The Immediate Effects of Different Types of Augmented Feedback on Fast Walking Speed Performance and Intrinsic Motivation After Stroke

Saleh M Alhirsan; Carmen E Capó-Lugo; Christopher P Hurt; Gitendra Uswatte; Haiyan Qu; David A Brown

doi:10.1016/j.arrct.2023.100265

The Immediate Effects of Different Types of Augmented Feedback on Fast Walking Speed Performance and Intrinsic Motivation After Stroke

Arch Rehabil Res Clin Transl. 2023 Apr 14;5(2):100265. doi: 10.1016/j.arrct.2023.100265. eCollection 2023 Jun.

Authors

Saleh M Alhirsan^{1

2}, Carmen E Capó-Lugo², Christopher P Hurt², Gitendra Uswatte³, Haiyan Qu⁴, David A Brown⁵

Affiliations

¹ Department of Physical Therapy, School of Applied Medical Sciences, Jouf University, Aljouf, Saudi Arabia.
² Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL.
³ Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL.
⁴ Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL.
⁵ Division of Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch, Galveston, TX.

Abstract

Objective: To examine the immediate effects of different types of augmented feedback on walking speed and intrinsic motivation post-stroke.

Design: A within-subjects repeated-measures design.

Setting: A university rehabilitation center.

Participants: Eighteen individuals with chronic stroke hemiparesis with a mean age of 55.67±13.63 years and median stroke onset of 36 (24, 81) months (N=18).

Interventions: Not applicable.

Primary outcome: Fast walking speed measured on a robotic treadmill for 13 meters without feedback and 13 meters with augmented feedback on each of the 3 experimental conditions: (1) without virtual reality (VR), (2) with a simple VR interface, and (3) with VR-exergame. Intrinsic motivation was measured using the Intrinsic Motivation Inventory (IMI).

Results: Although the differences were not statistically significant, fast-walking speed was higher in the augmented feedback without VR (0.86±0.44 m/s); simple VR interface (0.87±0.41 m/s); VR-exergame (0.87±0.44 m/s) conditions than in the fast-walking speed without feedback (0.81±0.40 m/s) condition. The type of feedback had a significant effect on intrinsic motivation (P=.04). The post hoc analysis revealed borderline significance on IMI-interest and enjoyment between the VR-exergame condition and the without-VR condition (P=.091).

Conclusion: Augmenting feedback affected the intrinsic motivation and enjoyment of adults with stroke asked to walk fast on a robotic treadmill. Additional studies with larger samples are warranted to examine the relations among these aspects of motivation and ambulation training outcomes.

Keywords: Feedback; Motivation; Rehabilitation; Stroke; Walking speed.