Adaptive changes in foot placement for split-belt treadmill walking in individuals with stroke

Hirata, Keisuke; Hanawa, Hiroki; Miyazawa, Taku; Kubota, Keiichi; Sonoo, Moeka; Kokubun, Takanori; Kanemura, Naohiko

doi:10.1016/j.jelekin.2019.07.003

Cited by 5 publications

(9 citation statements)

References 36 publications

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“…All symmetry ratios were converted to standardized mean differences (Hedge's g). Data from 4 studies 8,10,15,22 were obtained from the original research articles, whereas data from 6 studies 7,9,11,[16][17][18] were obtained from the authors through electronic correspondence. Data from 7 studies [12][13][14][23][24][25][26] were not obtained after reaching out to the corresponding authors.…”

Section: Data Extraction and Analysismentioning

confidence: 99%

“…Twenty of the studies used a 2:1 ratio for speed differences between the 2 belts during the split-belt paradigm. Out of these 20 studies, 9 calculated the fast belt speed as the fastest comfortable walking speed and the slow belt speed as half of that speed, 7,9,11,13,16,[23][24][25][26] 6 calculated the slow belt speed as the participant's self-selected speed and the fast belt as twice the self-selected speed, 8,10,22,27,28,30 3 studies had the fast belt move at 1.0 m/s and the slow belt move at 0.5 m/s, 12,14,17 and 2 studies calculated each participant's self-selected speed and the fast belt was 133% of that speed and the slow belt was 66% of that speed. 18,29 One study 25 had a group complete the training at 3 different speed ratios, 1.5:1, 2:1, and 2.5:1.…”

Section: Belt Speedsmentioning

confidence: 99%

“…8,14,17,24,25,29,38 The other 7 studies utilized a repeated measures design where participants walked in 2 conditions, one with their nonparetic side on the fast belt and another with their paretic side on the fast belt. 7,9,10,12,15,28,30 Limb placement strategy can vary depending on the objective of the study. 12…”

Section: Limb Placement Strategiesmentioning

confidence: 99%

“…The lack of significant differences between baseline and late adaptation indicate that individuals poststroke overcame the error induced by the treadmill and returned to their baseline walking pattern while walking on the treadmill. 7,9,10,16,18 Several studies suggest that the treadmill protocol has little impact on the participants' ability to adapt back to baseline walking during treadmill training. 10,17,30 Contradictory to these claims, Tyrell and colleagues reported that participants returned to baseline asymmetry during an error augmentation protocol but failed to do so when the split-belt minimized the error in the participants' gait.…”

Section: Late Adaptationmentioning

confidence: 99%

“…The speed of each belt, which limb is placed on each belt, training duration, and other methodological factors lead to variable outcomes across studies investigating split-belt training. [7][8][9][10][11] A common objective of split-belt training paradigms for individuals poststroke is to reduce step length asymmetry through the adaptation of gait characteristics to the perturbing locomotor environment. [12][13][14] This is typically done by placing the limb with the shorter step length on the fast belt.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Split-Belt Treadmill Interventions on Step Length Asymmetry in Individuals Poststroke: A Systematic Review With Meta-Analysis

Dzewaltowski

Hedrick

Leutzinger

et al. 2021

Neurorehabil Neural Repair

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Background Individuals poststroke experience gait asymmetries that result in decreased community ambulation and a lower quality of life. A variety of studies have utilized split-belt treadmill training to investigate its effect on gait asymmetry, but many employ various methodologies that report differing results. Objective The purpose of this meta-analysis was to determine the effects of split-belt treadmill walking on step length symmetry in individuals poststroke both during and following training. Methods A comprehensive search of PubMed/MEDLINE, CINAHL, Web of Science, and Scopus was conducted to find peer-reviewed journal articles that included individuals poststroke that participated in a split-belt treadmill walking intervention. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used to assess risk of bias. Pooled Hedge’s g with random effects models were used to estimate the effect of split-belt training on step length symmetry. Results Twenty-one studies were assessed and included in the systematic review with 11 of them included in the meta-analysis. Included studies had an average STROBE score of 16.2 ± 2.5. The pooled effects for step length asymmetry from baseline to late adaptation were not significant ( g = 0.060, P = .701). Large, significant effects were found at posttraining after a single session ( g = 1.04, P < .01), posttraining after multiple sessions ( g = −0.70, P = .01), and follow-up ( g = −0.718, P = .023). Conclusion Results indicate split-belt treadmill training with the shorter step length on the fast belt has the potential to improve step length symmetry in individuals poststroke when long-term training is implemented, but randomized controlled trials are needed to confirm the efficacy of split-belt treadmill training.

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Section: Data Extraction and Analysismentioning

confidence: 99%

Section: Belt Speedsmentioning

confidence: 99%

Section: Limb Placement Strategiesmentioning

confidence: 99%

Section: Late Adaptationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The Effect of Split-Belt Treadmill Interventions on Step Length Asymmetry in Individuals Poststroke: A Systematic Review With Meta-Analysis

Dzewaltowski

Hedrick

Leutzinger

et al. 2021

Neurorehabil Neural Repair

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Habitual exercise evokes fast and persistent adaptation during split-belt walking

Brinkerhoff

Sánchez

Roper

2022

Preprint

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Changing movement patterns in response to environmental perturbations is a critical aspect of gait and is related to reducing the energetic cost of the movement. Aerobic exercise improves energetic capacity for submaximal exercise and may affect how people adapt movement to reach an energetic minimum. The purpose of this study was to determine whether differences in recreational aerobic exercise training influence gait adaptation in healthy young adults. Active (n=19) and Inactive (n=13) young adults walked on a split-belt treadmill with one belt moving twice the speed of the other belt for 10 minutes. Step length asymmetry (SLA) and mechanical work done by each leg were measured over each stride. Nonlinear mixed effects models compared the timecourse of adaptation between Active and Inactive young adults, and t-tests compared net work at the end of adaptation between Active and Inactive young adults. Compared to Inactive young adults, Active young adults initially adapted SLA and positive work by the fast leg quickly, and continued to gradually adapt them over the duration of split-belt treadmill walking. There was no effect of exercise on adaptation of negative work by the fast leg or on net mechanical work. Young adults who regularly participate in aerobic exercise respond more quickly to the onset of a perturbation, and throughout the perturbation they continue to explore movement strategies to reduce energetic cost.

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The detrimental effect of stroke on motor adaptation

Abram,

Tsay,

Yosef

et al. 2024

Preprint

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Background. While it is evident that stroke impairs motor control, it remains unclear whether stroke impacts motor adaptation, the ability to flexibly modify movements in response to changes in the body and the environment. The mixed results in the literature may be due to differences in participants' brain lesions, sensorimotor tasks, or a combination of both. Objective. We first sought to better understand the overall impact of stroke on motor adaptation and then delineated the impact of lesion hemisphere and sensorimotor task on adaptation poststroke. Methods. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review and meta-analysis of 17 studies comparing individuals poststroke to neurotypical controls, with each group consisting of over 200 participants. Results. We found that stroke impairs motor adaptation (d = -0.64; 95% CI [-1.06, -0.22]), and that the extent of this impairment did not differ across sensorimotor tasks but may vary with the lesioned hemisphere. Specifically, we observed greater evidence for impaired adaptation in individuals with left hemisphere lesions compared to those with right hemisphere lesions. Conclusions. This review not only clarifies the detrimental effect of stroke on motor adaptation but also underscores the need for finer-grained studies to determine precisely how various sensorimotor learning mechanisms are impacted. The current findings may guide future mechanistic and applied research at the intersection of motor learning and neurorehabilitation.

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Adaptive changes in foot placement for split-belt treadmill walking in individuals with stroke

Cited by 5 publications

References 36 publications

The Effect of Split-Belt Treadmill Interventions on Step Length Asymmetry in Individuals Poststroke: A Systematic Review With Meta-Analysis

The Effect of Split-Belt Treadmill Interventions on Step Length Asymmetry in Individuals Poststroke: A Systematic Review With Meta-Analysis

Habitual exercise evokes fast and persistent adaptation during split-belt walking

The detrimental effect of stroke on motor adaptation

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