Effect of simple kinetic feedback training on stance symmetry in individuals with acute hemiparetic stroke - An Experimental study.

OBJECTIVE : To find out the effect of simple kinetic feedback training on stance symmetry in individuals with acute hemiparetic stroke. STUDY DESIGN : Two groups pre and post test experimental study design. SUBJECTS: Fifteen hemiparetic individuals of acute middle cerebral artery stroke and age group between 45 to 65, who are medically stable including both the genders. Functional balance grade for standing- fair. INTERVENTION : 8 patients in the experimental group received simple kinetic feedback training and 7 patients in the control group received lateral weight shifting exercises and both the groups received conventional therapy. OUTCOME MEASURE : Weight bearing symmetry scores. RESULTS : Statistical analysis was done by using‘t’ test showed no significant improvement in weight bearing symmetry scores between experimental group and control group. CONCLUSION : It is concluded that there is no statistically significant improvement on stance symmetry even though there was a clinical improvement by simple kinetic feedback training in individuals with acute hemiparetic stroke. Larger sample size and longer treatment duration has to be carried out by using simple kinetic feedback training

An Investigation of Kinetic Visual Biofeedback on Dynamic Stance Symmetry

The intent of the following research is to utilize task-specific, constraint-induced therapies and apply towards dynamic training for symmetrical balance. Modifications to an elliptical trainer were made to both measure weight distributions during dynamic stance as well as provide kinetic biofeedback through a man-machine interface. Following a review of the background, which includes research from several decades that are seminal to current studies, a design review is discussed to cover the design of the modified elliptical (Chapter 2). An initial study was conducted in a healthy sample population in order to determine the best visual biofeedback representation by comparing different man-machine interfaces (Chapter 3). Index of gait symmetry measures indicated that one display interface optimized participant performance during activity with the modified elliptical trainer. A second study was designed to determine the effects of manipulating the gain of the signal to encourage increased distribution towards the non-dominant weight bearing limb. The purpose of the second study was to better understand the threshold value of gain manipulation in a healthy sample set. Results analyzing percentage error as a measure of performance show that a range between 5-10% allows for a suitable threshold value to be applied for participants who have suffered a stroke. A final study was conducted to apply results/knowledge from the previous two studies to a stroke cohort to determine short-term carryover following training with the modified elliptical trainer. Data taken from force measurements on the elliptical trainer suggest that there was carryover with decreased error from pre to post training. For one participant GaitRite® data show a significant difference from pre to post measurements in single limb support. The results of the research suggest that visual biofeedback can improve symmetrical performance during dynamic patterns. For a better understanding of visual biofeedback delivery, one display representation proved to be beneficial compared to the others which resulted in improved performance. Results show that healthy human participants can minimize error with visual biofeedback and continue minimizing error until a threshold value of 10%. Finally, results have shown promise towards applying such a system for kinetic gait rehabilitation