Using Telerehabilitation to Improve Walking in Individuals following Stroke

David L. Jaffe, MS

Abstract: The goal of this project is to apply and evaluate a system for individuals following stroke that improves their gait including balance, step length, stride length, gait asymmetry, walking speed, ability to step over objects, and walking endurance.

Computer-generated objects are presented in a head-mounted display, superimposed on a real-time lateral view of the subject walking on a treadmill. Subjects are instructed to step over the stationary virtual obstacle they see in their display. "Collisions" between the users' feet and the computer-generated obstacle are detected using an image capture card. When a collision is detected, a short audio clip is played and a vibro-tactile stimulus is applied to the "colliding foot". This training and the visual, audio, and tactile feedback promotes improved gait. The method is also safer and more compact than conventional training techniques and provides more rapid and precise feedback to both the patient and the clinician.

This first phase of this project has demonstrated that the simulated environment with computer-generated objects is effective in improving walking. The addition of a tele-video link would permit a remote therapist to view what the subject sees in their display and provide real-time suggestions on how to improve their obstacle performance.