Real-time feedback of dynamic foot pressure index for gait training of toe-walking children with spastic diplegia

Abstract

Purpose: The aim of this study was to determine whether and how real-time feedback of dynamic foot pressure index (DFPI) could be used to correct toe-walking gait in spastic diplegic children with dynamic equinus.

Methods: Thirteen spastic diplegic children with dynamic equinus were asked to wear a monitoring device to record their ambulation during daily gait, conventional training gait, and feedback training gait. Parameters based on their DFPI and stride duration were compared among the three test conditions.

Results: The results with feedback training were significantly better for all DFPI parameters in comparison to patients’ daily gait and showed significant improvements in DFPI for toe-walking gait and percentage of normal gait in comparison to conventional training methods. Moreover, stride duration under two training gaits was longer than patient’s daily gait, but there was no significant difference between the two training gaits.

Conclusions: Although the stride duration for the two training gaits was similar, gait training with real-time feedback of DFPI did produce noticeably superior results by increasing heel-loading impulse of toe-walking gait and percentage of normal gait in comparison to convention training methods. However, its effectiveness was still impacted by the motion limitations of diplegic children.

Implications for Rehabilitation

• The DFPI-based gait training feedback system introduced in this study was shown to be more effective at toe-walking gait rehabilitation training over conventional training methods.

• The feedback system accomplished superior improvement in correcting toe-walking gait, but its effectiveness in an increasing heel-loading impulse in normal gait was still limited by the motion limitations of diplegic children.

• Stride duration of normal gait and toe-walking gait was similar under conventional and feedback gait training.

Keywords:

• Dynamic foot pressure index
• gait training
• real-time feedback
• spastic diplegia
• stride duration
• toe-walking gait

Acknowledgements

The authors thank all subjects who participated in the research and Colin J. McClean for his suggestions on the preparation of this manuscript.

Disclosure statement

The authors report no declarations of interest.

Funding

This work was supported by the National Natural Science Foundation of China [grant number 11120101001 and 11421202], and the Ministry of Science and Technology of China [grant number 2016YFB1101101].