GAIT FACILITATION PROGRAM USING A HORIZONTAL BICYCLE BUILT AND DESIGNED TO MONITOR KINETIC CHAIN PARAMETERS – CASE STUDY

Abstract

Introduction. Pedaling therapy is defined as a plan of physical activity prescribed to facilitate rehabilitation from immobilizing diseases and any conditions that disrupt the movement and activity of daily life or maintain well-being through neuro-reeducation, gait training, and therapeutic activities. 
Material and method. It was addressed in a case study of a 40 years female patient who presented with a physiotherapy indication for gait rehabilitation from the specialist physician after immobilization in plasterboard for four weeks, the postfracture status of the lateral malleolus of the left lower limb fibula. A personalized cycling program was applied for five weeks, period March-April 2022 using a pedaling system designed and built with plantar pressure sensors attached to the pedals to monitor outputs. There was performed gait analysis, joint and muscular testing using goniometry, Borg Cycling Scale for the perception of effort and rehabilitation zone correlations, and Visual Analog Scale (VAS) for pain. The patient’s risk chart is based on the bioimpedance parameters for determining the body composition using Zepp Analyzer. Heart rate reserve, as well as heart rate training, was calculated according to Karvonen's formula supervised with Smartwatch Huawei Watch GT 2 during the cycling rehabilitation program. The sensor signals attached to the pedals are converted to analog values for both feet and the force in Newton is measured according to the values transmitted.
Results and Conclusions. Rehabilitation treatment consisted of applying to the therapeutic program according to the rehabilitation phases for 5 weeks maintaining a perceptual level of 4/10 Borg (maintaining the resistance zone 2) with progressive intensity from level 3 to 5. After the rehabilitation program, average analog values between the two members were 219/240 - left / right respectively 0.89 / 0.98 N showing an insignificant force difference of 0.09 N in absolute value. The final evaluation of the joint balance by goniometry enhances exceeding the values of the functional-coefficient. Muscle balance registered an optimal value of 5/5 for the left foot. The pulse corresponding to the target range not exceeded 130. The kinetic chain deficit has improved, the muscle testing indicating a range of motion of 53 degrees in the ankle left joint versus 11 degrees after immobilization. Remission of edema after phase I (first week) proved an anti-inflammatory effect. Left foot support on the ground became possible without pain (VAS = 0). The application of the proposed pedaling program using the built horizontal device led to the achievement of the objectives regarding the facilitation of the ambulance, the system is reliable and technically functional.