Neurophysiological Correlates of Gait Retraining With Real-Time Visual and Auditory Feedback

Most people acquire motor skills through feedback-based training. How the human brain processes sensory feedbacks during training, especially in a gait training, remain largely unclear. The purpose of this paper is to explore how humans adopt a new gait pattern to reduce impacts during walking-with the aid of visual and audio feedbacks. This paper demonstrates the features of underlying brain activity in incorporating the visual or auditory cues to acquire a new gait pattern. Electroencephalography (EEG) and peak positive acceleration (PPA) of the heel were collected from 23 participants during walking on a treadmill with no feedback, with visual feedback, or with audio feedback. The feedbacks were presented after each foot strike, where a sub-threshold PPA triggered a positive feedback (green/low-pitched), and a suprathreshold PPA triggered a negative feedback (red/high-pitched). The participants were instructed to voluntarily control their gait, so that low PPA could be achieved. This control was perturbed in some sessions by an additional cognitive task, and the influence of such distraction was also explored. The PPA was significantly lower in the sessions with visual or audio feedback than in sessions without feedback, showing an immediate improvement in gait pattern, when the feedback was provided. Different feedbacks modulated neural activities at different locations and/or levels during training. Alpha event-related synchronization (ERS) was particularly increased during the encoding of auditory feedback or the introduction of a distracting task. In the meantime, prominent frontal and posterior theta ERS were coupled with negative feedback, and strong beta event-related desynchronization (ERD) was observed only in sessions with feedbacks. Our results indicate that feedback effectively enhances motor planning when acquiring a new gait.