Training to walk amid uncertainty with Re-Step: Measurements and changes with perturbation training for hemiparesis and cerebral palsy

Simona Bar-Haim, Netta Harries, Yeshayahu Hutzler, Mark Belokopytov, Igor Dobrov

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Purpose: To describe Re-StepTM, a novel mechatronic shoe system that measures center of pressure (COP) gait parameters and complexity of COP dispersion while walking, and to demonstrate these measurements in healthy controls and individuals with hemiparesis and cerebral palsy (CP) before and after perturbation training. Method: The Re-StepTM was used to induce programmed chaotic perturbations to the feet while walking for 30 min for 36 sessions over 12-weeks of training in two subjects with hemiparesis and two with CP. Results: Baseline measurements of complexity indices (fractal dimension and approximate entropy) tended to be higher in controls than in those with disabilities, while COP variability, mean and variability of step time and COP dispersion were lower. After training the disabled subjects these measurement values tended toward those of the controls, along with a decrease in step time, 10m walk time, average step time, percentage of double support and increased Berg balance score. Conclusions: This pilot trial reveals the feasibility and applicability of this unique measurement and perturbation system for evaluating functional disabilities and changes with interventions to improve walking.

Original languageEnglish
Pages (from-to)417-425
Number of pages9
JournalDisability and Rehabilitation: Assistive Technology
Volume8
Issue number5
DOIs
StatePublished - 1 Sep 2013
Externally publishedYes

Keywords

  • Center of pressure
  • Cerebral palsy
  • Chaotic perturbation
  • Gait training
  • Ground reaction force
  • Hemiparesis
  • Walking complexity

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