Background: Compared to age-matched controls the risk of falling is significantly higher in people with chronic stroke. It is, therefore, important to improve mobility in stroke survivors and decrease their risk of falling. Trips are a leading cause of falls. Tripping risk is greater when Minimum Foot Clearance (MFC) is reduced, and MFC variability increased.
Aim: To determine the effects of biofeedback-augmented gait training on the MFC clearance in stroke survivors using an RCT design.
Methods: We recruited 46 stroke survivors; 42 were randomised either to a group that received biofeedback (n = 21) or no biofeedback (n = 21). Both groups completed 10 treadmill-walking sessions. Participants in the biofeedback group received real-time feedback on MFC. An infrared marker attached to the front of the shoe was tracked in real-time, with swing foot vertical displacement displayed continuously on a computer monitor. A target increased-MFC range was determined, and participants instructed to maintain MFC within that range. Affected limb’s MFC was recorded at baseline and after completing the training sessions (post-training) via 3D motion capture during 5-10 minutes of treadmill walking at self-selected speed. Change in MFC between baseline and post training was calculated as a percentage and compared between groups.
Results: Post -training data was available for 40 participants (biofeedback n = 19, no biofeedback n = 21). A significantly greater percentage change was detected in the biofeedback group (32.1% +/- 45.6) compared to the control group (6.2% +/-30.2); p = .045.
Conclusion: Treadmill gait training with real-time visual feedback of foot trajectory is effective in increasing MFC height. Real-time augmented biofeedback training can help in gait rehabilitation post- stroke and may reduce trip and falls risk.