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Augmenting propulsion demands during split-belt walking increases locomotor adaptation of asymmetric step lengths
BACKGROUND: Promising studies have shown that the gait symmetry of individuals with hemiparesis due to brain lesions, such as stroke, can improve through motor adaptation protocols forcing patients to use their affected limb more. However, little is known about how to facilitate this process. Here w...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268294/ https://www.ncbi.nlm.nih.gov/pubmed/32493440 http://dx.doi.org/10.1186/s12984-020-00698-y |
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author | Sombric, Carly J. Torres-Oviedo, Gelsy |
author_facet | Sombric, Carly J. Torres-Oviedo, Gelsy |
author_sort | Sombric, Carly J. |
collection | PubMed |
description | BACKGROUND: Promising studies have shown that the gait symmetry of individuals with hemiparesis due to brain lesions, such as stroke, can improve through motor adaptation protocols forcing patients to use their affected limb more. However, little is known about how to facilitate this process. Here we asked if increasing propulsion demands during split-belt walking (i.e., legs moving at different speeds) leads to more motor adaptation and more symmetric gait in survivors of a stroke, as we previously observed in subjects without neurological disorders. METHODS: We investigated the effect of propulsion forces on locomotor adaptation during and after split-belt walking in the asymmetric motor system post-stroke. To test this, 12 subjects in the chronic phase post-stroke experienced a split-belt protocol in a flat and incline session so as to contrast the effects of two different propulsion demands. Step length asymmetry and propulsion forces were used to compare the motor behavior between the two sessions because these are clinically relevant measures that are altered by split-belt walking. RESULTS: The incline session resulted in more symmetric step lengths during late split-belt walking and larger after-effects following split-belt walking. In both testing sessions, subjects who have had a stroke adapted to regain speed and slope-specific leg orientations similarly to young, intact adults. Importantly, leg orientations, which were set by kinetic demands, during baseline walking were predictive of those achieved during split-belt walking, which in turn predicted each individual’s post-adaptation behavior. These results are relevant because they provide evidence that survivors of a stroke can generate the leg-specific forces to walk more symmetrically, but also because we provide insight into factors underlying the therapeutic effect of split-belt walking. CONCLUSIONS: Individuals post-stroke at a chronic stage can adapt more during split-belt walking and have greater after-effects when propulsion demands are augmented by inclining the treadmill surface. Our results are promising since they suggest that increasing propulsion demands during paradigms that force patients to use their paretic side more could correct gait asymmetries post-stroke more effectively. |
format | Online Article Text |
id | pubmed-7268294 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-72682942020-06-07 Augmenting propulsion demands during split-belt walking increases locomotor adaptation of asymmetric step lengths Sombric, Carly J. Torres-Oviedo, Gelsy J Neuroeng Rehabil Research BACKGROUND: Promising studies have shown that the gait symmetry of individuals with hemiparesis due to brain lesions, such as stroke, can improve through motor adaptation protocols forcing patients to use their affected limb more. However, little is known about how to facilitate this process. Here we asked if increasing propulsion demands during split-belt walking (i.e., legs moving at different speeds) leads to more motor adaptation and more symmetric gait in survivors of a stroke, as we previously observed in subjects without neurological disorders. METHODS: We investigated the effect of propulsion forces on locomotor adaptation during and after split-belt walking in the asymmetric motor system post-stroke. To test this, 12 subjects in the chronic phase post-stroke experienced a split-belt protocol in a flat and incline session so as to contrast the effects of two different propulsion demands. Step length asymmetry and propulsion forces were used to compare the motor behavior between the two sessions because these are clinically relevant measures that are altered by split-belt walking. RESULTS: The incline session resulted in more symmetric step lengths during late split-belt walking and larger after-effects following split-belt walking. In both testing sessions, subjects who have had a stroke adapted to regain speed and slope-specific leg orientations similarly to young, intact adults. Importantly, leg orientations, which were set by kinetic demands, during baseline walking were predictive of those achieved during split-belt walking, which in turn predicted each individual’s post-adaptation behavior. These results are relevant because they provide evidence that survivors of a stroke can generate the leg-specific forces to walk more symmetrically, but also because we provide insight into factors underlying the therapeutic effect of split-belt walking. CONCLUSIONS: Individuals post-stroke at a chronic stage can adapt more during split-belt walking and have greater after-effects when propulsion demands are augmented by inclining the treadmill surface. Our results are promising since they suggest that increasing propulsion demands during paradigms that force patients to use their paretic side more could correct gait asymmetries post-stroke more effectively. BioMed Central 2020-06-03 /pmc/articles/PMC7268294/ /pubmed/32493440 http://dx.doi.org/10.1186/s12984-020-00698-y Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Sombric, Carly J. Torres-Oviedo, Gelsy Augmenting propulsion demands during split-belt walking increases locomotor adaptation of asymmetric step lengths |
title | Augmenting propulsion demands during split-belt walking increases locomotor adaptation of asymmetric step lengths |
title_full | Augmenting propulsion demands during split-belt walking increases locomotor adaptation of asymmetric step lengths |
title_fullStr | Augmenting propulsion demands during split-belt walking increases locomotor adaptation of asymmetric step lengths |
title_full_unstemmed | Augmenting propulsion demands during split-belt walking increases locomotor adaptation of asymmetric step lengths |
title_short | Augmenting propulsion demands during split-belt walking increases locomotor adaptation of asymmetric step lengths |
title_sort | augmenting propulsion demands during split-belt walking increases locomotor adaptation of asymmetric step lengths |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268294/ https://www.ncbi.nlm.nih.gov/pubmed/32493440 http://dx.doi.org/10.1186/s12984-020-00698-y |
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