Dataset Information

The Immediate Effects of Different Types of Augmented Feedback on Fast Walking Speed Performance and Intrinsic Motivation After Stroke.

ABSTRACT:

Objective

To examine the immediate effects of different types of augmented feedback on walking speed and intrinsic motivation post-stroke.

Design

A within-subjects repeated-measures design.

Setting

A university rehabilitation center.

Participants

Eighteen individuals with chronic stroke hemiparesis with a mean age of 55.67±13.63 years and median stroke onset of 36 (24, 81) months (N=18).

Interventions

Not applicable.

Primary outcome

Fast walking speed measured on a robotic treadmill for 13 meters without feedback and 13 meters with augmented feedback on each of the 3 experimental conditions: (1) without virtual reality (VR), (2) with a simple VR interface, and (3) with VR-exergame. Intrinsic motivation was measured using the Intrinsic Motivation Inventory (IMI).

Results

Although the differences were not statistically significant, fast-walking speed was higher in the augmented feedback without VR (0.86±0.44 m/s); simple VR interface (0.87±0.41 m/s); VR-exergame (0.87±0.44 m/s) conditions than in the fast-walking speed without feedback (0.81±0.40 m/s) condition. The type of feedback had a significant effect on intrinsic motivation (P=.04). The post hoc analysis revealed borderline significance on IMI-interest and enjoyment between the VR-exergame condition and the without-VR condition (P=.091).

Conclusion

Augmenting feedback affected the intrinsic motivation and enjoyment of adults with stroke asked to walk fast on a robotic treadmill. Additional studies with larger samples are warranted to examine the relations among these aspects of motivation and ambulation training outcomes.

SUBMITTER: Alhirsan SM

PROVIDER: S-EPMC10258376 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The Immediate Effects of Different Types of Augmented Feedback on Fast Walking Speed Performance and Intrinsic Motivation After Stroke.

Alhirsan Saleh M SM Capó-Lugo Carmen E CE Hurt Christopher P CP Uswatte Gitendra G Qu Haiyan H Brown David A DA

Archives of rehabilitation research and clinical translation 20230414 2

<h4>Objective</h4>To examine the immediate effects of different types of augmented feedback on walking speed and intrinsic motivation post-stroke.<h4>Design</h4>A within-subjects repeated-measures design.<h4>Setting</h4>A university rehabilitation center.<h4>Participants</h4>Eighteen individuals with chronic stroke hemiparesis with a mean age of 55.67±13.63 years and median stroke onset of 36 (24, 81) months (N=18).<h4>Interventions</h4>Not applicable.<h4>Primary outcome</h4>Fast walking speed m ...[more]

PMID: 37312981

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Project description:BackgroundThe rehabilitation of gait disorders in patients with multiple sclerosis (MS) and stroke is often based on conventional treadmill training. Virtual reality (VR)-based treadmill training can increase motivation and improve therapy outcomes. The present study evaluated an immersive virtual reality application (using a head-mounted display, HMD) for gait rehabilitation with patients to (1) demonstrate its feasibility and acceptance and to (2) compare its short-term effects to a semi-immersive presentation (using a monitor) and a conventional treadmill training without VR to assess the usability of both systems and estimate the effects on walking speed and motivation.MethodsIn a within-subjects study design, 36 healthy participants and 14 persons with MS or stroke participated in each of the three experimental conditions (VR via HMD, VR via monitor, treadmill training without VR).ResultsFor both groups, the walking speed in the HMD condition was higher than in treadmill training without VR and in the monitor condition. Healthy participants reported a higher motivation after the HMD condition as compared with the other conditions. Importantly, no side effects in the sense of simulator sickness occurred and usability ratings were high. No increases in heart rate were observed following the VR conditions. Presence ratings were higher for the HMD condition compared with the monitor condition for both user groups. Most of the healthy study participants (89%) and patients (71%) preferred the HMD-based training among the three conditions and most patients could imagine using it more frequently.ConclusionsFor the first time, the present study evaluated the usability of an immersive VR system for gait rehabilitation in a direct comparison with a semi-immersive system and a conventional training without VR with healthy participants and patients. The study demonstrated the feasibility of combining a treadmill training with immersive VR. Due to its high usability and low side effects, it might be particularly suited for patients to improve training motivation and training outcome e. g. the walking speed compared with treadmill training using no or only semi-immersive VR. Immersive VR systems still require specific technical setup procedures. This should be taken into account for specific clinical use-cases during a cost-benefit assessment.

Project description:BackgroundIncreasing one's walking speed is an important goal in post-stroke gait rehabilitation. Insufficient arm swing in people post-stroke might limit their ability to propel the body forward and increase walking speed.PurposeTo investigate the speed-dependent changes (and their contributing factors) in the arm swing of persons post-stroke.Material and methodsTwenty-five persons post-stroke (53±12.1 years; 40.72±43.0 months post-stroke) walked on a treadmill at comfortable (0.83m/s) and fast (1.01m/s) speed. Shoulder and elbow kinematics were compared between conditions using Statistical Parametric Mapping (SPM) analysis, and discrete parameters using a Wilcoxon signed-rank test or an independent sample t-test. The relations between speed-dependent changes in shoulder and elbow range of motion and clinical and gait parameters were assessed using Spearman correlation coefficients.ResultsThe non-paretic arm showed expected speed-dependent kinematic adaptations with increases in active range of motion for shoulder flexion (p<0.001), extension (p<0.05), abduction (p = 0.001), rotation (p = 0.004) and elbow flexion (p<0.001). The paretic arm only showed an increase in shoulder abduction and elbow flexion (both p<0.001). Persons post-stroke with a more impaired arm swing coordination pattern only showed speed-dependent adaptations for elbow flexion (p<0.001) at the paretic side during fast walking. In contrast, persons post-stroke with a normal arm swing coordination pattern presented with increases in active range of motion of the shoulder abduction and elbow flexion (both p<0.001) at the paretic side when walking fast. More upper limb impairment (r = -0.521, p<0.01) and a wider step width (r = 0.534, p<0.01) were related to a larger increase in mean elbow flexion during faster walking.ConclusionsPersons post-stroke show different changes in arm swing kinematics at the paretic compared to the non-paretic side when increasing walking speed. The changes are related to the impairment level and stability during walking, indicating that therapeutic interventions aiming to increase walking speed by improving arm swing might need to target these factors.

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Dataset Information

The Immediate Effects of Different Types of Augmented Feedback on Fast Walking Speed Performance and Intrinsic Motivation After Stroke.

Objective

Design

Setting

Participants

Interventions

Primary outcome

Results

Conclusion

Publications

The Immediate Effects of Different Types of Augmented Feedback on Fast Walking Speed Performance and Intrinsic Motivation After Stroke.

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