An innovative gamified gait biofeedback interface targeting propulsion: feasibility and preliminary effects

Area of Science:

• Rehabilitation Medicine
• Biomechanics
• Human-Computer Interaction

Background:

• Gait deficits persist in stroke survivors post-rehabilitation, necessitating improved therapeutic strategies.
• Gamification and real-time biofeedback can enhance engagement and therapeutic impact in gait retraining.
• A novel gamified gait biofeedback interface was developed to improve propulsion during training.

Purpose of the Study:

• To assess the feasibility of a customized, gamified gait biofeedback interface.
• To evaluate the preliminary effects of this interface on gait biomechanics and physiological intensity.
• To compare gamified biofeedback (gBF) with conventional biofeedback (cBF) and no biofeedback (noBF).

Main Methods:

• A repeated-measures design compared three treadmill walking conditions: no biofeedback (noBF), conventional biofeedback (cBF), and gamified biofeedback (gBF).
• Gait biomechanics (ground reaction force, limb angle, ankle moment), physiological intensity (heart rate, RPE), and user experience (NASA-TLX, UXQ) were measured.
• Fifteen participants (9 able-bodied, 6 post-stroke) completed the study.

Main Results:

• Both gBF and cBF significantly increased peak anterior ground reaction force, trailing limb angle, and ankle moment compared to noBF.
• Both biofeedback conditions led to greater physiological intensity (heart rate, RPE) than noBF.
• gBF resulted in higher workload (mental demand, temporal demand, frustration, effort) and novelty compared to cBF.

Conclusions:

• Real-time gamified gait biofeedback is feasible and can enhance gait biomechanics and physiological intensity.
• gBF shows potential comparable to cBF for gait improvements, with increased engagement and task demand.
• Further research is needed to refine game design and evaluate gBF in larger populations and with varied training dosages.