Trainer in a pocket - proof-of-concept of mobile, real-time, foot kinematics feedback for gait pattern normalization in individuals after stroke, incomplete spinal cord injury and elderly patients.
Daniel Schließmann, Maria Nisser, Christian Schuld and 6 others
PMID 29843763WHAT IT FOUND
Shoe sensors gave verbal gait feedback to adults after stroke, incomplete spinal cord injury, or older age.
The trained foot angle or timing moved toward normal during the training visits, but walking speed and Timed Up and Go did not improve.
Key findings
01Pooled across the three participant groups, the average level for the trained gait parameter fell significantly over the training visits.
02There were no significant changes in walking speed or Timed Up and Go time over the study or at follow-up.
03In the foot-to-ground angle subgroup, iSCI and elderly participants moved toward the normal angle on the trained side, while the stroke subgroup showed no significant change.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
There was no control group, and participants continued their usual therapy, so the feedback system alone cannot be credited for any change. The study analysed 41 participants after dropouts, and follow-up was not possible in the elderly group, so the result is a small feasibility signal rather than a reliable effect estimate. Inclusion was broad and selected patients who could already walk, so it may not apply to people with more severe gait impairment. Many outcomes were tested with limited statistical correction, increasing the chance that some findings are unstable. The main outcome was a system-defined level, not a patient-important function measure. Walking speed and Timed Up and Go did not improve. The authors note that rapid changes could involve trick movements or attention effects, and that larger studies are needed.
Declared interests
The supplied text names Bundesministerium für Wirtschaft und Energie as the funder and does not report author conflicts of interest.
The easy way to misread this
Do not conclude that this system improves walking ability. The trained gait parameter moved closer to normal, but walking speed and Timed Up and Go did not change, and there was no control group.