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Improving Stepping-Over
Responses in the Elderly using Simulated Objects
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Principal Investigators: David L. Jaffe, MS and
David A. Brown, PhD, PT (Northwestern University)
Project Staff: Cheryl D. Pierson-Carey, MS, PT;
Ellie L. Buckley, MS PT; Ruth Yap, MS; and Kyle A. Smith, MPT, ATC
Project Category: Stroke - 2001
Objective: The long term goal of this work was to
apply and evaluate a system for individuals with stroke that trains, monitors,
and improves their walking characteristics including stride length, walking
speed, balance, ability to step over objects, and endurance. The proposed
method was expected to be safer and physically more compact than conventional
training techniques and to provide more rapid and precise feedback to both the
patient and the clinician.
Research Plan: This project compared two training
interventions: stepping over real foam objects (Overground) and stepping over
computer-generated objects (Treadmill). The latter protocol consists of a
computer simulated environment: computer generated objects are presented in a
head-mounted display, superimposed on a real-time side view of the subject
walking on a treadmill. "Collisions" between the users' feet and the
computer-generated obstacles are detected using a commercial computer imaging
system with vibro-tactile feedback given to the "colliding foot". The
combination of visual, audio, tactile feedback, and advice from a physical
therapist promoted more effective walking strategies with stroke patients. Gait
parameters were monitored before training, after training, and two-weeks
post-training.
Work Accomplished: Twenty-one subjects with stroke
were enrolled in the two-week training program. Subject data has been analyzed
to identify gait improvements with the two training techniques.
Expected Outcome: The results demonstrated
improvements for subjects in both training groups in walking speed, cadence,
stride length, and ability to step over stationary objects. Treadmill
intervention data from subjects with stroke in the study show significantly
increased walking speed and stride length measures for both normal and fast
walking evaluation tests. Eighty to 95% of these improvements were retained two
weeks after the end of the training.
This project demonstrated that training individuals with
stroke to step over objects improves their gait parameters which, in turn, led
to increased walking speed and confidence.
A Report of Invention has been submitted to the VA and
the Stanford Office of Technology Licensing for this project. This will start
the process of patenting the Treadmill training technique and possible
commercialization. Collaborations with other researchers are being
pursued.
Funding Source: VA RR&D Merit Review
Funding Status: Completed
Reprinted from the 2001 Annual Report
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