Wearable Biofeedback Improves Human-Robot Compliance during Ankle-Foot Exoskeleton-Assisted Gait Training: A Pre-Post Controlled Study in Healthy Participants
The adjunctive use of biofeedback systems with exoskeletons may accelerate post-stroke gait rehabilitation. Wearable patient-oriented human-robot interaction-based biofeedback is proposed to improve patient-exoskeleton compliance regarding the interaction torque’s direction (joint motion strategy) a...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-10-01
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| Series: | Sensors |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1424-8220/20/20/5876 |
| _version_ | 1827704080234971136 |
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| author | Cristiana Pinheiro Joana Figueiredo Nuno Magalhães Cristina P. Santos |
| author_facet | Cristiana Pinheiro Joana Figueiredo Nuno Magalhães Cristina P. Santos |
| author_sort | Cristiana Pinheiro |
| collection | DOAJ |
| description | The adjunctive use of biofeedback systems with exoskeletons may accelerate post-stroke gait rehabilitation. Wearable patient-oriented human-robot interaction-based biofeedback is proposed to improve patient-exoskeleton compliance regarding the interaction torque’s direction (joint motion strategy) and magnitude (user participation strategy) through auditory and vibrotactile cues during assisted gait training, respectively. Parallel physiotherapist-oriented strategies are also proposed such that physiotherapists can follow in real-time a patient’s motor performance towards effective involvement during training. A preliminary pre-post controlled study was conducted with eight healthy participants to conclude about the biofeedback’s efficacy during gait training driven by an ankle-foot exoskeleton and guided by a technical person. For the study group, performance related to the interaction torque’s direction increased during (<i>p</i>-value = 0.07) and after (<i>p</i>-value = 0.07) joint motion training. Further, the performance regarding the interaction torque’s magnitude significantly increased during (<i>p</i>-value = 0.03) and after (<i>p</i>-value = 68.59 × 10<sup>−3</sup>) user participation training. The experimental group and a technical person reported promising usability of the biofeedback and highlighted the importance of the timely cues from physiotherapist-oriented strategies. Less significant improvements in patient–exoskeleton compliance were observed in the control group. The overall findings suggest that the proposed biofeedback was able to improve the participant-exoskeleton compliance by enhancing human-robot interaction; thus, it may be a powerful tool to accelerate post-stroke ankle-foot deformity recovery. |
| first_indexed | 2024-03-10T15:32:42Z |
| format | Article |
| id | doaj.art-a306db58266f44d9ae0510bc2d649d2f |
| institution | Directory Open Access Journal |
| issn | 1424-8220 |
| language | English |
| last_indexed | 2024-03-10T15:32:42Z |
| publishDate | 2020-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Sensors |
| spelling | doaj.art-a306db58266f44d9ae0510bc2d649d2f2023-11-20T17:29:38ZengMDPI AGSensors1424-82202020-10-012020587610.3390/s20205876Wearable Biofeedback Improves Human-Robot Compliance during Ankle-Foot Exoskeleton-Assisted Gait Training: A Pre-Post Controlled Study in Healthy ParticipantsCristiana Pinheiro0Joana Figueiredo1Nuno Magalhães2Cristina P. Santos3Center for MicroElectroMechanical Systems (CMEMS), Department of Industrial Electronics, School of Engineering, University of Minho, 4800-058 Guimarães, PortugalCenter for MicroElectroMechanical Systems (CMEMS), Department of Industrial Electronics, School of Engineering, University of Minho, 4800-058 Guimarães, PortugalCenter for MicroElectroMechanical Systems (CMEMS), Department of Industrial Electronics, School of Engineering, University of Minho, 4800-058 Guimarães, PortugalCenter for MicroElectroMechanical Systems (CMEMS), Department of Industrial Electronics, School of Engineering, University of Minho, 4800-058 Guimarães, PortugalThe adjunctive use of biofeedback systems with exoskeletons may accelerate post-stroke gait rehabilitation. Wearable patient-oriented human-robot interaction-based biofeedback is proposed to improve patient-exoskeleton compliance regarding the interaction torque’s direction (joint motion strategy) and magnitude (user participation strategy) through auditory and vibrotactile cues during assisted gait training, respectively. Parallel physiotherapist-oriented strategies are also proposed such that physiotherapists can follow in real-time a patient’s motor performance towards effective involvement during training. A preliminary pre-post controlled study was conducted with eight healthy participants to conclude about the biofeedback’s efficacy during gait training driven by an ankle-foot exoskeleton and guided by a technical person. For the study group, performance related to the interaction torque’s direction increased during (<i>p</i>-value = 0.07) and after (<i>p</i>-value = 0.07) joint motion training. Further, the performance regarding the interaction torque’s magnitude significantly increased during (<i>p</i>-value = 0.03) and after (<i>p</i>-value = 68.59 × 10<sup>−3</sup>) user participation training. The experimental group and a technical person reported promising usability of the biofeedback and highlighted the importance of the timely cues from physiotherapist-oriented strategies. Less significant improvements in patient–exoskeleton compliance were observed in the control group. The overall findings suggest that the proposed biofeedback was able to improve the participant-exoskeleton compliance by enhancing human-robot interaction; thus, it may be a powerful tool to accelerate post-stroke ankle-foot deformity recovery.https://www.mdpi.com/1424-8220/20/20/5876ankle-foot exoskeletonbiofeedback control strategiesgait traininghuman-robot interactionuser-centered designwearable biofeedback |
| spellingShingle | Cristiana Pinheiro Joana Figueiredo Nuno Magalhães Cristina P. Santos Wearable Biofeedback Improves Human-Robot Compliance during Ankle-Foot Exoskeleton-Assisted Gait Training: A Pre-Post Controlled Study in Healthy Participants Sensors ankle-foot exoskeleton biofeedback control strategies gait training human-robot interaction user-centered design wearable biofeedback |
| title | Wearable Biofeedback Improves Human-Robot Compliance during Ankle-Foot Exoskeleton-Assisted Gait Training: A Pre-Post Controlled Study in Healthy Participants |
| title_full | Wearable Biofeedback Improves Human-Robot Compliance during Ankle-Foot Exoskeleton-Assisted Gait Training: A Pre-Post Controlled Study in Healthy Participants |
| title_fullStr | Wearable Biofeedback Improves Human-Robot Compliance during Ankle-Foot Exoskeleton-Assisted Gait Training: A Pre-Post Controlled Study in Healthy Participants |
| title_full_unstemmed | Wearable Biofeedback Improves Human-Robot Compliance during Ankle-Foot Exoskeleton-Assisted Gait Training: A Pre-Post Controlled Study in Healthy Participants |
| title_short | Wearable Biofeedback Improves Human-Robot Compliance during Ankle-Foot Exoskeleton-Assisted Gait Training: A Pre-Post Controlled Study in Healthy Participants |
| title_sort | wearable biofeedback improves human robot compliance during ankle foot exoskeleton assisted gait training a pre post controlled study in healthy participants |
| topic | ankle-foot exoskeleton biofeedback control strategies gait training human-robot interaction user-centered design wearable biofeedback |
| url | https://www.mdpi.com/1424-8220/20/20/5876 |
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