Ambulatory assessment of walking balance after stroke using instrumented shoes

And just when the hell will stroke survivors get a walking protocol? These earlier posts have obviously not done one bit of good getting to useful stroke walking analysis and rehab. With NO stroke leadership following up a stroke strategy it takes decades longer to get something useful for survivors.  With this objective analysis of walking problems maybe we can finally get stroke protocols that address those problems. Rather than the craptastic support I got from one of my PTs, 'Walk this way'.

A Personalized Self-Management Rehabilitation System with an Intelligent Shoe for Stroke Survivors: A Realist Evaluation

What does your doctor think about comparing it to these?

Sensoria™ Fitness Socks

Sensor embedded socks

The Parkinson's shoe

The latest here:

Ambulatory assessment of walking balance after stroke using instrumented shoes 

• Fokke B. van Meulen†Email author,
• Dirk Weenk,
• Jaap H. Buurke,
• Bert-Jan F. van Beijnum and
• Peter H. Veltink

†Contributed equally

Journal of NeuroEngineering and Rehabilitation201613:48

DOI: 10.1186/s12984-016-0146-5

©  van Meulen et al. 2016

Received: 14 October 2015

Accepted: 13 April 2016

Published: 19 May 2016

Abstract

Background

For optimal guidance of walking rehabilitation therapy of stroke patients in an in-home setting, a small and easy to use wearable system is needed. In this paper we present a new shoe-integrated system that quantifies walking balance during activities of daily living and is not restricted to a lab environment. Quantitative parameters were related to clinically assessed level of balance in order to assess the additional information they provide.

Methods

Data of 13 participants who suffered a stroke were recorded while walking 10 meter trials and wearing special instrumented shoes. The data from 3D force and torque sensors, 3D inertial sensors and ultrasound transducers were fused to estimate 3D (relative) position, velocity, orientation and ground reaction force of each foot. From these estimates, center of mass and base of support were derived together with a dynamic stability margin, which is the (velocity) extrapolated center of mass with respect to the front-line of the base of support in walking direction. Additionally, for each participant step lengths and stance times for both sides as well as asymmetries of these parameters were derived.

Results

Using the proposed shoe-integrated system, a complete reconstruction of the kinematics and kinetics of both feet during walking can be made. Dynamic stability margin and step length symmetry were not significantly correlated with Berg Balance Scale (BBS) score, but participants with a BBS score below 45 showed a small-positive dynamic stability margin and more asymmetrical step lengths. More affected participants, having a lower BBS score, have a lower walking speed, make smaller steps, longer stance times and have more asymmetrical stance times.

Conclusions

The proposed shoe-integrated system and data analysis methods can be used to quantify daily-life walking performance and walking balance, in an ambulatory setting without the use of a lab restricted system. The presented system provides additional insight about the balance mechanism, via parameters describing walking patterns of an individual subject. This information can be used for patient specific and objective evaluation of walking balance and a better guidance of therapies during the rehabilitation.

Trial registration

The study protocol is a subset of a larger protocol and registered in the Netherlands Trial Registry, number NTR3636.