CHICAGO — Augmented reality biofeedback could be an effective tool to reduce abnormalities in gait and could be used to provide telerehabilitation services to patients who may not have access to traditional clinics, according to a presenter at the American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium.

“In general, there are abnormalities in balance and/or gait that require rehabilitation,” Jonathan Akins, PhD, of the Department of Biomedical Engineering at Widener University, said in his presentation. “This is not specific to a limb loss population. Some limitations to what is currently available is that there is no standardization, as well as unmonitored time.

Particularly relating to unmonitored time, if you have an individual going to physical therapy and they spend 1 hour there, three times per week, that is a lot of time that is being unmonitored.” Akins and other researchers hypothesized that real-time biofeedback could provide instantaneous information on balance and gait adjustments, as well as improvements.

Smart glasses, which project a screen onto the lenses, would be an ideal technology to display and provide instant biofeedback, he said. To design a biofeedback interface for smart glasses, as well as to evaluate effectiveness at measuring participant performance, researchers used Epson Moverio BT-200 smart glasses and recruited 10 healthy participants. A control unit for the interface was placed in a belt that was secured to the lumbar spine.

An accelerometer control unit measured lumbar and lateral flexion. With the use of an Android application, researchers could display real-time biofeedback onto the lenses of the smart glasses, so data could be seen by the wearer. Researchers tested visual conditions with the participants wearing the interfaced belt as they performed balance and gait exercises under the following conditions: first, not wearing the glasses; then, wearing the glasses but receiving no biofeedback; and finally, wearing the glasses and receiving biofeedback.

According to Akins, participants reported a significant increase in root mean square values — calculated from angles sagittal and frontal planes to determine trunk angle magnitude from vertical — for two-limb stance when they wore the smart glasses and received biofeedback. Regarding gait, investigators found a significant decrease in flexion and lateral flexion root mean square values. They also found a significant decrease in gait velocity.

“This pilot study was an initial step to investigate balance and gait changes in response to augmented reality biofeedback,” Akins said. “In the future, research is needed to investigate the optimal kinematic or gait parameter, identify the most effective and preferred feedback modality, and investigate immediate and long-term effects in a pathological population.”

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