A haptic floor for interaction and diagnostics with goal based tasks during virtual reality supported balance training.

Background : Balance training of patients after stroke is one of the primary tasks of physiotherapy after the hospitalization. It is based on the intensive training, which consists of simple, repetitive, goal-based tasks. The tasks are carried out by physiotherapists, who follow predefined protocols. Introduction of a standing frame and a virtual reality decrease the physical load and number of required physiotherapists. The patients benefit in terms of safety and increased motivation. Additional feedback – haptic floor can enhance the virtual reality experience, add additional level of difficulty and could be also used for generating postural perturbations. The purpose of this article is to examine whether haptic information can be used to identify specific anomalies in dynamic posturography. Methods : The performance and stability of closed-loop system of the haptic floor were tested using frequency analysis. A postural response normative was set up from data assessed in four healthy individuals who were exposed to unexpected movements of the haptic floor in eight directions. Postural responses of a patient after stroke participating in virtual reality supported balance training, where collisions resulted in floor movements, were assessed and contrasted to the normative. Results : Haptic floor system was stable and controllable up to the frequency of 1.1 Hz, sufficient for the generation of postural perturbations. Responses obtained after perturbations in two major directions for a patient after stroke demonstrated noticeable deviations from the normative. Conclusions : Haptic floor design, together with a standing frame and a virtual reality used for balance training, enables an assessment of directionally specific postural responses. The system was designed to identify postural disorders during balance training and rehabilitation progress outside specialized clinics, e.g. at patient’s home.