Stroke is the 5th leading cause of death in the US and one of the leading causes of death around the world. In addition, strokes are a major cause of disability, as well. Many patients suffer from cognitive or movement disabilities after a stroke, a common debilitating impairment being difficulty walking, and although physical therapy can improve this in some patients, marked limping, unsteady gait, and poor capacity for obstacle clearance may persist. This increases a patient’s risk of falling and injuring themselves, often meaning that they have less independence than they had before.

Physical therapist assisting senior man to walk with the support

To address this problem, investigators at the Institute for Research in Rehabilitation (Clinique romande de réadaptation) in Sion, Switzerland developed the GASPAR trial (Gait Adaptation for Stroke Patients with Augmented Reality). This trial use projectors to display shapes on the walking surface of a treadmill, which allows a physical therapist to lead the patient through rehabilitation exercises for things like gait symmetry, coordination enhancement, and gait agility. For example, the Zebris sessions, which are done on the FDM-T treadmill (Zebris Medical, Isny im Allgäu, Germany) equipped with 10,000 sensors to detect foot pressure, aim to improve walking speed, step length, and gait symmetry.

Image Source: www.prophysics-sol.se
Image Source: www.prophysics-sol.se

 

After a one-minute warm up, the patient begins a 30-minute training session, in which the patient must synchronize his or her steps with “stepping stones,” the speed of which are calculated using the gait recorded during the warm up. After that, two types of training are suggested depending on the patient’s needs: the first is symmetry training, in which the stepping stones progressively fall into a more symmetrical pattern, and the second is step-length training, in which the stepping stones progressively encourage the patient to take longer strides. After the training session, a one minute walk without the stepping stones is recorded in order to evaluate the immediate effect on the patient’s gait. You can watch some of the gait analysis technology in this video.

 

This trial will test 70 to 100 participants. Participants will be recruited from rehabilitation patients at the Clinique Romande de Réadaptation SUVACare in Sion, Switzerland. The participants will all be patients in the first stage of rehabilitation (within 40 days of the incident) after having suffered a stroke, traumatic brain injury, or spinal cord injury in acute to subacute phase. The physical requirements will include, of course, a need for gait training, but also the ability to walk for two minutes with no or minimal aid. Patients undergo 20 gait training sessions over four weeks. Each training session will last for about 30 minutes, plus warm up and the post-session analysis of the immediate and long-term progress.

Image Source: rts.ch
Image Source: rts.ch

 

This trial initiated recruitment on June 2016, and the results are being analyzed presently. When imaginative medical professionals are equipped with Augmented Reality technology, we see revolutionary results! We at ARinMED are thrilled by this study, which, if the results are positive, will could show physical therapists and patients the potential for AR and encourage them to try it out. What do you think? Tell us in the comment section!

 

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5081976/pdf/13063_2016_Article_1630.pdf

 

Category: PHYSICAL THERAPY

 

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