In Subacute to Chronic Neurologic Patients, What Is the Effect of Stochastic Resonance (Accelera) on Gait Outcome Measures? A Pilot for Feasibility

Research Objectives: To determine the feasibility of stochastic resonance (Accelera) use in a clinical setting.
Secondary aims are: To explore stochastic resonance (Accelera) use and gait outcomes in the subacute to chronic neurologic population.

Design: A retrospective observational approach was utilized to pilot use and understand the feasibility of use of stochastic resonance (SR) in clinical gait training sessions. The Accelera SR-100 is a commercially available piece of technology that uses vibration in a given range of frequencies, to elicit a sensory stimulus when donned on a patient’s extremity. Although SR has been utilized in populations with peripheral neuropathy and cerebral palsy, it is less known if this augmented intervention could be useful during subacute to chronic rehabilitation. The device was used within its indicated uses on people presenting with gait impairment.

Setting: This setting is an outpatient neurologic clinic.

Participants: We will conduct retrospective analysis of patients’ records for all patients who utilized the device and were (1) diagnosed with a neurologic condition (2) ambulatory with or without assistance (3) and walked at a self-selected gait speed of less than 1.4 meters per second.

Interventions: SR was utilized during conventional skilled PT with high intensity gait training. Participants also performed balance or any postural neuromuscular reeducation, strength training, transfer training, and gait training on varied surfaces.

Main Outcome Measures: For feasibility, the number of sessions used, patient comfort, and the donning and doffing time will be described. Functional gait and balance outcomes include 10-meter walk test, 6-minute walk test, Timed Up and Go Test, and Activities-Specific Balance Confidence Scale. Changes in spasticity were measured with Modified Ashworth Scale.

Results: SR via the Accelera was utilized as an augmented intervention. From a smartphone, it requires less than five minutes to connect the device, as well as don and doff the device. SR as an augmented intervention was especially useful working with a patient with high spasticity during ambulation.
Three subjects with significant spasticity have participated in sessions with the device. This is an ongoing study and data is still being collected at this time. Participants had no adverse effects.

Conclusions: Use of stochastic resonance during gait training is feasible and time efficient. It appears helfpul during gait sessions, but full analysis of outcomes is to be completed. With these preliminary results, more investigation into the effectiveness of stochastic resonance as a neuromodulating technique for gait training is needed.

Author(s) Disclosures: The authors have nothing to disclose.