Effect Of Wearable Intelligent Plantar Pressure Visual Feedback Technique In Gait And Balance Training For Post-stroke Patients:A Randomized Controlled Trial

1.Research backgroundThere are about 2.5 million new stroke cases and 7.5 million stroke survivors each year in China.They will be accompanied by long-term dysfunctions.Gait and balance dysfunction is one of the most important dysfunction that affects the independence of daily life in patients with stroke.So,gait and balance dysfunction rehabilitation is considered an important part of post-stroke rehabilitation.The current researches show that the early intensive training,task-oriented rehabilitation and multi-sensory stimulation are conducive to brain plasticity which play the most important role in improving gait and balance dysfunction after stroke.But the treatments lack of accuracy and individuation.Methods for monitoring and recording gait and balance function of patients through plantar pressure have been used in the laboratory for more than 20 years,and the correlation between plantar pressure and gait and balance control in stroke patients has also been validated.In recent years,the successful development of the low-power flexible plantar pressure sensor embedded in the insole and the rapid development of wireless communication technology,make the data monitoring of plantar pressure no longer being limited by place and active of training.Thus,it is possible to form the clinically available wearable intelligent plantar visual feedback system to enables more real-time,accurate and standardized analysis of the patient’s gait and balance function.2.ObjectTo observe the effect of wearable intelligent plantar pressure visual feedback technique in the training on gait and balance for post-stroke patients.To discuss the application method and value of this technique in clinical balance training as well.3.Subjects and methods3.1 SubjectsThirty patients with post-stroke hemiplegia were recruited from May 2017 to May 2017 in Department of Rehabilitation Medicine,Zhujiang Hospital of Southern Medical University,including 20 males and 10 females;left hemiplegia in 13 cases and right hemiplegia in 17 cases,Mean age 42.6±12.88 years,were randomly assigned to experimental group and control group,15 cases each.3.2 Training methodsTwo groups of patients both treated with conventional medicine and rehabilitation treatments according to their needs,including physical therapy,occupational therapy and speech therapy.Patients in control group were given conventional treatment + conventional balance and gait training and experimental group patients participated in conventional treatment + the gait and balance training with wearable intelligent plantar pressure visual feedback technique.Both groups train for 30min once daily,5 days per week for 4 weeks.3.3 Assessment methodsThe patients were divided into experimental group and control group by random word table method,15 cases in each group.There was no significant difference between the two groups in the general situation and disease course data(P>0.05),which was comparable.The gait and balance function of the two groups were evaluated before and after 4 weeks of training by the same therapist as follows.gait parameters are assessed by wearable three-dimensional gait motion capture system and wearable intelligent plantar pressure visual feedback technique to evaluate the walk function of two groups.Berg Balance Scale(BBS),Timed Up and Go test(TUG),and the static balances recorded by wearable intelligent plantar pressure visual feedback technique to evaluate the two groups of balance function.3.4 Statistical analysisThe data was analyzed by IBM SPSS Statistics 24.0 statistical software and the data was expressed as mean ± standard deviation(x ± s).Quantitative data were compared using the paired sample t test,and qualitative data were tested using x2 test.Paired t-test was used to compare the data between the two groups of patients before and after the training for gait and balance.Independent sample t-test was used to compare the difference between the results of evaluation after training and before the training of the two groups.P<0.05 was used as a criterion for significant differences,and a two-sided test was used.4.ResultsAll patients in the experimental group were trained using wearable intelligent plantar pressure visual feedback technique during the expernment,and they could learn the method of gait and balance training with the plantar pressure image given by visual feedback at the first training,without discomfort and adverse reactions.4.1 The gait and balance outcome measures of two groups of patients before and after training:There are no significant differences in gait parameters and balance outcomes between the two groups before training(P>0.05).Compared with 4 weeks after training,the control group had significant differences(P<0.05)except for the time of unilateral and ipsilateral single support and the asymmetry of single support(P<0.05).In addition to step asymmetry rate and single support time asymmetry,the differences of other outcomes are significant(P<0.05).4.2 The outcome before and after training measures between the two groups patients:After 4 weeks of training,all the outcome measures difference between the experimental group and the control group are significantly different and bigger(P<0.05).5 ConclusionIn this study,we use wearable intelligent plantar pressure visual feedback technique in post-stroke patient gait and balance training.It proves that this method can effectively improve the gait and balance function of the stroke patients with hemiplegia,enhance the control of gravity,correct the asymmetry of the gait and improve the walking ability of the patients.Furthermore,it is more effectively than the traditional gait and balance training methods.