International Journal of Physical Medicine & Rehabilitation
Open Access

Abstract

Effect of Tilt Sensor versus Heel Loading on Neuroprosthesis Stimulation Reliability and Timing for Individuals Post-Stroke during Level and Non- Level Treadmill Walking

M. Barbara Silver-Thorn, Michelle B Gallagher and Jason T Long

Study background: Non-level walking may adversely affect stimulation of neuroprostheses as initial programming is performed during level walking. The objectives of this study were to assess stimulation reliability of tilt and heel sensor-based neuroprosthesis stimulation during level and non-level walking, examine stimulation initiation and termination timing during level and non-level walking, and determine whether heel or tilt sensor-based stimulation control is more robust for non-level ambulation.

Methods: Eight post-stroke individuals with drop foot who were able to actively ambulate within the community were selected for participation. Each subject acclimated to the neuroprosthesis and walked on a treadmill randomly positioned in inclined, level and declined orientations. The primary measures of interest were stimulation reliability and timing.

Results: Statistically significant differences in tilt, but not heel, sensor-based stimulation reliability were observed between level and non-level walking trials. Tilt sensor-based stimulation initiation occurred significantly closer to swing as the treadmill processed from declined to inclined orientations. No statistically significant differences in stimulation reliability or timing were observed between theoretical heel versus clinical tilt sensor-based stimulation control.

Discussion and conclusions: Tilt sensor-based stimulation reliability may be adversely affected by non-level walking. Differences in stimulation initiation timing with tilt sensor-based control during non-level walking may be advantageous as stimulation initiation closer to swing during inclined ambulation may allow for greater ankle plantar flexion to assist with forward progression. Despite a lack of significant differences in stimulation reliability or timing between sensors, theoretical heel sensor-based stimulation control exhibited more consistent stimulation timing with less variability than for tilt sensor-based stimulation during non-level ambulation.