journal article·2024-09-18Open access

Effects of Gradual Spatial and Temporal Cues Provided by Synchronized Walking Avatar on Elderly Gait

Dane A. L. Miller, Hirotaka Uchitomi, Yoshihiro Miyake

Applied Sciences· Volume 14· Issue 18

Abstract

Aging often leads to elderly gait characterized by slower speeds, shorter strides, and increased cycle; improving gait can significantly enhance the quality of life. Early gait training can help reduce gait impairment later on. Augmented reality (AR) technologies have shown promise in gait training, providing real-time feedback and guided exercises to improve walking patterns and gait parameters. The aim of this study was to observe the effects of gradual spatial and temporal cues provided by a synchronized walking avatar on the gait of elderly participants. This experiment involved 19 participants aged over 70 years, who walked while interacting with a synchronized walking avatar that provided audiovisual spatial and temporal cues. Spatial cueing and temporal cueing were provided through distance changes and phase difference changes, respectively. The WalkMate AR system was used to synchronize the avatar’s walking cycle with the participants’, delivering auditory cues matched to foot contacts. This study assessed the immediate and carry-over effects of changes in distance and phase difference on stride length, cycle time, and gait speed. The results indicate that gradual spatial and temporal cueing significantly influences elderly gait parameters, with potential applications in gait rehabilitation and training.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Action Observation and Synchronization · Balance, Gait, and Falls Prevention · Virtual Reality Applications and Impacts

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Computer Science, Tokyo Institute of Technology, Tokyo 152-8550, Japan

Funding

Japan Science and Technology Agency (JST) CREST · Japan Society for the Promotion of Science (JSPS) KAKENHI · JST-Mirai Program

References (59)

Show source-provided references
1. Toward a better understanding of gait changes with age and disablement: Neuromuscular adaptation10.1097/00003677-200304000-00009 ↗
2. Slowness in elderly gait10.1080/07340669008251531 ↗
3. The effect of aging on gait parameters in able-bodied older subjects: A literature review10.1007/s40520-015-0420-6 ↗
4. Gait Disorders in Older Adults10.1111/j.1532-5415.1996.tb06417.x ↗
5. Gait in the elderly10.1016/S0966-6362(97)01118-1 ↗
6. Slowness, variability, and modulations of gait in healthy elderly10.1016/S0166-4115(96)80006-9 ↗
7. Balance and gait in the elderly: A contemporary review10.1002/lio2.252 ↗
8. Gait in the elderly: A narrative review10.62004/kpc.v2i3.31 ↗
9. Stefanacci, R.G., and Wilkinson, J.R. (2024, July 28). Gait Disorders in Older Adults. MSD Manual 2023, Available online: https://www.msdmanuals.com/en-jp/professional/geriatrics/gait-disorders-in-older-adults/gait-disorders-in-older-adults.
10. Mahlknecht, P., Kiechl, S., Bloem, B.R., Willeit, J., Scherfler, C., Gasperi, A., Rungger, G., Poewe, W., and Seppi, K. (2013). Prevalence and burden of gait disorders in elderly men and women aged 60–97 years: A population-based study. PLoS ONE, 8.10.1371/journal.pone.0069627 ↗
11. Neurological gait disorders in elderly people: Clinical approach and classification10.1016/S1474-4422(06)70678-0 ↗
12. Gait disorders in adults and the elderly: A clinical guide10.1007/s00508-016-1096-4 ↗
13. Studies of gait and mobility in the elderly10.1093/ageing/10.3.147 ↗
14. Promoting elderly mobility and fall prevention through virtual reality: A sustainable approach to gait balance training10.56183/iberoeds.v4iS.669 ↗
15. Lee, K. (2020). Virtual Reality Gait Training to Promote Balance and Gait Among Older People: A Randomized Clinical Trial. Geriatrics, 6.10.3390/geriatrics6010001 ↗
16. Mirelman, A., Rochester, L., Reelick, M.F., Nieuwhof, F., Pelosin, E., Abbruzzese, G., Dockx, K., Nieuwboer, A., and Hausdorff, J.M. (2013). V-Time: A Treadmill Training Program Augmented by Virtual Reality to Decrease Fall Risk in Older Adults: Study Design of a Randomized Controlled Trial. Bmc Neurol., 13.10.1186/1471-2377-13-15 ↗
17. Delbes, L., Mascret, N., Goulon, C., and Montagne, G. (2022). Validation of an Immersive Virtual Reality Device Accepted by Seniors That Preserves the Adaptive Behavior Produced in the Real World. Front. Bioeng. Biotechnol., 10.10.3389/fbioe.2022.917486 ↗
18. Visually-Guided Gait Training in Paretic Patients During the First Rehabilitation Phase: Study Protocol for a Randomized Controlled Trial10.1186/s13063-016-1630-8 ↗
19. Clinical usefulness of augmented reality using infrared camera based real-time feedback on gait function in cerebral palsy: A case study10.1589/jpts.28.1387 ↗
20. Matsuda, Y., Nakamura, J., Amemiya, T., Ikei, Y., and Kitazaki, M. (2021). Enhancing virtual walking sensation using self-avatar in first-person perspective and foot vibrations. Front. Virtual Real., 2.10.3389/frvir.2021.654088 ↗
21. Real-time avatar-based feedback to enhance the symmetry of spatiotemporal parameters after stroke: Instantaneous effects of different avatar views10.1109/TNSRE.2020.2979830 ↗
22. Labbe, D.R., Kouakoua, K., Aissaoui, R., Nadeau, S., and Duclos, C. (2021). Proprioceptive stimulation added to a walking self-avatar enhances the illusory perception of walking in static participants. Front. Virtual Real., 2.10.3389/frvir.2021.557783 ↗
23. The validity and usability of an eight marker model for avatar-based biofeedback gait training10.1016/j.clinbiomech.2019.08.013 ↗
24. Alyami, M., and Nessler, J.A. (2021). Walking on a vertically oscillating platform with simulated gait asymmetry. Symmetry, 13.10.3390/sym13040555 ↗
25. Spatiotemporal Gait Guidance Using Audiovisual Cues of Synchronized Walking Avatar in Augmented Reality10.1109/ACCESS.2022.3200744 ↗
26. Gait in younger and older adults during rhythmic auditory stimulation is influenced by groove, familiarity, beat perception, and synchronization demands10.1016/j.humov.2022.102972 ↗
27. Variations in spatiotemporal parameters in young and older women while walking at different speeds
28. Hori, K., Mao, Y., Ono, Y., Ora, H., Hirobe, Y., Sawada, H., Inaba, A., Orimo, S., and Miyake, Y. (2020). Inertial measurement unit-based estimation of foot trajectory for clinical gait analysis. Front. Physiol., 10.10.3389/fphys.2019.01530 ↗
29. Interpersonal synchronization of body motion and the Walk-Mate walking support robot10.1109/TRO.2009.2020350 ↗
30. Gait guidance using rhythm synchronization with auditory cues and walking avatar in augmented reality
31. Mao, Y., Ogata, T., Ora, H., Tanaka, N., and Miyake, Y. (2021). Estimation of stride-by-stride spatial gait parameters using inertial measurement unit attached to the shank with inverted pendulum model. Sci. Rep., 11.10.1038/s41598-021-81009-w ↗
32. Inertial sensor based reference gait data for healthy subjects10.1016/j.gaitpost.2011.02.023 ↗
33. Risk factors for recurrent falls in the elderly in long-term institutional care10.1016/S0033-3506(95)80076-X ↗
34. Independent influence of gait speed and step length on stability and fall risk10.1016/j.gaitpost.2010.06.013 ↗
35. Comparing the efficacy of metronome beeps and stepping stones to adjust gait: Steps to follow!10.1007/s00221-010-2531-9 ↗
36. Multiple walking speed–frequency relations are predicted by constrained optimization10.1006/jtbi.2001.2279 ↗
37. Patel, P., Enzastiga, D., Casamento-Moran, A., Christou, E.A., and Lodha, N. (2022). Increased Temporal Stride Variability Contributes to Impaired Gait Coordination After Stroke. Sci. Rep., 12.10.1038/s41598-022-17017-1 ↗
38. Gill, S.V., Ogamba, M., and Lewis, C.L. (2016). Effects of Additional Anterior Body Mass on Gait. BMC Pregnancy Childbirth, 16.10.1186/s12884-016-0893-0 ↗
39. Spatiotemporal parameters during turning gait maneuvers of different amplitudes in young and elderly healthy adults: A descriptive and comparative study10.1016/j.gaitpost.2022.11.010 ↗
40. Madrid, J., Benning, L., Selig, M., Ulrich, B., Jolles, B.M., Favre, J., and Benninger, D.H. (2024). Slowing gait during turning: How volition of modifying walking speed affects the gait pattern in healthy adults. Front. Hum. Neurosci., 18.10.3389/fnhum.2024.1269772 ↗
41. Mancini, M., Smulders, K., Harker, G., Stuart, S., and Nutt, J.G. (2018). Assessment of the ability of open-and closed-loop cueing to improve turning and freezing in people with Parkinson’s disease. Sci. Rep., 8.10.1038/s41598-018-31156-4 ↗
42. Yogev-Seligmann, G., Josman, N., Bitterman, N., Rosenblum, S., Naaman, S., and Gilboa, Y. (2023). The development of a home-based technology to improve gait in people with Parkinson’s disease: A feasibility study. Biomed. Eng. Online, 22.10.1186/s12938-023-01066-2 ↗
43. Khan, O., Ahmed, I., Cottingham, J., Rahhal, M., Arvanitis, T.N., and Elliott, M.T. (2020). Timing and correction of stepping movements with a virtual reality avatar. PLoS ONE, 15.10.1371/journal.pone.0229641 ↗
44. The mirror-neuron system10.1146/annurev.neuro.27.070203.144230 ↗
45. Effect of action observation by subject type on the balance and the gait of stroke patients10.13066/kspm.2019.14.1.7 ↗
46. The effect of training stride length and stride frequency on increasing sprint speed10.59670/ml.v20i6.5079 ↗
47. Granatosky, M., and McElroy, E. (2022). Stride frequency or length? a phylogenetic approach to understand how animals regulate locomotor speed. J. Exp. Biol., 225.10.1242/jeb.243231 ↗
48. Comparison of effect of rhythmic auditory cueing versus rhythmic visual cueing on gait abnormalities with gait parameters in parkinson’s patients10.18231/j.ijn.2022.024 ↗
49. The effects of visual cues from optical stimulation devices on gait disturbance in patients with parkinson’s disease10.1589/jpts.35.230 ↗
50. Vaz, J., Rand, T., Fujan-Hansen, J., Mukherjee, M., and Stergiou, N. (2020). Auditory and visual external cues have different effects on spatial but similar effects on temporal measures of gait variability. Front. Physiol., 11.10.3389/fphys.2020.00067 ↗
51. The temporal pattern and the probability distribution of visual cueing can alter the structure of stride-to-stride variability10.1016/j.neulet.2021.136193 ↗
52. Self in motion: Sensorimotor and cognitive mechanisms in gait agency10.1152/jn.01042.2012 ↗
53. Walking with avatars: Gait-related visual information for following a virtual leader10.1016/j.humov.2019.04.003 ↗
54. Lyu, T., Yan, K., Lyu, J., Zhao, X., Wang, R., Zhang, C., Li, M., Xiong, C., Liu, C., and Wei, Y. (2023). Comparative efficacy of gait training for balance outcomes in patients with stroke: A systematic review and network meta-analysis. Front. Neurol., 14.10.3389/fneur.2023.1093779 ↗
55. Hove, M.J., Suzuki, K., Uchitomi, H., Orimo, S., and Miyake, Y. (2012). Interactive rhythmic auditory stimulation reinstates natural 1/f timing in gait of Parkinson’s patients. PLoS ONE, 7.10.1371/journal.pone.0032600 ↗
56. Interactive cueing with walk-mate for hemiparetic stroke rehabilitation10.1186/1743-0003-9-58 ↗
57. Into the groove: Can rhythm influence parkinson’s disease?10.1016/j.neubiorev.2013.08.003 ↗
58. Harrison, E., and Horin, A. (2018). Internal cueing improves gait more than external cueing in healthy adults and people with parkinson disease. Sci. Rep., 8.10.1038/s41598-018-33942-6 ↗
59. The effect of instruction to synchronize over step frequency while walking with auditory cues on a treadmill10.1016/j.humov.2013.11.006 ↗