title: [Feedback therapy for improving heel contact and toe off motion during ambulation (author's transl)].
abstract: The postural defects of cerebral palsy children arising at heel contact during ambulation result, in many cases, in considerable initial vertical loads. These, in turn, lead to unfavorable motor patterns, a high degree of joint load, and undesirable spinal movements. An acoustic feedback system aimed at improving the motor process was developed; this turns vertical loads arising during ambulation into sounds, enabling thus to control a motor learning process. A KISTLER measuring platform was used as measuring instrument; this instrument translates vertical forces into a sequence of tones via a tone generator. In a series of experiments, the children with motor disorders learned to perform consciously a heel contact and toe off pattern which is checked and controlled through the use of tones and acoustic feedback. The aim is to achieve a slow increase in power at heel contact, a graduated power peak, and a well defined floor contact phase. The computation of the test using a 2 x 3 x 3 factor variance analysis showed a highly significant reduction in load increase not only in children with hemiplegia but also in those with diplegia. The most important findings was the fact that all the children were capable of practising a complex motor process controlled by an external feedback system and to compensate accordingly. In addition, at the end of the test, the children were in a position to reproduce alternatively the various motor patterns, and were thus able to distinguish between joint-loading and joint-relieving heel contact and toe off pattern. Moreover, the children's considerable motivation to practise on the 'sound plate' represented a substantial therapeutic aid.
mesh_terms: D000161:Acoustic Stimulation; D000704:Analysis of Variance; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D005246:Feedback; D006429:Hemiplegia / Q000534:rehabilitation; D006801:Humans; D008124:Locomotion; D008722:Methods; D011187:Posture
vernacular_title: Feedbacktherapie zur Verbesserung der Aufsetz- und Abrollbewegung beim Gehen.