Training propulsion: Locomotor adaptation to accelerations of the trailing limb

Farrens, Andria J.; Marbaker, Rachel; Lilley, Maria; Sergi, Fabrizio

doi:10.1109/icorr.2019.8779374

Cited by 8 publications

(9 citation statements)

References 14 publications

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“…It is important to consider the mechanism by which a rehabilitation approach drives changes in gait. For example, the mismatch between the belt speeds during split-belt treadmill walking induces a mechanism of motor learning termed ‘adaptation’ that results in immediate short-term aftereffects (i.e., the newly learned gait pattern persists into one’s everyday gait pattern immediately following a bout of training [22,48]) that may become more permanent over time [37]. Other approaches (e.g., biofeedback, fast treadmill walking) drive immediate changes in gait during training but do not result in robust short-term aftereffects.…”

Section: Discussionmentioning

confidence: 99%

Simple within-stride changes in treadmill speed can drive selective changes in human gait symmetry

Browne

Stenum

Padmanabhan

et al. 2022

Preprint

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BackgroundMillions of people worldwide are affected by clinical conditions that result in gait asymmetry (e.g., stroke, cerebral palsy, lower limb amputation). There is a need for customizable rehabilitation approaches that can flexibly target different aspects of gait asymmetry with minimal need for specialized equipment. Here, we studied how simple within-stride changes in treadmill speed could drive selective, predictable changes in human gait symmetry.MethodsIn Experiment 1, ten healthy young adults walked on an instrumented treadmill with and without a closed-loop controller engaged. The controller changed the treadmill speed to 1.50 m/s or 0.75 m/s depending on whether the right or left leg generated propulsive (i.e., forward-directed) ground reaction forces, respectively. In Experiment 2, a separate group of ten healthy young adults walked on the treadmill with and without an open-loop controller engaged. This controller changed the treadmill speed to 1.50 m/s or 0.75 at a prescribed time interval. We used a metronome to guide the participants to step at a series of different time points relative to the controller-driven speed change. We collected kinematic and kinetic data in Experiments 1 and 2.ResultsIn Experiment 1, participants walked with asymmetric kinematics and ground reaction forces when the closed-loop controller was engaged. The leg that accelerated during propulsion (right leg) showed a smaller leading limb angle and a larger trailing limb angle than the leg that decelerated during propulsion (left leg). The right leg also generated smaller propulsive forces than the left leg. In Experiment 2, the patterns of asymmetry in spatiotemporal gait parameters, kinematics, and ground reaction forces depended on the timing of the speed change within the gait cycle. Step times, leading limb angles, and peak propulsion became asymmetric when the treadmill speed changed early in stance. When the treadmill speed changed later in stance, step lengths, step times, and propulsion impulses became asymmetric.ConclusionsSimple manipulations of treadmill speed can drive predictable, selective changes in human gait symmetry. Future work will explore this customizable technique as a potential approach for restoring gait symmetry in clinical populations.

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Section: Discussionmentioning

confidence: 99%

Simple within-stride changes in treadmill speed can drive selective changes in human gait symmetry

Browne

Stenum

Padmanabhan

et al. 2022

Preprint

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“…This technique has been shown to also increase gait speed when coupled with a Virtual Reality (VR) environment (Fung et al, 2006). Furthermore, inducing an unexpected acceleration of the trailing limb can have an increase in propulsive forces, which is a common metric for assessing walking ability (Farrens et al, 2019). This study also allowed the user to actively change the treadmill speed in real time, which has also shown promise of higher walking speed in stroke patients (Ray et al, 2020).…”

Section: Goal-directed and Task-oriented Trainingmentioning

confidence: 99%

A Review of Robot-Assisted Lower-Limb Stroke Therapy: Unexplored Paths and Future Directions in Gait Rehabilitation

2020

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Stroke affects one out of every six people on Earth. Approximately 90% of stroke survivors have some functional disability with mobility being a major impairment, which not only affects important daily activities but also increases the likelihood of falling. Originally intended to supplement traditional post-stroke gait rehabilitation, robotic systems have gained remarkable attention in recent years as a tool to decrease the strain on physical therapists while increasing the precision and repeatability of the therapy. While some of the current methods for robot-assisted rehabilitation have had many positive and promising outcomes, there is moderate evidence of improvement in walking and motor recovery using robotic devices compared to traditional practice. In order to better understand how and where robot-assisted rehabilitation has been effective, it is imperative to identify the main schools of thought that have prevailed. This review intends to observe those perspectives through three different lenses: the goal and type of interaction, the physical implementation, and the sensorimotor pathways targeted by robotic devices. The ways that researchers approach the problem of restoring gait function are grouped together in an intuitive way. Seeing robot-assisted rehabilitation in this unique light can naturally provoke the development of new directions to potentially fill the current research gaps and eventually discover more effective ways to provide therapy. In particular, the idea of utilizing the human inter-limb coordination mechanisms is brought up as an especially promising area for rehabilitation and is extensively discussed.

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“…Seventy-one articles were then removed based on title and abstract, leaving 35 fulltext articles to be screened for eligibility. After the assessment of full text, 9 articles were removed for not including individuals poststroke, [32][33][34][35][36][37][38][39][40] 3 were removed for including biofeedback in their protocol, [41][42][43] 1 study did not investigate the effects of split-belt training on step length asymmetry as a postintervention, 44 and 1 study did not report how long it had been since their subjects had suffered a stroke. 45 The reference list of each journal article was reviewed in an attempt to find any additional studies not found in our initial search.…”

Section: Article Screeningmentioning

confidence: 99%

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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Training propulsion: Locomotor adaptation to accelerations of the trailing limb

Cited by 8 publications

References 14 publications

Simple within-stride changes in treadmill speed can drive selective changes in human gait symmetry

Simple within-stride changes in treadmill speed can drive selective changes in human gait symmetry

A Review of Robot-Assisted Lower-Limb Stroke Therapy: Unexplored Paths and Future Directions in Gait Rehabilitation

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

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