{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T00:16:38Z","timestamp":1760228198093,"version":"build-2065373602"},"reference-count":52,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T00:00:00Z","timestamp":1652140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Michigan-Shanghai Jiao Tong University Collaboration on Nanotechnology for Energy and Biomedical Applications","award":["14X120010006","P30 AG024824","P30 AG024827","RTNR"],"award-info":[{"award-number":["14X120010006","P30 AG024824","P30 AG024827","RTNR"]}]},{"name":"University of Michigan Older Americans Independence Center","award":["14X120010006","P30 AG024824","P30 AG024827","RTNR"],"award-info":[{"award-number":["14X120010006","P30 AG024824","P30 AG024827","RTNR"]}]},{"name":"University of Pittsburgh Older Americans Independence Center","award":["14X120010006","P30 AG024824","P30 AG024827","RTNR"],"award-info":[{"award-number":["14X120010006","P30 AG024824","P30 AG024827","RTNR"]}]},{"name":"The Hong Kong Polytechnic University Research Studentship","award":["14X120010006","P30 AG024824","P30 AG024827","RTNR"],"award-info":[{"award-number":["14X120010006","P30 AG024824","P30 AG024827","RTNR"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Slip-induced falls, responsible for approximately 40% of falls, can lead to severe injuries and in extreme cases, death. A large foot\u2013floor contact angle (FFCA) during the heel-strike event has been associated with an increased risk of slip-induced falls. The goals of this feasibility study were to design and assess a method for detecting FFCA and providing cues to the user to generate a compensatory FFCA response during a future heel-strike event. The long-term goal of this research is to train gait in order to minimize the likelihood of a slip event due to a large FFCA. An inertial measurement unit (IMU) was used to estimate FFCA, and a speaker provided auditory semi-real-time feedback when the FFCA was outside of a 10\u201320 degree target range following a heel-strike event. In addition to training with the FFCA feedback during a 10-min treadmill training period, the healthy young participants completed pre- and post-training overground walking trials. Results showed that training with FFCA feedback increased FFCA events within the target range by 16% for \u201chigh-risk\u201d walkers (i.e., participants that walked with more than 75% of their FFCAs outside the target range) both during feedback treadmill trials and post-training overground trials without feedback, supporting the feasibility of training FFCA using a semi-real-time FFCA feedback system.<\/jats:p>","DOI":"10.3390\/s22103641","type":"journal-article","created":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T21:52:11Z","timestamp":1652219531000},"page":"3641","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Reducing Slip Risk: A Feasibility Study of Gait Training with Semi-Real-Time Feedback of Foot\u2013Floor Contact Angle"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6507-2329","authenticated-orcid":false,"given":"Christina Zong-Hao","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA"},{"name":"Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7310-3436","authenticated-orcid":false,"given":"Tian","family":"Bao","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6576-4904","authenticated-orcid":false,"given":"Christopher A.","family":"DiCesare","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA"}]},{"given":"Isaac","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA"}]},{"given":"April","family":"Chambers","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15260, USA"},{"name":"Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA 15260, USA"}]},{"given":"Peter B.","family":"Shull","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3407-9226","authenticated-orcid":false,"given":"Yong-Ping","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China"}]},{"given":"Rakie","family":"Cham","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15260, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7967-6788","authenticated-orcid":false,"given":"Kathleen H.","family":"Sienko","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI 48109, USA"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1007\/s001980070086","article-title":"Fracture risk associated with a fall according to type of fall among the elderly","volume":"11","author":"Luukinen","year":"2000","journal-title":"Osteoporos. Int."},{"key":"ref_2","first-page":"861","article-title":"State of science: Occupational slips, trips and falls on the same level","volume":"59","author":"Chang","year":"2016","journal-title":"Ergonomics"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1080\/00140139.2013.787122","article-title":"Biomechanical characteristics of slipping during unconstrained walking, turning, gait initiation and termination","volume":"56","author":"Nagano","year":"2013","journal-title":"Ergonomics"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"225","DOI":"10.3233\/OER-2003-3404","article-title":"Kinematics of the foot during slips","volume":"3","author":"Chambers","year":"2002","journal-title":"Occup. Ergon."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/S0966-6362(01)00150-3","article-title":"Changes in gait when anticipating slippery floors","volume":"15","author":"Cham","year":"2002","journal-title":"Gait Posture"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1080\/00140130500478553","article-title":"Gait parameters as predictors of slip severity in younger and older adults","volume":"49","author":"Moyer","year":"2006","journal-title":"Ergonomics"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.gaitpost.2008.12.012","article-title":"Biomechanics of trailing leg response to slipping-Evidence of interlimb and intralimb coordination","volume":"29","author":"Moyer","year":"2009","journal-title":"Gait Posture"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/S0925-7535(01)00059-5","article-title":"Heel contact dynamics during slip events on level and inclined surfaces","volume":"40","author":"Cham","year":"2002","journal-title":"Saf. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"471","DOI":"10.7547\/1030471","article-title":"Effects of nonslip socks on the gait patterns of older people when walking on a slippery surface","volume":"103","author":"Hatton","year":"2013","journal-title":"J. Am. Podiatr. Med. Assoc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1123\/japa.2019-0293","article-title":"Can Insoles Be Used to Improve Static and Dynamic Balance of Community-Dwelling Older Adults? A Systematic Review on Recent Advances and Future Perspectives","volume":"28","author":"Ma","year":"2020","journal-title":"J. Aging Phys. Act."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"103663","DOI":"10.1016\/j.apergo.2021.103663","article-title":"In contrast to slip-resistant shoes, fluid drainage capacity explains friction performance across shoes that are not slip-resistant","volume":"100","author":"Meehan","year":"2022","journal-title":"Appl. Ergon."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.jbiomech.2018.04.018","article-title":"Kinematics and kinetics of the shoe during human slips","volume":"74","author":"Iraqi","year":"2018","journal-title":"J. Biomech."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.jbiomech.2015.11.021","article-title":"Generalization of treadmill perturbation to overground slip during gait: Effect of different perturbation distances on slip recovery","volume":"49","author":"Lee","year":"2016","journal-title":"J. Biomech."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1080\/21577323.2013.815139","article-title":"Changes in walking characteristics of young and older adults when anticipating slippery floors","volume":"1","author":"Chambers","year":"2013","journal-title":"IIE Trans. Occup. Ergon. Hum. Factors"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/1743-0003-9-10","article-title":"Cell phone based balance trainer","volume":"9","author":"Lee","year":"2012","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/1743-0003-9-53","article-title":"Biofeedback improves postural control recovery from multi-axis discrete perturbations","volume":"9","author":"Sienko","year":"2012","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_17","first-page":"iv28","article-title":"A Newly-Developed Smart Insole System with Instant Reminder: Paves the Way towards Integrating Artificial Intelligence (AI) Technology to Improve Balance and Prevent Falls","volume":"48","author":"Ma","year":"2019","journal-title":"Age Ageing"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"63","DOI":"10.3233\/VES-170606","article-title":"The role of sensory augmentation for people with vestibular deficits: Real-time balance aid and\/or rehabilitation device?","volume":"27","author":"Sienko","year":"2017","journal-title":"J. Vestib. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"944","DOI":"10.3389\/fneur.2018.00944","article-title":"Potential mechanisms of sensory augmentation systems on human balance control","volume":"9","author":"Sienko","year":"2018","journal-title":"Front. Neurol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s12984-015-0055-z","article-title":"Haptic wearables as sensory replacement, sensory augmentation and trainer\u2014A review","volume":"12","author":"Shull","year":"2015","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"323","DOI":"10.3233\/VES-190683","article-title":"Effects of long-term vestibular rehabilitation therapy with vibrotactile sensory augmentation for people with unilateral vestibular disorders\u2014A randomized preliminary study","volume":"29","author":"Bao","year":"2019","journal-title":"J. Vestib. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s12984-017-0339-6","article-title":"Effects of long-term balance training with vibrotactile sensory augmentation among community-dwelling healthy older adults: A randomized preliminary study","volume":"15","author":"Bao","year":"2018","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"31709","DOI":"10.3390\/s151229883","article-title":"A vibrotactile and plantar force measurement-based biofeedback system: Paving the way towards wearable balance-improving devices","volume":"15","author":"Ma","year":"2015","journal-title":"Sensors"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.humov.2017.07.006","article-title":"A wearable vibrotactile biofeedback system improves balance control of healthy young adults following perturbations from quiet stance","volume":"55","author":"Ma","year":"2017","journal-title":"Hum. Mov. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Ma, C.Z.-H., Wong, D., Lam, W., Wan, A., and Lee, W. (2016). Balance improvement effects of biofeedback systems with state-of-the-art wearable sensors: A systematic review. Sensors, 16.","DOI":"10.3390\/s16040434"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Ma, C.Z., Wan, A.H., Wong, D.W., Zheng, Y.-P., and Lee, W.C. (2014, January 8\u201310). Improving postural control using a portable plantar pressure-based vibrotactile biofeedback system. Proceedings of the 2014 IEEE Conference on Biomedical Engineering and Sciences (IECBES), Kuala Lumpur, Malaysia.","DOI":"10.1109\/IECBES.2014.7047632"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/1743-0003-10-93","article-title":"The effect of vibrotactile feedback on postural sway during locomotor activities","volume":"10","author":"Sienko","year":"2013","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1159\/000481454","article-title":"Effects of wearable sensor-based balance and gait training on balance, gait, and functional performance in healthy and patient populations: A systematic review and meta-analysis of randomized controlled trials","volume":"64","author":"Gordt","year":"2018","journal-title":"Gerontology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.gaitpost.2014.03.189","article-title":"Quantified self and human movement: A review on the clinical impact of wearable sensing and feedback for gait analysis and intervention","volume":"40","author":"Shull","year":"2014","journal-title":"Gait Posture"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.apmr.2016.07.006","article-title":"Gait retraining with real-time biofeedback to reduce knee adduction moment: Systematic review of effects and methods used","volume":"98","author":"Richards","year":"2017","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1080\/10749357.2017.1380339","article-title":"Changes in gait and plantar foot loading upon using vibrotactile wearable biofeedback system in patients with stroke","volume":"25","author":"Ma","year":"2018","journal-title":"Top. Stroke Rehabil."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1186\/s12984-017-0313-3","article-title":"Configurable, wearable sensing and vibrotactile feedback system for real-time postural balance and gait training: Proof-of-concept","volume":"14","author":"Xu","year":"2017","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_33","first-page":"20556683211014125","article-title":"Feasibility of a real-time pattern-based kinematic feedback system for gait retraining in pediatric cerebral palsy","volume":"8","author":"Liu","year":"2021","journal-title":"J. Rehabil. Assist. Technol. Eng."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s12984-018-0389-4","article-title":"Trainer in a pocket-proof-of-concept of mobile, real-time, foot kinematics feedback for gait pattern normalization in individuals after stroke, incomplete spinal cord injury and elderly patients","volume":"15","author":"Nisser","year":"2018","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1016\/j.jbiomech.2011.03.016","article-title":"Training multi-parameter gaits to reduce the knee adduction moment with data-driven models and haptic feedback","volume":"44","author":"Shull","year":"2011","journal-title":"J. Biomech."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.physio.2010.12.004","article-title":"Normal walking speed: A descriptive meta-analysis","volume":"97","author":"Bohannon","year":"2011","journal-title":"Physiotherapy"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1016\/j.gaitpost.2013.02.005","article-title":"The effects of treadmill or overground walking training program on gait in Parkinson\u2019s disease","volume":"38","author":"Bello","year":"2013","journal-title":"Gait Posture"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1109\/TOH.2017.2689023","article-title":"Continuous Movement Tracking Performance for Predictable and Unpredictable Tasks With Vibrotactile Feedback","volume":"10","author":"Shull","year":"2017","journal-title":"IEEE Trans. Haptics"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1167\/jov.21.9.2023","article-title":"Walking speed and trunk sway: Influence of an approaching person\u2019s gait pattern on collision avoidance","volume":"21","author":"Bourgaize","year":"2021","journal-title":"J. Vis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1080\/00222895.1987.10735403","article-title":"Using relative motion plots to measure changes in intra-limb and inter-limb coordination","volume":"19","author":"Sparrow","year":"1987","journal-title":"J. Mot. Behav."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"3101","DOI":"10.1016\/j.jbiomech.2008.07.024","article-title":"Quantifying rearfoot\u2013forefoot coordination in human walking","volume":"41","author":"Chang","year":"2008","journal-title":"J. Biomech."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1080\/00222895.2017.1371111","article-title":"Investigating the constrained action hypothesis: A movement coordination and coordination variability approach","volume":"50","author":"Vidal","year":"2018","journal-title":"J. Mot. Behav."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Button, C., Davids, K., and Schollhorn, W. (2006). Coordination profiling of movement systems. Mov. Syst. Var., 133\u2013152.","DOI":"10.5040\/9781492596851.ch-007"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"101678","DOI":"10.1016\/j.foot.2020.101678","article-title":"Analysing patterns of coordination and patterns of control using novel data visualisation techniques in vector coding","volume":"44","author":"Needham","year":"2020","journal-title":"Foot"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Xu, J., Lee, U.H., Bao, T., Huang, Y., Sienko, K.H., and Shull, P.B. (2017, January 9\u201312). Wearable sensing and haptic feedback research platform for gait retraining. Proceedings of the 2017 IEEE 14th International Conference on Wearable and Implantable Body Sensor Networks (BSN), Eindhoven, The Netherlands.","DOI":"10.1109\/BSN.2017.7936023"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1186\/s12984-018-0419-2","article-title":"Validation of wearable visual feedback for retraining foot progression angle using inertial sensors and an augmented reality headset","volume":"15","author":"Karatsidis","year":"2018","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_47","first-page":"3812602","article-title":"The efficacy of gait training using a body weight support treadmill and visual biofeedback in patients with subacute stroke: A randomized controlled trial","volume":"2018","author":"Przysada","year":"2018","journal-title":"BioMed Res. Int."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1016\/j.apmr.2016.11.022","article-title":"Effects of gait training with body weight support on a treadmill versus overground in individuals with stroke","volume":"98","author":"Gama","year":"2017","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"102673","DOI":"10.1016\/j.humov.2020.102673","article-title":"Changes in coordination and variability during running as a function of head stability demands","volume":"73","author":"Lim","year":"2020","journal-title":"Hum. Mov. Sci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"011010","DOI":"10.1115\/1.4047993","article-title":"Enhancing the Accuracy of Vertical Ground Reaction Force Measurement During Walking Using Pressure-Measuring Insoles","volume":"143","author":"DeBerardinis","year":"2021","journal-title":"J. Biomech. Eng."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1123\/japa.2016-0136","article-title":"Comprehensive gait analysis of healthy older adults who have undergone long-distance walking","volume":"25","author":"Elhadi","year":"2017","journal-title":"J. Aging Phys. Act."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.gaitpost.2018.05.032","article-title":"Biomechanical Approach in Facilitating Long-Distance Walking of Elderly People Using Footwear Modifications","volume":"64","author":"Elhadi","year":"2018","journal-title":"Gait Posture"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/10\/3641\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:08:59Z","timestamp":1760137739000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/22\/10\/3641"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,10]]},"references-count":52,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["s22103641"],"URL":"https:\/\/doi.org\/10.3390\/s22103641","relation":{},"ISSN":["1424-8220"],"issn-type":[{"type":"electronic","value":"1424-8220"}],"subject":[],"published":{"date-parts":[[2022,5,10]]}}}