14 Chapter 1 Box 2. C-MILL The C-Mill1,2 (Motek, Amsterdam, The Netherlands) is a treadmill setup with a walking area of 1x3meters, integrated force plates, a projector, and a safety frame. Visual context (e.g., stepping targets or obstacles) can be projected onto the walking surface to create an augmented reality environment. This is done in an interactive manner. Due to online monitoring of the position and timing of foot placement of the user via the integrated force plates, the visual context can be projected in a gait-dependent manner, and realtime feedback of success or failure can be provided. The C-Mill has specifically been designed to train gait adaptability in a context-specific manner. It offers various tasks, including goal-directed stepping, obstacle negotiation and adaptation to various walking speed. This mimics daily life, as walking in the community requires a person to be able to adapt their gait to meet environmental demands, such as negotiating one’s way through a cluttered terrain, increasing walking speed for a green traffic light, or slowing down speed in a crowded area. The C-Mill provides a safe training environment, given that it has a safety harness for fall protection. As an additional feature, an optional body-weight support system can be installed to unload patients up to 40% of their body weight. Regarding the work presented in this thesis, the body-weight support feature was not used during the gait adaptability training. Training was always supervised by a physical therapist with ample experience in C-Mill training. Figure 1: The C-Mill with various exercises projected onto the treadmill belt.
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