Effects of gait adaptation training on augmented reality treadmill for patients with stroke in community ambulation

• Published in: International journal for quality in health care Vol. 36; no. 1
• Main Authors: Yang, Hang, Gao, Zhenzhen, Zhou, Ye, Liao, Zhenyi, Song, Caiping, Mao, Yajun
• Format: Journal Article
• Language: English
• Published: UK Oxford University Press 20-02-2024
• Subjects: AR technology; gait adaptation training; stroke; community ambulation; Community ambulation; Gait adaptation training; Stroke
• ISSN: 1353-4505; 1464-3677
• DOI: 10.1093/intqhc/mzae008

Abstract
Gait adaptability is essential for stroke survivors to achieve efficient and safe community ambulation. However, conventional treadmill rehabilitation is only a repetitive practice of leg movement. This study compared the effects of augmented reality treadmill-based gait adaptation training with regular treadmill programs for patients with stroke. Forty patients with stroke (n = 40) were randomly assigned to the gait adaptation training {n = 20, age: 49.85 [standard deviation (SD) 8.44] years; onset of stroke: 107.80 (SD 48.31) days} and regular training [n = 20, age: 50.75 (SD 8.05) years, onset of stroke: 111.60 (SD 49.62) days] groups. Both groups completed three sessions of training per week for 5 weeks (15 sessions). The primary outcomes were the 10-m walk test and success rate of obstacle avoidance, while secondary outcomes included the Berg balance scale, component timed-up-and-go, and fall rate in a 6-month follow-up period. Assessments were performed before and after the intervention. The paired t-test was applied to compare the differences within groups and independent sample t-test was performed to compare the differences between groups. The 10-m walk test, success rate of obstacle avoidance, Berg balance scale, and component timed-up-and-go all significantly improved in the both groups (P < .001). The success rate of obstacle avoidance [P = .02, 95% confidence interval (CI): −21.07, −1.64], Berg Balance Scale (P = .02, 95% CI: −8.03, −0.67), ‘turning around time’ (P = .04, 95% CI: 0.08, 2.81), ‘stand-to-sit’ (P = .03, 95% CI: 0.16, 2.41) and ‘total time’ (P = .048, 95% CI: 0.04, 10.32) improved significantly in gait adaptation training group after intervention, while the 10-m walk test (P = .09, 95% CI: −0.17, 0.01), timed ‘sit-to-stand’ (P = .09, 95% CI: −0.14, 2.04), and ‘linear walking’ (P = .09, 95% CI: −0.27, 3.25) in gait adaptation training group did not show statistical difference compared to the regular training group. Total fall rate during the follow-up period was statistically decreased in the gait adaptation training group (P = .045). Both interventions improved mobility outcomes, with augmented reality treadmill-based gait adaptation indicating greater improvement in obstacle avoidance, balance, turning, and stand-to-sit. Augmented reality treadmill-based gait adaptation training emerges as an effective and promising intervention for patients with stroke in early rehabilitation.