Exploring Musical Feedback for Gait Retraining: A Novel Approach to Orthopedic Rehabilitation.

Background/objectives: Gait retraining is widely used in orthopedic rehabilitation to address abnormal movement patterns. However, retaining walking modifications can be challenging without guidance from physical therapists. Real-time auditory biofeedback can help patients learn and maintain gait alterations. This study piloted the feasibility of the musification of feedback to medialize the center of pressure (COP).

Methods: To provide musical feedback, COP and plantar pressure were captured in real time at 100 Hz from a wireless 16-sensor pressure insole. Twenty healthy subjects (29 ± 5 years old, 75.9 ± 10.5 Kg, 1.73 ± 0.07 m) were recruited to walk using this system and were further analyzed via marker-based motion capture. A lowpass filter muffled a pre-selected music playlist when the real-time center of pressure exceeded a predetermined lateral threshold. The only instruction participants received was to adjust their walking to avoid the muffling of the music.

Results: All participants significantly medialized their COP (-9.38% ± 4.37, range -2.3% to -19%), guided solely by musical feedback. Participants were still able to reproduce this new walking pattern when the musical feedback was removed. Importantly, no significant changes in cadence or walking speed were observed. The results from a survey showed that subjects enjoyed using the system and suggested that they would adopt such a system for rehabilitation.

Conclusions: This study highlights the potential of musical feedback for orthopedic rehabilitation. In the future, a portable system will allow patients to train at home, while clinicians could track their progress remotely through cloud-enabled telemetric health data monitoring.