The Effects of Real-Time Haptic Feedback on Gait and Cognitive Load in Older Adults

Gait speed is a key indicator of mobility and health in older adults, with declines often reflecting neuromotor deficits rather than musculoskeletal or cardiopulmonary limitations. This study presents a wearable smartphone-based haptic feedback system that applies feedback to the thighs to increase...

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Main Authors: Ehsan Sharafian M., Colby Ellis, Ben Sidaway, Marie Hayes, Babak Hejrati
Format: Article
Language:English
Published: IEEE 2025-01-01
Series:IEEE Transactions on Neural Systems and Rehabilitation Engineering
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Online Access:https://ieeexplore.ieee.org/document/11030669/
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author Ehsan Sharafian M.
Colby Ellis
Ben Sidaway
Marie Hayes
Babak Hejrati
author_facet Ehsan Sharafian M.
Colby Ellis
Ben Sidaway
Marie Hayes
Babak Hejrati
author_sort Ehsan Sharafian M.
collection DOAJ
description Gait speed is a key indicator of mobility and health in older adults, with declines often reflecting neuromotor deficits rather than musculoskeletal or cardiopulmonary limitations. This study presents a wearable smartphone-based haptic feedback system that applies feedback to the thighs to increase peak thigh extension (PTE) and, consequently, improve stride length and walking speed. Thirty community-dwelling older adults (<inline-formula> <tex-math notation="LaTeX">${79}.{9}~ {\pm }~{6}.{5}$ </tex-math></inline-formula> years) participated in this study. Three treatment conditions were evaluated: (1) tactile feedback due to incorrect response when PTE was below the target (<inline-formula> <tex-math notation="LaTeX">${F}_{\text {IR}}$ </tex-math></inline-formula>); (2) tactile feedback due to correct response when the target PTE was met (<inline-formula> <tex-math notation="LaTeX">${F}_{\textit {CR} }$ </tex-math></inline-formula>); and (3) verbal instructions (<inline-formula> <tex-math notation="LaTeX">${I}_{\boldsymbol {V}}$ </tex-math></inline-formula>) without feedback. Cognitive demand during treatment was assessed using a probe reaction time task. Walking trials comparing baseline with treatment conditions were conducted. We found significant differences for all gait parameters across walking trials (<inline-formula> <tex-math notation="LaTeX">$\mathit {p} \lt {0}.{001}$ </tex-math></inline-formula>), but no significant difference among the three treatment conditions. The haptic feedback system significantly increased stride length by 14% and gait speed by 18%. Gains in speed and stride length were achieved using the haptic system during a single session, comparable to following verbal instructions. Although no statistical difference was found across treatments, thigh feedback employed a different mechanism than verbal instructions for attaining greater speed. Adding haptic feedback increased reaction time, but these increases were small (<inline-formula> <tex-math notation="LaTeX">${F}_{\textit {IR} }$ </tex-math></inline-formula>: 27ms, <inline-formula> <tex-math notation="LaTeX">${F}_{\textit {CR} }$ </tex-math></inline-formula>: 74ms), indicating minimal cognitive load. The observed gait improvements suggest haptic feedback is a viable option for gait training for older adults.
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spelling doaj-art-59d782bc912f484dbc3e2276922e4be32025-08-20T02:35:50ZengIEEEIEEE Transactions on Neural Systems and Rehabilitation Engineering1534-43201558-02102025-01-01332335234410.1109/TNSRE.2025.357886511030669The Effects of Real-Time Haptic Feedback on Gait and Cognitive Load in Older AdultsEhsan Sharafian M.0https://orcid.org/0009-0001-8165-7375Colby Ellis1https://orcid.org/0009-0006-2543-7761Ben Sidaway2Marie Hayes3https://orcid.org/0000-0002-7240-4966Babak Hejrati4https://orcid.org/0000-0002-3134-8128Department of Mechanical Engineering, The University of Maine, Orono, ME, USADepartment of Mechanical Engineering, The University of Maine, Orono, ME, USASchool of Physical Therapy, Husson University, Bangor, ME, USADepartment of Psychology, The University of Maine, Orono, ME, USADepartment of Mechanical Engineering, The University of Maine, Orono, ME, USAGait speed is a key indicator of mobility and health in older adults, with declines often reflecting neuromotor deficits rather than musculoskeletal or cardiopulmonary limitations. This study presents a wearable smartphone-based haptic feedback system that applies feedback to the thighs to increase peak thigh extension (PTE) and, consequently, improve stride length and walking speed. Thirty community-dwelling older adults (<inline-formula> <tex-math notation="LaTeX">${79}.{9}~ {\pm }~{6}.{5}$ </tex-math></inline-formula> years) participated in this study. Three treatment conditions were evaluated: (1) tactile feedback due to incorrect response when PTE was below the target (<inline-formula> <tex-math notation="LaTeX">${F}_{\text {IR}}$ </tex-math></inline-formula>); (2) tactile feedback due to correct response when the target PTE was met (<inline-formula> <tex-math notation="LaTeX">${F}_{\textit {CR} }$ </tex-math></inline-formula>); and (3) verbal instructions (<inline-formula> <tex-math notation="LaTeX">${I}_{\boldsymbol {V}}$ </tex-math></inline-formula>) without feedback. Cognitive demand during treatment was assessed using a probe reaction time task. Walking trials comparing baseline with treatment conditions were conducted. We found significant differences for all gait parameters across walking trials (<inline-formula> <tex-math notation="LaTeX">$\mathit {p} \lt {0}.{001}$ </tex-math></inline-formula>), but no significant difference among the three treatment conditions. The haptic feedback system significantly increased stride length by 14% and gait speed by 18%. Gains in speed and stride length were achieved using the haptic system during a single session, comparable to following verbal instructions. Although no statistical difference was found across treatments, thigh feedback employed a different mechanism than verbal instructions for attaining greater speed. Adding haptic feedback increased reaction time, but these increases were small (<inline-formula> <tex-math notation="LaTeX">${F}_{\textit {IR} }$ </tex-math></inline-formula>: 27ms, <inline-formula> <tex-math notation="LaTeX">${F}_{\textit {CR} }$ </tex-math></inline-formula>: 74ms), indicating minimal cognitive load. The observed gait improvements suggest haptic feedback is a viable option for gait training for older adults.https://ieeexplore.ieee.org/document/11030669/Gait trainingolder adultshaptic feedbackcognitive loadstride length
spellingShingle Ehsan Sharafian M.
Colby Ellis
Ben Sidaway
Marie Hayes
Babak Hejrati
The Effects of Real-Time Haptic Feedback on Gait and Cognitive Load in Older Adults
IEEE Transactions on Neural Systems and Rehabilitation Engineering
Gait training
older adults
haptic feedback
cognitive load
stride length
title The Effects of Real-Time Haptic Feedback on Gait and Cognitive Load in Older Adults
title_full The Effects of Real-Time Haptic Feedback on Gait and Cognitive Load in Older Adults
title_fullStr The Effects of Real-Time Haptic Feedback on Gait and Cognitive Load in Older Adults
title_full_unstemmed The Effects of Real-Time Haptic Feedback on Gait and Cognitive Load in Older Adults
title_short The Effects of Real-Time Haptic Feedback on Gait and Cognitive Load in Older Adults
title_sort effects of real time haptic feedback on gait and cognitive load in older adults
topic Gait training
older adults
haptic feedback
cognitive load
stride length
url https://ieeexplore.ieee.org/document/11030669/
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