Dynamic biomechanical effect of lower body positive pressure treadmill training for hemiplegic gait rehabilitation after stroke: A case report

BACKGROUND Lower body positive pressure(LBPP)treadmill has potential applications for improving the gait of patients after stroke,but the related mechanism remains unclear.CASE SUMMARY A 62-year-old male patient suffered from ischemic stroke with hemiplegic gait.He was referred to our hospital because of a complaint of left limb weakness for 2 years.The LBPP training was performed one session per day and six times per week for 2 wk.The dynamic plantar pressure analysis was taken every 2 d.Meanwhile,three-digital gait analysis and synchronous electromyography as well as clinical assessments were taken before and after LBPP intervention and at the 4-wk follow-up.During LBPP training,our patient not only improved his lower limb muscle strength and walking speed,but more importantly,the symmetry index of various biomechanical indicators improved.Moreover,the patient’s planter pressure transferring from the heel area to toe area among the LBPP training process and the symmetry of lower body biomechanical parameters improved.CONCLUSION In this study,we documented a dynamic improvement of gait performance in a stroke patient under LBPP training,which included lower limb muscle strength,walking speed,and symmetry of lower limb biomechanics.Our study provides some crucial clues about the potential dynamic mechanism for LBPP training on gait and balance improvement,which is related to rebuilding foot pressure distribution and remodeling symmetry of biomechanics of the lower limb.

Plantar ROI Characterization during the Stance Phase of Gait Based on a Low-cost Pressure Acquisition Platform

Plantar Region of Interest （ROI） detection is important for the early diagnosis and treatment ofmorphologic defects of the foot and foot bionic research. Conventional methods have employed complex procedures and expensive instruments which prohibit their widespread use in healthcare. In this paper an automatic plantar ROIs detection method using a customized low-cost pressure acquisition device is proposed. Plantar pressure data and 3D motion capture data were collected from 28 subjects （14 healthy subjects and 14 subjects with hallux valgus）. The maximal inter-frame difference during the stance phase was calculated. Consequently, the ROIs were defined by the first-order difference in combination with prior anatomic knowl- edge. The anatomic locations were determined by the maximal inter-frame difference and second maximal inter-frame differ- ence, which nearly coincided. Our system can achieve average recognition accuracies of 92.90%, 89.30%, 89.30%, 92.90%, 92.90%, and 89.30% for plantar ROIs hallux and metatarsi I-V, respectively, as compared with the annotations using the 3D motion capture system. The maximal difference of metatarsus heads II-V, and the impulse of the medial and lateral heel features made a significant contribution to the classification ofhallux valgus and healthy subjects with ≥ 80% sensitivity and specificity. Furthermore, the plantar pressure acquisition system is portable and convenient to use, thus can be used in home- or commu- nity-based healthcare applications.