Real-Time Kinematic, Temporospatial, and Kinetic Biofeedback During Gait Retraining in Patients: A Systematic Review

Background. Biofeedback has been used in rehabilitation settings for gait retraining. Purpose. The purpose of this review was to summarize and synthesize the findings of studies involving real-time kinematic, temporospatial, and kinetic biofeedback. The goal was to provide a general overview of the effectiveness of these forms of biofeedback in treating gait abnormalities. Data Sources. Articles were identified through searches of the following data-bases: MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Cochrane Central Register for Controlled Trials. All searches were limited to the English language and encompassed the period from 1965 to November 2007. Study Selection. Titles and abstracts were screened to identify studies that met the following requirements: the study included the use of kinematic, temporospatial, or kinetic biofeedback during gait training, and the population of interest showed abnormal movement patterns as a result of a pathology or injury. Data Extraction. All articles that met the inclusion criteria were assessed by use of the Methodological Index for Nonrandomized Studies. Data Synthesis. Seven articles met the inclusion criteria and were included in the review. Effect sizes were calculated for the primary outcome variables for all studies that provided enough data. Effect sizes generally suggested moderate to large treatment effects for all methods of biofeedback during practice. Limitations. Several of the studies lacked adequate randomization; therefore, readers should exercise caution when interpreting authors' conclusions. Conclusions. Each biofeedback method appeared to result in moderate to large treatment effects immediately after treatment. However, it is unknown whether the effects were maintained. Future studies should ensure adequate randomization of participants and implementation of motor learning concepts and should include retention testing to assess the long-term success of biofeedback and outcome measures capable of demonstrating coordinative changes in gait and improvement in function.