Highlights
- •An application for biofeedback gait training was developed for an integrated treadmill.
- •With 8 passive markers, simple gait biomechanics can be calculated in real-time.
- •Gait can be visualised and challenged using an avatar in virtual reality.
- •The application is clinically usable and may benefit patient populations undergoing gait training.
Abstract
Background
Virtual reality presents a platform for therapeutic gaming, and incorporation of immersive
biofeedback on gait may enhance outcomes in rehabilitation. Time is limited in therapeutic
practice, therefore any potential gait training tool requires a short set up time,
while maintaining clinical relevance and accuracy. The aim of this study was to develop,
validate, and establish the usability of an avatar-based application for biofeedback-enhanced
gait training with minimal set up time.
Methods
A simplified, eight marker model was developed using eight passive markers placed
on anatomical landmarks. This allowed for visualisation of avatar-based biofeedback
on pelvis kinematics, hip and knee sagittal angles in real-time. Retrospective gait
analysis data from typically developing children (n = 41) and children with cerebral
palsy (n = 25), were used to validate eight marker model. Gait outcomes were compared
to the Human Body Model using statistical parametric mapping. Usability for use in
clinical practice was tested in five clinical rehabilitation centers with the system
usability score.
Findings
Gait outcomes of Human Body Model and eight marker model were comparable, with small
differences in gait parameters. The discrepancies between models were <5°, except
for knee extension where eight marker model showed significantly less knee extension,
especially towards full extension. The application was considered of ‘high marginal
acceptability’ (system usability score, mean 68 (SD 13)).
Interpretation
Gait biofeedback can be achieved, to acceptable accuracy for within-session gait training,
using an eight marker model. The application may be considered usable and implemented
for use in patient populations undergoing gait training.
Keywords
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Article info
Publication history
Published online: August 24, 2019
Accepted:
August 21,
2019
Received:
January 11,
2019
Identification
Copyright
© 2019 Elsevier Ltd. All rights reserved.
