Assessing the Impact of Real-Time Visual Feedback during Treadmill Training on Walking Improvement in Stroke Patients

Authors

DOI:

https://doi.org/10.52756/ijerr.2024.v39spl.014

Keywords:

Stroke, gait training, visual feedback, treadmill, walking speed, balance

Abstract

After a stroke, most patients often suffer reduced walking ability and balance. Restoring walking ability and improving balance are major goals of stroke rehabilitation. Treadmills are often used in clinical setups to achieve this goal. The objective of this study is to assess the efficacy of different approaches and determine their comparative effectiveness, such as real-time sagittal visual feedback during treadmill training with the conventional mirror feedback treadmill training program of the same intensity in stroke patients. The Real-time Visual feedback after Stroke in Treadmill training (REVISIT) trial is a two-arm randomized control trial. Thirty eligible stroke survivors undergoing rehabilitation were randomly assigned to either real-time visual sagittal feedback along with the front mirror (experimental) group or only the front mirror treadmill training (control) group for 5-6 weeks. All participants underwent 15 sessions of treadmill training, with each session lasting up to 15 minutes at a safe speed of their choosing. The REVISIT (experimental) groups received real-time, visual sagittal view feedback of the involved lower limb trajectory along with the routine front mirror view during treadmill training and they were requested to alter their gait pattern. The trial contributed to the existing innovation and modifications of incorporating real-time visual feedback during treadmill training in post-stroke gait rehabilitation. The findings will help in the design of a gait rehabilitation program with a treadmill for post-stroke subjects to improve walking speed and balance for those who have greater difficulties in community ambulation.

References

Ada, L., Dean, C. M., & Lindley, R. (2013). Randomized Trial of Treadmill Training to Improve Walking in Community-Dwelling People after Stroke: The AMBULATE Trial. International Journal of Stroke, 8(6), 436–444. https://doi.org/10.1111/j.1747-4949.2012.00934.x

Bennett, J. A. (2005). The Consolidated Standards of Reporting Trials (CONSORT): Guidelines for Reporting Randomized Trials. Nursing Research, 54(2), 128-132. https://doi.org/10.1097/00006199-200503000-00007

Bishnoi, A., Lee, R., Hu, Y., Mahoney, J. R., & Hernandez, M. E. (2022). Effect of Treadmill Training Interventions on Spatiotemporal Gait Parameters in Older Adults with Neurological Disorders: Systematic Review and Meta-Analysis of Randomized Controlled Trials. International Journal of Environmental Research and Public Health, 19(5), 2824. https://doi.org/10.3390/ijerph19052824

Basak, S., & Biswas, K. (2016). A study of selective physiological parameters in physical training college students. Int. J. Exp. Res. Rev., 3, 1-6.

Basak, S., & Dutta, S. (2016). A comparative study of physical fitness parameters between General college students and Training college students. Int. J. Exp. Res. Rev., 4, 26-30.

Bowen, A. (2001). Dual-task effects of talking while walking on velocity and balance following a stroke. Age and Ageing, 30(4), 319–323. https://doi.org/10.1093/ageing/30.4.319

Chan, A.W., Tetzlaff, J. M., Altman, D. G., Laupacis, A., Gøtzsche, P. C., Krleža-Jerić, K., Hróbjartsson, A., Mann, H., Dickersin, K., Berlin, J. A., Doré, C. J., Parulekar, W. R., Summerskill, W. S. M., Groves, T., Schulz, K. F., Sox, H. C., Rockhold, F. W., Rennie, D., & Moher, D. (2013). SPIRIT 2013 Statement: Defining Standard Protocol Items for Clinical Trials. Annals of Internal Medicine, 158(3), 200. https://doi.org/10.7326/0003-4819-158-3-201302050-00583

Chen, G., Patten, C., Kothari, D. H., & Zajac, F. E. (2005). Gait deviations associated with post-stroke hemiparesis: Improvement during treadmill walking using weight support, speed, support stiffness, and handrail hold. Gait & Posture, 22(1), 57–62. https://doi.org/10.1016/j.gaitpost.2004.06.008

Coenen, P., Werven, G., Nunen, M., Dieën, J., Gerrits, K., & Janssen, T. (2012). Robot-assisted walking vs overground walking in stroke patients: An evaluation of muscle activity. Journal of Rehabilitation Medicine, 44(4), 331–337. https://doi.org/10.2340/16501977-0954

Cohen, J. (2013). Statistical power analysis for the behavioral sciences. Routledge. https://doi.org/10.4324/9780203771587

Dalal, P. M., Malik, S., Bhattacharjee, M., Trivedi, N. D., Vairale, J., Bhat, P., Deshmukh, S., Khandelwal, K., & Mathur, V. D. (2008). Population-Based Stroke Survey in Mumbai, India: Incidence and 28-Day Case Fatality. Neuroepidemiology, 31(4), 254–261. https://doi.org/10.1159/000165364

Drużbicki, M., Przysada, G., Guzik, A., Brzozowska-Magoń, A., Kołodziej, K., Wolan-Nieroda, A., Majewska, J., & Kwolek, A. (2018). The Efficacy of Gait Training Using a Body Weight Support Treadmill and Visual Biofeedback in Patients with Subacute Stroke: A Randomized Controlled Trial. BioMed Research International, 2018, 1–10. https://doi.org/10.1155/2018/3812602

Gama, G. L., Celestino, M. L., Barela, J. A., Forrester, L., Whitall, J., & Barela, A. M. (2017). Effects of Gait Training With Body Weight Support on a Treadmill Versus Overground in Individuals With Stroke. Archives of Physical Medicine and Rehabilitation, 98(4), 738–745. https://doi.org/10.1016/j.apmr.2016.11.022

Hesse, S., Bertelt, C., Jahnke, M. T., Schaffrin, A., Baake, P., Malezic, M., & Mauritz, K. H. (1995). Treadmill Training With Partial Body Weight Support Compared With Physiotherapy in Nonambulatory Hemiparetic Patients. Stroke, 26(6), 976–981. https://doi.org/10.1161/01.STR.26.6.976

Jones, S. P., Baqai, K., Clegg, A., Georgiou, R., Harris, C., Holland, E.-J., Kalkonde, Y., Lightbody, C. E., Maulik, P. K., Srivastava, P. M., Pandian, J. D., Kulsum, P., Sylaja, P., Watkins, C. L., & Hackett, M. L. (2022). Stroke in India: A systematic review of the incidence, prevalence, and case fatality. International Journal of Stroke, 17(2), 132–140. https://doi.org/10.1177/17474930211027834

Kang, H. (2015). Sample size determination for repeated measures design using G Power software. Anesthesia and Pain Medicine, 10(1), 6–15. https://doi.org/10.17085/apm.2015.10.1.6

Khant, A., Dave, Y., Tare, H., Udugade, B., Udugade, S., Choudante, S., & Pulate, C. (2023). Effectiveness of respiratory muscle training on pulmonary function and quality of life in cotton industry workers. Int. J. Exp. Res. Rev., 32, 160-165. https://doi.org/10.52756/ijerr.2023.v32.013

Langhammer, B., & Lindmark, B. (2007). Performance-Related Values for Gait Velocity, Timed Up-and-Go and Functional Reach in Healthy Older People and Institutionalized Geriatric Patients. Physical & Occupational Therapy In Geriatrics, 25(3), 55–69. https://doi.org/10.1080/J148v25n03_04

Langhammer, B., & Stanghelle, J. K. (2010). Exercise on a treadmill or walking outdoors? A randomized controlled trial comparing effectiveness of two walking exercise programmes late after stroke. Clinical Rehabilitation, 24(1), 46–54. https://doi.org/10.1177/0269215509343328

Li, R.Q., Li, Z.-M., Tan, J.-Y., Chen, G.-L., & Lin, W.-Y. (2017). Effects of motor imagery on walking function and balance in patients after stroke: A quantitative synthesis of randomized controlled trials. Complementary Therapies in Clinical Practice, 28, 75–84. https://doi.org/10.1016/j.ctcp.2017.05.009

Maki, T., Quagliato, E., Cacho, E., Paz, L., Nascimento, N., Inoue, M., & Viana, M. (2006). Estudo de confiabilidade da aplicação da escala de Fugl-Meyer no Brasil. Revista Brasileira de Fisioterapia, 10(2), 177–183. https://doi.org/10.1590/S1413-35552006000200007

Mehrholz, J., Thomas, S., Werner, C., Kugler, J., Pohl, M., & Elsner, B. (2017). Electromechanical-assisted training for walking after stroke. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD006185.pub4

Montero-Odasso, M., Schapira, M., Varela, C., Pitteri, C., Soriano, E. R., Kaplan, R., Camera, L. A., & Mayorga, L. M. (2004). Gait velocity in senior people. An easy test for detecting mobility impairment in community elderly. The Journal of Nutrition, Health & Aging, 8(5), 340–343.

Moseley, A. M., Stark, A., Cameron, I. D., & Pollock, A. (2005). Treadmill training and body weight support for walking after stroke. In The Cochrane Collaboration (Ed.), Cochrane Database of Systematic Reviews, pp. CD002840.pub2). https://doi.org/10.1002/14651858.CD002840.pub2

Murray, C. J. L., Aravkin, A. Y., Zheng, P., Abbafati, C., Abbas, K. M., Abbasi-Kangevari, M., Abd-Allah, F., Abdelalim, A., Abdollahi, M., Abdollahpour, I., Abegaz, K. H., Abolhassani, H., Aboyans, V., Abreu, L. G., Abrigo, M. R. M., Abualhasan, A., Abu-Raddad, L. J., Abushouk, A. I., Adabi, M., … Lim, S. S. (2020). Global burden of 87 risk factors in 204 countries and territories, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet, 396(10258), 1223–1249. https://doi.org/10.1016/S0140-6736(20)30752-2

Park, G., Lee, S. H., & Kim, J. (2018). Analysis of the Treadmill Utilization for the Development of a Virtual Reality Walking Interface. International Journal of Control and Automation, 11(2), 161–174. https://doi.org/10.14257/ijca.2018.11.2.14

Perera, S., Mody, S. H., Woodman, R. C., & Studenski, S. A. (2006). Meaningful Change and Responsiveness in Common Physical Performance Measures in Older Adults. Journal of the American Geriatrics Society, 54(5), 743–749. https://doi.org/10.1111/j.1532-5415.2006.00701.x

Polese, J. C., Ada, L., Dean, C. M., Nascimento, L. R., & Teixeira-Salmela, L. F. (2013). Treadmill training is effective for ambulatory adults with stroke: A systematic review. Journal of Physiotherapy, 59(2), 73–80. https://doi.org/10.1016/S1836-9553(13)70159-0

Rosengren, K. S., McAuley, E., & Mihalko, S. L. (1998). Gait adjustments in older adults: Activity and efficacy influences. Psychology and Aging, 13(3), 375–386. https://doi.org/10.1037/0882-7974.13.3.375

Schröder, J., Truijen, S., Criekinge, T., & Saeys, W. (2019). Feasibility and effectiveness of repetitive gait training early after stroke: A systematic review and meta-analysis. Journal of Rehabilitation Medicine, 51(2), 78–88. https://doi.org/10.2340/16501977-2505

Steffen, T. M., Hacker, T. A., & Mollinger, L. (2002). Age- and Gender-Related Test Performance in Community-Dwelling Elderly People: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and Gait Speeds. Physical Therapy, 82(2), 128–137. https://doi.org/10.1093/ptj/82.2.128

Tabachnick, B. G., Fidell, L. S., & Ullman, J. B. (2019). Using multivariate statistics (7th edition). Pearson.

Tanaka, H., Monahan, K. D., & Seals, D. R. (2001). Age-predicted maximal heart rate revisited. Journal of the American College of Cardiology, 37(1), 153–156. https://doi.org/10.1016/S0735-1097(00)01054-8

Thayabaranathan, T., Kim, J., Cadilhac, D. A., Thrift, A. G., Donnan, G. A., Howard, G., Howard, V. J., Rothwell, P. M., Feigin, V., Norrving, B., Owolabi, M., Pandian, J., Liu, L., & Olaiya, M. T. (2022). Global stroke statistics 2022. International Journal of Stroke, 17(9), 946–956. https://doi.org/10.1177/17474930221123175

Thrift, A. G., Howard, G., Cadilhac, D. A., Howard, V. J., Rothwell, P. M., Thayabaranathan, T., Feigin, V. L., Norrving, B., & Donnan, G. A. (2017). Global stroke statistics: An update of mortality data from countries using a broad code of “cerebrovascular diseases.” International Journal of Stroke, 12(8), 796–801. https://doi.org/10.1177/1747493017730782

Tilson, J. K., Sullivan, K. J., Cen, S. Y., Rose, D. K., Koradia, C. H., Azen, S. P., Duncan, P. W., & for the Locomotor Experience Applied Post Stroke (LEAPS) Investigative Team. (2010). Meaningful Gait Speed Improvement During the First 60 Days Poststroke: Minimal Clinically Important Difference. Physical Therapy, 90(2), 196–208. https://doi.org/10.2522/ptj.20090079

Published

2024-05-30

How to Cite

R., P., Subramanian, S. sundaram, Ramanathan, K., & Alhalaiqa, F. (2024). Assessing the Impact of Real-Time Visual Feedback during Treadmill Training on Walking Improvement in Stroke Patients. International Journal of Experimental Research and Review, 39(Spl Volume), 180–189. https://doi.org/10.52756/ijerr.2024.v39spl.014

Most read articles by the same author(s)

<< < 1 2