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Experiences of treadmill walking and audio-visual feedback after stroke – an interview study

Authors Anna Danielsson
Karin Törnbom
Published in Nordic Stroke 2017. 19th Nordic Congress on Cerebrovascular Diseases, August 23-25, Aarhus, DK
Publication year 2017
Published at Institute of Neuroscience and Physiology, Department of Health and Rehabilitation
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Language en
Keywords stroke, Walking, audio-visual feedback
Subject categories Physiotherapy, Neuroscience


Introduction: Walking training after stroke is highly important and a high intensity is recommended. As in-patients rarely reach the recommended physical activity level, finding ways to motivate exercise is therefore a key issue in rehabilitation. Offering a variety of training methods e.g by using virtual reality, could be one option to increase exercise intensity. The purpose of the study was to explore how patients’ with stroke experience treadmill walking with a prototype for audio – visual (AV) feedback. Methods: Three woman and five men, with a median age of 52, undergoing walking training, participated during inpatient rehabilitation 2-10 months after stroke. They walked for two sessions of up to 30 minutes on a treadmill at self-selected speed, with and without AV- feedback, respectively. The AV-feedback was mediated through a realistic movie of a walking path displayed on a TV-screen. Movement sensors donned to the legs connected to software, directed the speed of the movie. In addition, nature sounds and the individual’s step rhythm were mediated through headphones. After the walking session the participants took part in an individual interview regarding their experience walking with and without the AV-feedback. Semi structured interviews were audio recorded, transcribed and analysed using qualitative content analysis. Interviews were read by both authors and a coding scheme based on key concepts related to the research questions was developed. All codes were retrieved in the interviews, grouped into categories and finally formulated into themes. Results: Three main themes; positive, negative and ambivalent experiences, were expressed. The AV- feedback was mainly considered as enjoyable, engaging and made walking on the treadmill more interesting than without. Some participants experienced dizziness and those sensitive to mental overload found parts of the feedback more or less wearing. No fall incidences occurred but patients with more pronounced balance problems reported physical fatigue in their supporting hand. Conclusions: In general, participants liked and found this inexpensive AV –feedback motivating and enjoyable. Yet, the individual’s capacity has to be taken into account when adding perceptional stimuli during treadmill walking. The additional value of virtual feedback aiming to increase exercise intensity ought to be further explored.

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