The intent of the following research is to utilize task-specific, constraint-induced therapies and apply towards dynamic training for symmetrical balance. Modifications to an elliptical trainer were made to both measure weight distributions during dynamic stance as well as provide kinetic biofeedback through a man-machine interface. Following a review of the background, which includes research from several decades that are seminal to current studies, a design review is discussed to cover the design of the modified elliptical (Chapter 2). An initial study was conducted in a healthy sample population in order to determine the best visual biofeedback representation by comparing different man-machine interfaces (Chapter 3). Index of gait symmetry measures indicated that one display interface optimized participant performance during activity with the modified elliptical trainer. A second study was designed to determine the effects of manipulating the gain of the signal to encourage increased distribution towards the non-dominant weight bearing limb. The purpose of the second study was to better understand the threshold value of gain manipulation in a healthy sample set. Results analyzing percentage error as a measure of performance show that a range between 5-10% allows for a suitable threshold value to be applied for participants who have suffered a stroke. A final study was conducted to apply results/knowledge from the previous two studies to a stroke cohort to determine short-term carryover following training with the modified elliptical trainer. Data taken from force measurements on the elliptical trainer suggest that there was carryover with decreased error from pre to post training. For one participant GaitRite® data show a significant difference from pre to post measurements in single limb support. The results of the research suggest that visual biofeedback can improve symmetrical performance during dynamic patterns. For a better understanding of visual biofeedback delivery, one display representation proved to be beneficial compared to the others which resulted in improved performance. Results show that healthy human participants can minimize error with visual biofeedback and continue minimizing error until a threshold value of 10%. Finally, results have shown promise towards applying such a system for kinetic gait rehabilitation.

Background: Ultrasound Tongue Imaging (UTI) is growing increasingly popular for assessing and treating Speech Sound Disorders (SSDs) and has more recently been used to qualitatively investigate compensatory articulations in speakers with cleft palate (CP). However, its therapeutic application for speakers with CP remains to be tested. A different set of developments, Visual Articulatory Models (VAMs), provide an offline dynamic model with context for lingual patterns. However, unlike UTI, they do not provide real-time biofeedback. Commercially available VAMs, such as Speech Trainer 3D, are available on iDevices, yet their clinical application remains to be tested. Aims: This thesis aims to test the diagnostic use of ultrasound, and investigate the effectiveness of both UTI and VAMs for the treatment of SSDs associated with submucous cleft palate (SMCP). Method: Using a single-subject multiple baseline design, two males with repaired SMCP, Andrew (aged 9;2) and Craig (aged 6;2), received six assessment sessions and two blocks of therapy, following a motor-based therapy approach, using VAMs and UTI. Three methods were used to measure therapy outcomes. Firstly, percent target consonant correct scores, derived from phonetic transcriptions provide outcomes comparable to those used in typical practice. Secondly, a multiplephonetically trained listener perceptual evaluation, using a two-alternative multiple forced choice design, to measure listener agreement provides a more objective measure. Thirdly, articulatory analysis, using qualitative and quantitative measures provides an additional perspective able to reveal covert errors. Results and Conclusions: There was overall improvement in the speech for both speakers, with a greater rate of change in therapy block one (VAMs) and listener agreement in the perceptual evaluation. Articulatory analysis supplemented phonetic transcriptions and detected covert articulations and covert contrast as well as supporting the improvements in auditory outcome scores. Both VAMs and UTI show promise as a clinical tool for the treatment of SSDs associated with CP.

The aim of this thesis was to evaluate the effect of rehabilitation with visual biofeedback at acute stage after vestibular schwannoma surgery and to evaluate if preoperative intratympanic aplication of gentamicin has influence on vestibular compensation of standing stability. The study was attended by 20 patients (12 women and 8 men) in the age from 28 to 63 years. Eight patients had vestibular schwannoma diagnosed in their left side, twelve in the right side. Rehabilitation program using interactive rehabilitation system Homebalance took place from the 5th postoperative day until hospital discharge, daily 15 to 20 min. To evaluate of therapeutic intervention objectively the device Synapsys Posturography System was used. Stabilometric examination was done before operation of vestibular schwannoma, after operation and after termination of rehabilitation with visual biofeedback. Statistic analysis showed significant increase of mean values of measured parameters CoP (sway velocity CoP, length of trajectory of CoP, area of the confidence ellipse CoP) postoperatively compared to preoperative values. After termination of therapeutic intervention there was any significant decrease of values of parameters CoP compared to postoperative status. Between group of patients with preoperative aplication of...

The thesis deals with the evaluation of gait and balance tests in patients after vestibular schwannoma surgery. The experimental part focuses on the evaluation of dynamics of walking tests during hospitalization of patients diagnosed with vestibular schwannoma. The aim of the experimental part is also to analyze statistically significant correlations between measurable parameters of vestibulo-ocular reflex and walking tests and to evaluate the correlation between the subjective scale of fall fear and the objective assessment of walking and dynamic postural stability. A total of 28 patients aged 33 to 68 (14 men and 14 women) were incuded in the research with diagnosed vestibular schwannoma. Measurements were performed three times in patients (before surgery, after surgery and before the end of hospitalization). After the surgery, in addition to standard rehabilitation, training with visual biofeedback was included using the interactive Homebalance system. Gait and balance assessments were performed throug the tests Timed Up and Go, Four Step Square Test and Functional Gait Assessment. Examinations were complemented by a questionnaire of subjective assessment of fear of falling Falls Efficacy Scale. Statistical analysis showed a significant correlation coefficient in the correlation of Four Step...