title: Clinical observational gait analysis to evaluate improvement of balance during gait with vibrotactile biofeedback.
abstract: OBJECTIVE
  This study explores the effect of vibrotactile biofeedback on gait in 20 patients with bilateral vestibular areflexia using observational gait analysis to score individual balance.
  
  
  METHODS
  A tilt sensor mounted on the head or trunk is used to detect head or body tilt and activates, via a microprocessor, 12 equally distributed vibrators placed around the waist. Two positions of the tilt sensor were evaluated besides no biofeedback in three different gait velocity tasks (slow/fast tandem gait, normal gait on foam) resulting in nine different randomized conditions. Biofeedback activated versus inactivated was compared. Twenty patients (10 males, 10 females, age 39-77 years) with a bilateral vestibular areflexia or severe bilateral vestibular hyporeflexia, severe balance problems and frequent falls participated in this study.
  
  
  RESULTS
  Significant improvements in balance during gait were shown in our patients using biofeedback and sensor on the trunk. Only two patients showed a significant individual gait improvement with the biofeedback system, but in the majority of our patients, it increased confidence and a feeling of balance.
  
  
  CONCLUSIONS
  This study indicates the feasibility of vibrotactile biofeedback for vestibular rehabilitation and to improve balance during gait.
authors.affiliation: Department of Biomedical Engineering, University Hospital Maastricht, Maastricht, the Netherlands. m.j.a.janssen@tue.nl
authors.forename: Maurice
authors.initials: M
authors.lastname: Janssen
authors.forename: Rianne
authors.initials: R
authors.lastname: Pas
authors.forename: Jos
authors.initials: J
authors.lastname: Aarts
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Janssen-Potten
authors.forename: Hans
authors.initials: H
authors.lastname: Vles
authors.forename: Christine
authors.initials: C
authors.lastname: Nabuurs
authors.forename: Rob
authors.initials: R
authors.lastname: van Lummel
authors.forename: Robert
authors.initials: R
authors.lastname: Stokroos
authors.forename: Herman
authors.initials: H
authors.lastname: Kingma
mesh_terms: D000328:Adult; D000368:Aged; D001676:Biofeedback, Psychology / Q000379:methods*; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology*; D012021:Reflex, Abnormal / Q000502:physiology; D012720:Severity of Illness Index; D015837:Vestibular Diseases / Q000503:physiopathology / Q000534:rehabilitation*