©2019 by Dr. Alli Gokeler


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Gait Training with Novel Visual Feedback

May 22, 2017


VizMoGait Almost every week there is a message in the media that a well-known athlete has torn the anterior cruciate ligament (ACL) of the knee.

Although often regarded as a necessity, an ACL reconstruction does not guarantee a normal function of the knee. On average, only half of patients return to competitive sports. Unfortunately, the ACLreconstruction does not provide protection against the onset of degenerative abnormalities of the knee. The kinematic changes in the reconstructed knee lead to abnormal knee joint stress, which, according to some, is associated with early development and progression of knee osteoarthrosis.

Normalization of the walking pattern can take years and patients can take the adjusted walking pattern as a normal walking pattern. Current rehabilitation programs have not yet shown the potential to completely normalize the deviating running pattern. Thus, it is important that an effective training program be applied, which will enable patients to learn a good walking technique immediately at the beginning of the rehabilitation.

Visual feedback can be used as an essential tool to improve lower arm movement patterns. Video feedback teaches you by observing. The imitation of physical exercise that is observed will play an important role. In imitation, visual input is coupled to motor output by the activation of mirror neurons. These visomotor neurons fade both in the self-performing of the action and in the passive perception of the action. The coupling of vision to motorism promotes automatism while moving. Imitation of a model through video feedback makes it possible to teach a correct moving technique.

Professor Bert Otten, professor of neuromechanics at the Center for Movement Sciences at the University Medical Center Groningen and Groningen University, has developed a software package for motor learning by imitating. We called this Visualization of Motion Feedback Tool (VizMo). VizMo uses body contour feedback (BCF) by showing an overlay video for a given motion. The overlay video consists of a contour of an expert model and a contour of the subject. These contours are shown from the same perspective. The contour of the expert is the target pattern and the subject is instructed to imitate the movement of this expert as well as possible. A video camera connected to a laptop film the movement of the subject, after which the overlay video is displayed. The score that follows is the percentage of overlay, with 100% overlay corresponding to exactly the same movement as the expert. The video enables the subject to compare its own performance with the expert model performance. This individual feedback focuses on everyone's individual limitations and improvements.

On the video you will see VizMo to improve gait patterns in patients with an ACL reconstruction as investigated by students of Movement Sciences Tessa Huisjes and Michele Keizer.

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