Handrail Holding During Treadmill Walking Reduces Locomotor Learning in Able-Bodied Persons

Abstract

Treadmills used for gait training in clinical rehabilitation and experimental settings are commonly fitted with handrails to assist or support persons in locomotor tasks. However, the effects of balance support through handrail holding on locomotor learning are unknown. Locomotor learning can be studied on split-belt treadmills, where participants walk on two parallel belts with asymmetric left and right belt speeds, to which they adapt their stepping pattern within a few minutes. The aim of this study was to determine how handrail holding affects the walking pattern during split-belt adaptation and after-effects in able-bodied persons. Fifty healthy young participants in five experimental groups were instructed to hold handrails, swing arms freely throughout the experiment or hold handrails during adaptation and swing arms freely during after-effects. Step length asymmetry and double support asymmetry were measured to assess the spatiotemporal walking pattern. The results showed that holding handrails during split-belt adaptation reduces magnitude of initial perturbation of step length asymmetry and reduces aftereffects in step length asymmetry upon return to symmetric belt speeds. The findings of this study imply that balance support during gait training reduces locomotor learning, which should be considered in daily clinical gait practice and future research on locomotor learning.

Transfer and retention effects of gait training with anterior-posterior perturbations to postural responses after medio-lateral gait perturbations in older adults

“…Handrails were detached to omit grasping reactions as this reduces the effects of perturbations and affects motor learning (Buurke et al, 2019). A full-body harness connected with a rope to an overhead frame allowed the participants to move freely without body weight support, but prevented them from hitting the treadmill in case of falling.…”

Short-Term Effects of Single-Session Split-Belt Treadmill Training on Dual-Task Performance in Parkinson's Disease and Healthy Elderly

“…Participants were not made aware of their particular training condition and were asked not to look down at the belts. Handrail use while training was discouraged to maximize motor learning (30), and participants wore a harness for safety without body weight support. Feedback was restricted to mentioning if foot placement was likely to cross the midline, and regarding the amount of time remaining in the training block.…”

On Nonlinear Regression for Trends in Split-Belt Treadmill Training

“…Therefore, during session II, the individuals may have adapted to their new baseline values. The higher asymmetry may also be explained by the hypothesis that in this study, the participants held onto a safety handrail throughout the adaptation phase where, as in the past study, they did not do so, and holding onto a safety handrail has been found to affect the response of participants in split-belt treadmill training [ 80 , 81 ]. The application of the proposed exponential models also revealed that there was an overshoot in the symmetry series from the adaptation phase in session II.…”