Highlights
- •Real-time avatar feedback improves post-stroke gait symmetry and coordination
- •Improvements in gait symmetry correlate with improvements in interlimb coordination
- •Observed improvements appear largely driven by adaptations on the non-paretic side
Abstract
Background
Gait asymmetry, which is common after stroke, is typically characterized using spatiotemporal
parameters of gait that do not consider the aspect of movement coordination. In this
manuscript, we examined whether an avatar-based feedback provided as a single-session
intervention to improve gait symmetry also improved inter-limb coordination among
people with stroke and we examined the relationship between changes in coordination
and step length symmetry.
Methods
Twelve stroke participants walked on a self-paced treadmill with and without a self-avatar
that replicated their locomotor movements in real time. Continuous relative phase
and angular coefficient of correspondence calculated using bilateral sagittal hip
movements were used to quantify temporal and spatial interlimb coordination, respectively.
Spatial gait symmetry, previously shown to improve with the avatar feedback, was quantified
using step length ratio between both limbs, with the largest value as numerator.
Findings
Participants who improved their spatial symmetry during avatar exposure also improved
their temporal coordination, while spatial coordination remained unchanged. Overall,
improvements in spatial symmetry correlated positively with improvements in temporal
coordination. The non-paretic hip and paretic ankle angle excursion in the sagittal
plane also significantly increased during avatar exposure.
Interpretation
Improvements in gait symmetry may be explained by changes in interlimb coordination.
Current data and existing literature further suggest that such improvements are largely
driven by adaptations in non-paretic leg movements, notably at the hip. By providing
real-time information on walking movements not affordable in other ways, avatar-based
feedback shows great potential to improve gait symmetry and interlimb coordination
post-stroke.
Keywords
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Article info
Publication history
Published online: November 13, 2022
Accepted:
November 9,
2022
Received:
July 14,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.