressing the issue. However, getting to the health clinic in person proved not to be easy.

Looking at the experience and the associated issues, Mantovani devised the wearable and founded Evolution Devices, a company that combines the new, virtual physical therapy platform paired with the wearable.

This holistic approach of combining remote physical therapy with an artificial intelligence powered stimulation device and patient app to personalize care is not currently available with any other fall-prevention or rehabilitation therapy.

With the EvoWalk platform, users are able to work with a neuro-certified physical therapists without having to go to therapy in person. Built-in sensors feed real-time motion data to artificial intelligence algorithms and provide actionable metrics through the connected mobile apps.

The EvoWalk device gathers detailed walking data and provides electrotherapy to stimulate muscles at the right time to rehab walking and prevent falls.

A video that shows the technology in action is available on YouTube.

Through this, dedicated physical therapists are able to work remotely with the patient every step of the way, adjusting the wearable as patients make progress.

Based on trials conducted ahead of the launch of the technology, pilot users have seen an up to tenfold increase in walking activity.

The launch of the new device was on September 21^st, 2021. The launch was supported by grants from the U.S. National Science Foundation, the National Institutes of Health, and the Toyota Mobility Foundation among others.

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[WEB] Walking Speed Following Stroke a Good Predictor of Recovery?

By Erik Greb, July 02, 2021

Walking speed after stroke may help predict which patients will show greater post-rehab improvement in their ability to simultaneously walk and perform a second task, suggests new research backed by imaging data.

In secondary analysis of a previous study, training enabled both “good” and “limited” walkers to increase travel distance during a 2-minute walk. However, for “dual-task” walking, good walkers improved their distance by approximately 10 m after training, whereas limited walkers improved by only 1 m.

Brain imaging showed increased brain activity in the limited walkers, which could reduce cognitive resources available for performing a second task while walking.

These findings may explain the apparent lack of superiority shown previously of dual-task training compared with single-task training for patients with stroke and impaired walking ability, researchers note.

“Imaging data were consistent with our hypothesis that walking automaticity might explain these results,” lead author Johnny Collett, PhD, senior clinical research fellow at Oxford Brookes University, Oxford, United Kingdom, told Medscape Medical News.

At baseline, participants who walked slowly had increased resting state connectivity between contralesional M1 and cortical areas associated with conscious gait control.

“In response to the intervention, we found increased connectivity with the precuneus in those who walked slowly at baseline, an adaptation that might support walking in more complex situations,” Collett said.

The findings were published online May 30 in Clinical Rehabilitation.

Benefits Questioned

After stroke, many patients have difficulty walking while performing a second task, such as holding a conversation. Training in dual-task walking has provided uncertain benefits, according to clinical research.

In healthy individuals, walking is believed to be a largely automatic process that requires minimal executive resources. Previous studies have suggested that a certain minimum walking speed is required to enable automatic control of walking in the brain.

“We know that those with better walking ability after stroke are better able to cope with additional cognitive loads while walking,” said Collett.

“Here, we proposed that increased automatic gait control may provide a mechanism whereby executive resources are freed up to attend to additional tasks,” he added.[…]

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[BLOG POST] Walking After Stroke: 7 Exercise to Improve Strength and Balance

Gait training and balance training are key components of post stroke rehabilitation to help you learn to walk, improve your balance and coordination, and increase the strength of your hips, knees, and ankles to support your body when you move.

By KRISTEN GASNICK, PT, DPT

20 JAN 2021 • 5 MIN READ

Walking independently after a stroke is one of the major goals in post stroke rehabilitation. Your gait is your specific pattern of walking that occurs in several phases that require specific patterns of muscle activation that allow the joints of the lower limbs to move smoothly and synchronously in coordination. The signals to these muscles can become disrupted after stroke, especially if hemiparesis, or one sided muscle weakness, is present.

Gait training and balance training are key components of post stroke rehabilitation to help you learn to walk, improve your balance and coordination, and increase the strength of your hips, knees, and ankles to support your body when you move.

Common gait deviations observed in patients post stroke include:

• Decreased gait speed and cadence, or steps per minute
• Decreased step length
• Decreased stance time on the weakened leg
• Decreased ankle dorsiflexion, limiting foot clearance
• Decreased standing balance and stability, especially with weight shifting

These changes result from a compromised ability to generate force to propel the body forward, instability of the pelvis that impairs balance, and decreased strength of the weakened leg, limiting the ability to bear weight through that side.

Gait deviations can reduce safety and efficiency of walking, resulting in increased fall risk.

Key muscle groups that can benefit from strength training to improve gait quality after stroke include the:

• Tibialis anterior: to dorsiflex the ankle, the motion of lifting the foot up toward the body to clear the foot from dragging and prevent tripping when taking a step
• Quadriceps: to extend the knee, providing stability to the knee to improve weight bearing tolerance and to prevent knee buckling
• Hip flexors: to lift the leg up to increase foot clearance and step length
• Glutes: to extend the hip, increasing the amount of force generated to propel the body forward, and to increase stability of the pelvis, to support balance with weight shifting between each leg and changing directions

Good outcomes for post stroke rehabilitation require a high degree of motivation, participation, and engagement of the patient.

The human leg contains a multitude of muscles that work together to support balance and walking.

Strength and Balance Exercises for Better Walking

1) Ankle Dorsiflexion

• Goal: to improve ankle dorsiflexion strength to improve foot clearance
• How-to: Loop a resistance band around your foot so that the force is pulling your foot down. Activate your tibialis anterior by drawing your foot up toward your body.
• Progression: Increase the resistance with a higher level of resistance band.

2) Marching

• Goal: to increase hip flexor strength to improve foot clearance, and increase single leg strength and stability when standing and weight shifting.
• How-to: (Sitting) Begin seated in a chair. Lift one leg up, hold for 2 seconds, then lower. Repeat on the other side. (Standing) Stand next to a table, chair, wall, or other stable object for support. Weight shift over onto one leg while slowly lifting up the other, hold for 2 seconds, then lower. Repeat on the other side. Hold onto something for support if needed.
• Progression: Add ankle weights in sitting or standing to increase difficulty. For standing marching, challenge yourself by not relying on arm support to maintain your balance.

3) Bridging

• Goal: to increase glute strength to improve force generation, step length, and gait speed
• How-to: Lay down on your back with your knees bent and feet flat. Draw your stomach in and squeeze your glutes to lift your hips up without arching your lower back, then lower.
• Progression: Add a resistance band around your knees to increase glute activation by abducting, or pushing your legs out, against the band.

4) Sit to Stand

• Goal: to increase quadriceps and glute strength for improved leg strength and stability
• How-to: Sit in a chair, lean forward, and use your legs to stand up. Then slowly lower yourself back into the chair with control without “plopping.” Try not to use your arms to help push you up from the chair.
• Progression: Add a resistance band around your knees to increase glute activation by abducting, or pushing your legs out, against the band, or lower the seat surface to make the movement more challenging

5) Side Stepping

• Goal: to increase glute activation and dynamic balance and stability with lateral weight shifting
• How-to: Stand in front of a wall or counter to hold onto support if needed. Step to the side with one leg then follow with the other. Repeat several times, then change directions and repeat.
• Progression: Add a resistance band around your knees to increase glute activation when side stepping. Challenge yourself by not relying on arm support to maintain your balance.

6) Forward to Backward Weight Shifting

• Goal: to improve foot clearance, pelvis stability, and standing balance with weight shifting
• How-to: Stand next to a table, chair, wall, or other stable object for support. Weight shift forward by taking a step forward with one foot, then lift that leg up and move it back behind your body to weight shift backward. Repeat several times, then switch sides.
• Progression: Add ankle weights to increase difficulty. Challenge yourself by not relying on arm support to maintain your balance.

7) Step-ups

• Goal: to increase hip flexor strength for improved foot clearance and step length, quadriceps and glute strength for improved force generation and gait speed, and pelvis stability and standing balance with weight shifting
• How-to: Stand in front of a step. Step with one foot followed by the other, then step down. Repeat several times, then switch sides.
• Progression: Challenge yourself by not relying on arm support to maintain your balance. Increase step height for added difficulty.

References
Wang, Yijia, et al. (2020). Gait characteristics of post-stroke hemiparetic patients with different walking speeds. International Journal of Rehabilitation Research. 43(1), 69-75. doi: 10.1097/MRR.0000000000000391

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Looking for a fun and effective way to exercise leg and core muscles for improved walking outcomes? Check out the Neofect Smart Balance system for therapy clinics here.

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[WEB PAGE] VIRTUAL GAMES HELP PEOPLE STAND, WALK IN REHAB

 

This study is not only the largest in terms of the number of participants but also comprehensive in that it included a range of devices. Image courtesy of Flinders University, Adelaide, Australia.

Virtual reality video games, activity monitors, and handheld computer devices can help people stand as well as walk, the largest trial worldwide into the effects of digital devices in rehabilitation has found. The study was undertaken at hospitals in Sydney and Adelaide, Australia, and had 300 participants ranging from 18 to 101 years old. Those who exercised using digital devices in addition to their usual rehabilitation were found to have better mobility (walking, standing up, and balance) after 3 weeks and after 6 months than those who just completed their usual rehabilitation. The results were published in PLOS Medicine.

Trial participants were recovering from strokes, brain injuries, falls, and fractures. Participants used on average 4 different devices while in hospital and 2 different devices when at home. Fitbits were the most used digital device but also tested were a suite of devices like Xbox, Wii, and iPads, making the exercises more interactive and enabling remote connection between patients and their physical therapists. Having a selection meant the physical therapist could tailor the choice of devices to meet the patient’s mobility problems while considering patient preferences.

Lead author Leanne Hassett, PhD, from the Faculty of Medicine and Health at the University of Sydney, said benefits reported by patients using the digital devices in rehabilitation included variety, fun, feedback about performance, cognitive challenge, that they enabled additional exercise, and the potential to use the devices with others, such as family, therapists, and other patients. “These benefits meant patients were more likely to continue their therapy when and where it suited them, with the assistance of digital healthcare,” she said.

Participants reported doing more walking at 6 months, meaning their rehabilitation was improved, but this was not detected in the physical activity measure (time spent upright) generally. In the younger age group, the devices also increased daily step count. Distinctions between physical activity were made through measurements with an activPAL, a small device attached to the thigh that records how much time is spent in different positions (sitting, standing, lying) as well as number of steps taken each day.

This study used research physical therapists to deliver the study; the next step will be to trial the approach in clinical practice by incorporating it into the work of physical therapists.

via VIRTUAL GAMES HELP PEOPLE STAND, WALK IN REHAB | Lower Extremity Review Magazine

[ARTICLE] The exoskeleton expansion: improving walking and running economy – Full Text

Abstract

Since the early 2000s, researchers have been trying to develop lower-limb exoskeletons that augment human mobility by reducing the metabolic cost of walking and running versus without a device. In 2013, researchers finally broke this ‘metabolic cost barrier’. We analyzed the literature through December 2019, and identified 23 studies that demonstrate exoskeleton designs that improved human walking and running economy beyond capable without a device. Here, we reviewed these studies and highlighted key innovations and techniques that enabled these devices to surpass the metabolic cost barrier and steadily improve user walking and running economy from 2013 to nearly 2020. These studies include, physiologically-informed targeting of lower-limb joints; use of off-board actuators to rapidly prototype exoskeleton controllers; mechatronic designs of both active and passive systems; and a renewed focus on human-exoskeleton interface design. Lastly, we highlight emerging trends that we anticipate will further augment wearable-device performance and pose the next grand challenges facing exoskeleton technology for augmenting human mobility.

Background

Exoskeletons to augment human walking and running economy: previous predictions and recent milestones

The day that people move about their communities with the assistance of wearable exoskeletons is fast approaching. A decade ago, Ferris predicted that this day would happen by 2024 [1] and Herr foresaw a future where people using exoskeletons to move on natural terrain would be more common than them driving automobiles on concrete roads [2]. Impressively, Ferris and Herr put forth these visions prior to the field achieving the sought-after goal of developing an exoskeleton that breaks the ‘metabolic cost barrier’. That is, a wearable assistive device that alters user limb-joint dynamics, often with the intention of reducing user metabolic cost during natural level-ground walking and running compared to not using a device. When the goal is to reduce effort, metabolic cost is the gold-standard for assessing lower-limb exoskeleton performance since it is an easily attainable, objective measure of effort, and relates closely to overall performance within a given gait mode [3, 4]. For example, reducing ‘exoskeleton’ mass improves user running economy, and in turn running performance [4]. Further, enhanced walking performance is often related to improved walking economy [3] and quality of life [5, 6]. To augment human walking and running performance, researchers seriously began attempting to break the metabolic cost barrier using exoskeletons in the first decade of this century, shortly after the launch of DARPA’s Exoskeletons for Human Performance Augmentation program [7,8,9,10].

It was not until 2013 that an exoskeleton broke the metabolic cost barrier [11]. In that year, Malcolm and colleagues [11] were the first to break the barrier when they developed a tethered active ankle exoskeleton that reduced their participants’ metabolic cost during walking (improved walking economy) by 6% (Fig. 1). In the following 2 years, both autonomous active [12] and passive [13] ankle exoskeletons emerged that also improved human walking economy (Fig. 1). Shortly after those milestones, Lee and colleagues [14] broke running’s metabolic cost barrier using a tethered active hip exoskeleton that improved participants’ running economy by 5% (Fig. 1). Since then, researchers have also developed autonomous active [15, 16] and passive [17, 18] exoskeletons that improve human running economy (Fig. 1).

Fig, 1 Milestones illustrating the advancement of exoskeleton technology. Tethered (blue) and autonomous (red) exoskeletons assisting at the ankle (circle), knee (triangle), and hip (square) joint to improve healthy, natural walking (left) and running (right) economy versus using no device are shown

[…]

 

Continue —->  The exoskeleton expansion: improving walking and running economy | Journal of NeuroEngineering and Rehabilitation | Full Text

[ARTICLE] Pharmacological Therapies for Motor Recovery After Stroke – Full Text

Abstract and Introduction

Abstract

Stroke is the most common serious neurological disorder. To date, the focus for research and trials has been on prevention and acute care. Many patients are left with serious neurological impairments and limitations in activity and participation after stroke. Recent preliminary research and trials suggest that the brain is ‘plastic’ and that the natural history of stroke recovery can be improved by physical therapy and pharmacotherapy. Motor weakness and the ability to walk have been the primary targets for testing interventions that may improve recovery after stroke. Physical therapeutic interventions enhance recovery after stroke; however, the timing, duration and type of intervention require clarification and further trials. Pharmacotherapy, in particular with dopaminergic and selective serotonin-reuptake inhibitors, shows promise in enhancing motor recovery after stroke; however, further large-scale trials are required.

Introduction

This review is a framework around an emerging and exciting area of stroke care – maximizing recovery after stroke. Stroke care is a continuum from prevention to hyperacute care to acute care to rehabilitation to community reintegration and back (Figure 1). The traditional medical model of care artificially divides care across multiple healthcare providers and locations. Prevention is most often in the hands of general and primary care medicine with the goal of maximizing stroke risk reduction strategies such as controlling hypertension. Hyperacute stroke care is in the hands of neurologists with a primary goal of providing thrombolysis to as many patients as possible and as quickly as possible. Acute stroke care is in the hands of neurologists and very often in the hands of internal medicine specialists who manage patients according to best practices on acute stroke units in acute care hospitals. Rehabilitation is under the care of physical medicine and rehabilitation physicians and allied health professionals usually in rehabilitation hospitals. Reintegration into the community is in the hands of home care and out-patient providers in the community. One patient, one neurological disorder and so many different care providers and locations.

Figure 1.The continuum of stroke care.

A tremendous amount of research and progress has been made in stroke care. The vast majority of the research and progress has focused on prevention, hyperacute and acute care. Major advances have been made in risk reduction strategies, ‘clot-busting’, and acute stroke unit care. When it comes to rehabilitation and maximizing someone’s recovery after stroke, aside from stroke care on a rehabilitation unit, a tremendous amount of research and knowledge is as yet missing. A recent review of the possible future of after-stroke care has aptly called this “the sleeping giant of stroke medicine”.^[1]

Recent research suggests that we are at the edge of major advances in post-stroke care. Animal and human studies show that the brain is ready to heal immediately after a stroke. The brain is ‘plastic’ and responds to external influences, such as physical therapy. The timing, the intensity and the exact external influence may all be important factors in maximizing recovery. Pharmacotherapy may influence how the injured brain recovers. This complex array of influences and recent research addressing these areas will be elaborated on in this review (Figure 2).

Figure 2.
Multiple factors may influence recovery after stroke.

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via Pharmacological Therapies for Motor Recovery After Stroke

[WEB SITE] Therapeutic Shoe is Helping Stroke Patients Relearn How to Walk

A therapeutic shoe engineered to help improve stroke recovery is proving successful and is expected to hit the market by the end of the year, researchers from University of South Florida suggest.

Results from the recently completed clinical trials on the US patented and licensed iStride Device, formerly the Gait Enhancing Mobile Shoe (GEMS), were published recently in the Journal of NeuroEngineering and Rehabilitation.

Gait asymmetry as the result of a stroke is associated with poor balance, a major cause of degenerative issues that make individuals more susceptible to falls and injuries.

The iStride device is designed to be strapped over the shoe of the stroke patient’s good leg and generate a backwards motion, exaggerating the existing step, making it harder to walk while wearing the shoe. The awkward movement strengthens the stroke-impacted leg, allowing gait to become more symmetrical once the shoe is removed. The impaired foot wears a matching shoe that remains stationary, a media release from University of South Florida (USF Innovation) notes.

“The backward motion of the shoe is generated passively by redirecting the wearer’s downward force during stance phase. Since the motion is generated by the wearer’s force, the person is in control, which allows easier adaptation to the motion,” developer Kyle Reed, PhD, associate professor of mechanical engineering at the University of South Florida, says in the release.

“Unlike many of the existing gait rehabilitation devices, this device is passive, portable, wearable and does not require any external energy.”

The trial included six people between ages 57 and 74 who suffered a cerebral stroke at least 1 year prior to the study. They all had asymmetry large enough to impact their walking ability. Each received 12, 30-minute gait training sessions for 4 weeks. With guidance from a physical therapist, the patients’ gait symmetry and functional walking were measured using the ProtoKinetics Zeno Walkway system.

All participants improved their gait’s symmetry and speed. That includes how long it takes to stand up from a sitting position and walk, as well as how long it takes to walk to a specific location and distance traveled within 6 minutes. Four improved the percentage of time spent in a gait cycle with both feet simultaneously planted on the ground, known as double limb support.

As far as the other two that didn’t improve, one started the study with severe impairment, while the other was highly functional. It’s also important to note that three participants joined the study limited to walking in their homes. Following the trial, two of them could successfully navigate public venues, the release explains.

Reed compared his method to a previous study conducted on split-belt treadmill training (SBT), which is commonly used by physical therapists to help stroke patients improve their gait. The equipment allows the legs to move at different speeds, forcing the patient to compensate in order to remain on the treadmill. While the SBT improves certain aspects of gait, unlike the iStride, it doesn’t strengthen double limb support.

That research concluded only about 60% of patients trained on the SBT corrected their gait when walking in a normal environment. Walking is context dependent where visual cues impact how quickly one tries to move, and in what direction. The iStride allows patients to adjust accordingly. Movement on a treadmill is predictable and provides individuals a static scene.

Since patients are often disappointed in their progress after being discharged from rehabilitation, the iStride’s portability allows patients to relearn to walk in a typical setting more often and for a longer duration.

Reed is now working on a home-based clinical trial with 21 participants and expects to publish results within the next year. He recently received a Fulbright scholarship to conduct research at Hong Kong Polytechnic University. He’s working in the rehabilitation sciences and biomedical engineering departments throughout the 2019-2020 academic year, per the release.

[Source(s): University of South Florida (USF Innovation), EurekAlert]

 

via Therapeutic Shoe is Helping Stroke Patients Relearn How to Walk – Rehab Managment