Intentional Increases in Push-Off Force Coupled with Visual Feedback: Towards New Strategies in Robot-Assisted Gait Rehabilitation

In recent years, robot-assisted gait rehabilitation has increased the use of visual feedback as a tool for therapy. In addition, specific training related to ground reaction forces, such as push-off force (POF), is associated with positive motor recovery outcomes after brain injuries such as stroke. This study investigated explicitly the effects of visual force feedback on intentional increases in POF. Findings include significant increases in POF for subjects who received visual feedback compared to the control. Further, significant increases in the activations of ankle and knee muscles are observed before, during, and after push-off when compared to baseline, along with strategic changes in all lower limb joint angles relating to POF- increasing strategies. This work sheds light on the interplay between visual feedback and intentional ground reaction force control, with direct implications for current robot-assisted gait training aspects. Targeted therapy focused on these strategies can be useful in the context of certain rehabilitation protocols based on the present results.