Effects of virtual reality training on gait biomechanics of individuals post-stroke

Useless.  A  complete demonstration of the tyranny of low expectations, potential for recovery/evaluate.  No discussion of how many got fully recovered. I would fire the mentors and senior researchers that allowed such crapola research.

Effects of virtual reality training on gait biomechanics of individuals post-stroke

 Anat Mirelman
a,b,c,
*, Benjamin L. Patritti
c
, Paolo Bonato
c,d
, Judith E. Deutsch
b
a
Gait and Neurodynamics Laboratory, Tel Aviv Sourasky Medical Center, Israel
b
RiVERS Lab, Doctoral Program in Physical Therapy, Department of Rehabilitation and Movement Science, University of Medicine and Dentistry of New Jersey, United States
c
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, United States
d
The Harvard-MIT Division of Health Sciences and Technology, United States

ABSTRACT

Objective:
 To evaluate gait biomechanics after training with a virtual reality(VR) system and to elucidate underlying mechanisms that contributed to the observed functional improvement in gait speed and distance.
Design:
 A single blind randomized control study.
Setting:
 Gait analysis laboratory in a rehabilitation hospital and the community.
Participants:
 Fifteen men and three women with hemiparesis caused by stroke.
Interventions:
 Subjects trained on a six-degree of freedom force-feedback robot interfaced with a VR simulation.Subjects were randomized to either aVRgroup(n = 9)or non-VRgroup(NVR,n =9). Training was performed three times a week for 4 weeks for approximately 1 h each visit.
Main outcome measures:
 Kinematic and kinetic gait parameters.
Results:
 Subjects in the VR group demonstrated a significantly larger increase in ankle power generation at push-off as a result of training ( p = 0.036). The VR group had greater change in ankle ROM post-training(19.5%)as compared to the NVR group(3.3%). Significant differences were found in knee ROM on the affected side during stance and swing, with greater change in the VR group. No significant changes were observed in kinematics or kinetics of the hip post-training.
Conclusions:
 These findings are encouraging because they support the potential for recovery of force and power of the lower extremity for individuals with chronic hemiparesis. It is likely that the effects of training included improved motor control at the ankle, which enabled the cascade of changes that produced the functional improvements seen after training.
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 2010 Elsevier B.V. All rights reserved.

Effects of unilateral real-time biofeedback on propulsive forces during gait

How are your doctors and therapists using this to get you to 100% recovery? ANYTHING AT ALL?
11 years later and I still have no pushoff from the affected leg. And pretty useless research since testing was done with healthy young controls. Your doctor and hospital  should be setting up research to test this in stroke impaired persons, but nothing like that will occur because they are waiting for SOMEONE ELSE TO SOLVE THE PROBLEM!
https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-017-0252-z

• Christopher Schenck and
• Trisha M. KesarEmail author

Journal of NeuroEngineering and Rehabilitation201714:52

DOI: 10.1186/s12984-017-0252-z

©  The Author(s). 2017

Received: 5 June 2016

Accepted: 12 May 2017

Published: 6 June 2017

Abstract

Background

In individuals with post-stroke hemiparesis, reduced push-off force generation in the paretic leg negatively impacts walking function. Gait training interventions that increase paretic push-off can improve walking function in individuals with neurologic impairment. During normal locomotion, push-off forces are modulated with variations in gait speed and slope. However, it is unknown whether able-bodied individuals can selectively modulate push-off forces from one leg in response to biofeedback. Here, in a group of young, neurologically-unimpaired individuals, we determined the effects of a real-time visual and auditory biofeedback gait training paradigm aimed at unilaterally increasing anteriorly-directed ground reaction force (AGRF) in the targeted leg.

Methods

Ground reaction force data during were collected from 7 able-bodied individuals as they walked at a self-selected pace on a dual-belt treadmill instrumented with force platforms. During 11-min of gait training, study participants were provided real-time AGRF biofeedback encouraging a 20–30% increase in peak AGRF generated by their right (targeted) leg compared to their baseline (pre-training) AGRF. AGRF data were collected before, during, and after the biofeedback training period, as well as during two retention tests performed without biofeedback and after standing breaks.

Results

Compared to AGRFs generated during the pre-training gait trials, participants demonstrated a significantly greater AGRF in the targeted leg during and immediately after training, indicating that biofeedback training was successful at inducing increased AGRF production in the targeted leg. Additionally, participants continued to demonstrate greater AGRF production in the targeted leg after two standing breaks, showing short-term recall of the gait pattern learned during the biofeedback training. No significant effects of training were observed on the AGRF in the non-targeted limb, showing the specificity of the effects of biofeedback toward the targeted limb.

Conclusions

These results demonstrate the short-term effects of using unilateral AGRF biofeedback to target propulsion in a specific leg, which may have utility as a training tool for individuals with gait deficits such as post-stroke hemiparesis. Future studies are needed to investigate the effects of real-time AGRF biofeedback as a gait training tool in neurologically-impaired individuals.