Design and Validation of Biofeedback

Increasing Active Range of Motion of the Ankle

Master thesis (2023)

Authors

L.J. Zielstra Mechanical Engineering

Contributors

W. Mugge Biomechatronics & Human-Machine Control - Mechanical, Maritime and Materials Engineering (supervisor 1)
E.R.M. Grootendorst Biomechatronics & Human-Machine Control - Mechanical, Maritime and Materials Engineering (coach)
J.H. de Groot Biomechanical Engineering (supervisor 2)
M. Stijntjes Support Biomechanical Engineering (supervisor 2)
Faculty
Mechanical Engineering
Copyright: © 2023 Lennart Zielstra
Stroke Biofeedback Gait training Spastic paresis Active ankle range of motion
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Published Date

17-02-2023

Language

English

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Faculty

Mechanical Engineering

Abstract

Stroke patients can have spastic paresis of the lower leg, impeding an ankle which hinders gait. A novel orthosis has been developed which counteracts this impediment to the ankle. It is expected that gait training will improve stroke patients' use of the orthosis by increasing their ankle dynamics. Gait training with biofeedback, which is based on physiological signal, has been shown to be effective for stroke patients. The main design requirement for the biofeedback is that it facilitates learning of an increased active range of motion of the ankle. To fulfill this requirement the biofeedback is based on the maximum angle in plantar- and dorsiflexion during the swing phase of the impeded leg. In this research, the biofeedback is validated on healthy participants with an impeded right ankle performing five gait trials. First an unimpeded reference trial was conducted capturing normal gait. After which the participant's ankle was impeded. During the initial impeded trial the participant got accustomed to the impediment during gait. Then two trials with feedback were conducted followed by a retention trial without feedback. During the retention trial the effects the biofeedback has on the ankle dynamics are determined. The outcome measures were chosen to validate whether the biofeedback facilitated learning of an increased active range of motion of the ankle. The outcome measures were the increase of active range of motion of the ankle from the initial impeded trial to the retention trial and the error quotient. The error quotient is a measure showing to what extent the angles making up the active range of motion during a trial were the same as during the reference trial. The active range of motion of the ankle of participants increased (p < 0.001) from the initial impeded trial to the retention trial. Moreover a significant decrease in the error quotient of participants was found between the initial impeded trial and the first feedback trial (p = 0.033), second feedback trial (p = 0.013) and retention trial (p = 0.020). Therefore, the biofeedback facilitated learning of an increased active range of motion of the ankle to participants. Further research is required to determine how to best adapt the biofeedback such that it is suitable for use by stroke patients in daily life.