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Title: Improving balance and gait using biomechanical and electronic approaches
Authors: Ma, Zonghao
Degree: Ph.D.
Issue Date: 2018
Abstract: Falls and fall-induced injuries, among elderly people and patients with balance and gait disorders, have been major public health problems globally. Due to aging/pathological related declines in cutaneous plantar surface sensitivity and proprioception, these people have higher chance of falls. Falls may lead to severe injuries, reduced mobility, reduction of quality of life, and even death. This project aims to employ biomechanical and electronic approaches to solve the above-mentioned critical problems. It improves the balance and gait of elderly people and patients by: 1) providing supplemented sensory information about body posture to users (i.e. biofeedback system integrated with force sensors at plantar surface of foot); and 2) altering the foot plantar pressure and contact area at the foot-floor interface (i.e. custom-fitted orthopaedic insoles with arch supports, metatarsal pads, and heel cups). Tactile sensation at plantar surface of foot continuously provides useful sensory information about the foot-ground contact characteristics, which contains crucial information about the body movement. Improving plantar pressure sensation could be one potential effective approach to enhance balance and gait, which appears to not have been achieved enough attention before. This project conducted a series of clinical trials to systematically investigate if plantar pressure sensation, balance and gait could be improved by vibrotactile biofeedback system and orthopaedic insoles, including: 1) Effect of biofeedback system on standing postural balance in healthy young and older adults (Study 1), 2) Effect of biofeedback system on postural balance while standing on a perturbation floor in healthy young adults (Study 2), 3) Effect of biofeedback system on plantar foot loading and gait control in patients with stroke (Study 3), and 4) Effect of orthopaedic insoles on standing postural balance in healthy older adults (Study 4).
This project adopted a step-by-step approach, started from improving postural balance during quite standing, and ended with attempts of improving dynamic balance during walking. All of them are linked together by the theme of improving balance through augmenting plantar pressure sensation. Repeated measures study design has been adopted to compare participant's balance and gait performance between with and without the interventions. Measurement of center-of-pressure parameters during static standing, center-of-mass parameters during standing under balance perturbations, and plantar pressure distribution and spatiotemporal gait parameters during walking, have been employed to objectively assess subject's postural balance and gait control in all experimental conditions of different studies. The findings of this study supported the effectiveness of vibrotactile biofeedback system and orthopaedic insoles in enhancing balance and gait control in health young and older adults, and patients with stroke, indicating that enhancing/supplementing plantar pressure sensation is one effective approach to improve balance and gait control, which inspires future research in this field. The wearable characteristics of vibrotactile biofeedback systems and orthopaedic insoles also allow them to be used in both indoor and outdoor settings, which further makes them appropriate to be applied as balance aids and balance training devices in daily life in the future. Future studies could consider investigating the effect of them during more complicated tasks, such as ascending/descending stairs and running, in more diverse and representative populations.
Subjects: Hong Kong Polytechnic University -- Dissertations
Falls (Accidents) in old age -- Prevention
Foot -- Mechanical properties
Pages: xix, 198 pages : color illustrations
Appears in Collections:Thesis

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