Derrick Lim and Dr. Kei Masani
​Study first author Derrick Lim, (L), is a PhD candidate in the lab of Dr. Kei Masani, a Senior Scientist at UHN's KITE Research Institute and senior author of the study. (Photo: UHN Research Communications)

By UHN Research Communications

Researchers from UHN's KITE Research Institute have investigated a new affordable and clinically accessible training system for improving the standing balance of spinal cord injury patients.

Spinal cord injury affects approximately 85,000 Canadians every year.

Individuals with incomplete spinal cord injury can regain their ability to walk. However, a majority of these individuals experience falls at least once a year.

Falling can reduce mobility, physical activity and also quality of life. Balance therapy helps increase muscle strength and reaction but relies on an individual's vision to help maintain standing balance.

Visual feedback balance training (VFBT) is a training method that incorporates visual cues to help improve balance and postural control. It involves shifting your body toward a target location on a screen.

Functional electrical stimulation is an additional rehabilitation technique that uses electrical impulses to activate muscles, helping individuals regain movement and improve function.

Researchers have explored combining VFBT with functional electrical stimulation as a comprehensive rehabilitation approach for improving balance control. However, these rehabilitation systems traditionally rely on costly force plates to measure a participant's movement.

The team led by Dr. Kei Masani, Senior Scientist at KITE and senior author of the study, investigated the integration of low-cost and portable sensors like a depth camera and pressure mat, which use motion tracking and distribution of pressure, respectively, to analyze movement.

The effectiveness of these sensors was put to the test by measuring the movements of 10 able-bodied participants – with no history of neurological disorders – as they completed balance rehabilitation exercises using the combined VFBT and functional electrical stimulation system.

A schematic of the combined visual feedback balance training (VFBT) and functional electrical stimulation system, (L), along with examples of VFBT exercises. (Photo: Getty Images)

Researchers found that the depth camera outperformed the pressure mat, showing higher accuracy and lower error relative to the force plate, in capturing crucial balance and movement measures.

These results suggest that the depth camera could replace the force plate in the VFBT and functional electrical stimulation rehabilitation system.

Derrick Lim, PhD candidate in the lab of Dr. Masani and first author of the study, is enthusiastic about these findings.

"This study marks a significant step to making rehabilitation more accessible and effective for individuals with spinal cord injuries," he says. "The use of affordable sensors opens doors to broader implementation in clinical settings, ultimately improving the quality of life for patients."

Future work will focus on using this system with individuals who have experienced spinal cord injury and have poorer balance capabilities. It has potential applications in other populations who experience neurological damage resulting in balance impairments, such as adults living with stroke.

This work was supported through the Collaborative Health Research Projects program, a joint initiative between both, the Canadian Institutes of Health Research (CIHR) and the Natural Sciences and Engineering Research Council of Canada (NSERC), as well as UHN Foundation. Dr. Kei Masani is an associate professor at the Institute of Biomedical Engineering at the University of Toronto.

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