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Title of Journal: Exp Brain Res

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Abbravation: Experimental Brain Research

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Springer-Verlag

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DOI

10.1016/0304-3940(94)90800-1

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1432-1106

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Effects of implicit visual feedback distortion on

Authors: SeungJae Kim Hermano Igo Krebs
Publish Date: 2012/03/13
Volume: 218, Issue: 3, Pages: 495-502
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Abstract

Gait rehabilitation after stroke often utilizes treadmill training delivered by either therapists or robotic devices However clinical results have shown no benefit from this modality when compared to usual care On the contrary results were inferior perhaps because in its present form it is not interactive and at least for stroke central pattern generators at the spinal level do not appear to be the key to promote recovery To enable gait therapy to be more effective therapy must be interactive and visual feedback appears to be an important option to engage patients’ participation In this study we tested healthy subjects to see whether an implicit “visual feedback distortion” influences gait spatial pattern Subjects were not aware of the visual distortion nor did they realize changes in their gait pattern The visual feedback of step length symmetry was distorted so that subjects perceived their step length as being asymmetric during treadmill training We found that a gradual distortion of visual feedback without explicit knowledge of the manipulation systematically modulated gait step length away from symmetry and that the visual distortion effect was robust even in the presence of cognitive load This indicates that although the visual feedback display used in this study did not create a conscious and vivid sensation of selfmotion the properties of the optical flow experimental modifications of visual information of subjects’ movement were found to cause implicit gait modulation Nevertheless our results indicate that modulation with visual distortion may require cognitive resources because during the distraction task the amount of gait modulation was reduced Our results suggest that a therapeutic program involving visual feedback distortion in the context of gait rehabilitation may provide an effective way to help subjects correct gait patterns thereby improving the outcome of rehabilitationThis work was supported in part by the Veterans Administration Baltimore Medical Center “Center of Excellence on TaskOriented Exercise and Robotics in Neurological Diseases” B3688R Dr Krebs is a coinventor in MITheld patents for the robotic devices used to treat patients with neurological deficits He holds equity positions in Interactive Motion Technologies Inc the company that manufactures this type of technology under license to MIT

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