TY - JOUR
T1 - Spatial and temporal asymmetries in gait predict split-belt adaptation behavior in stroke
AU - Malone, Laura A.
AU - Bastian, Amy J.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by National Institutes of Health grant R01 HD048741.
PY - 2014/3
Y1 - 2014/3
N2 - Background. Step asymmetries during gait in persons after stroke can occur in temporal or spatial domains. Prior studies have shown that split-belt locomotor adaptation can temporarily mitigate these asymmetries. Objective. We investigated whether baseline gait asymmetries affected how patients adapt and store new walking patterns. Methods. Subjects with stroke and age-matched controls were studied walking at a 2:1 speed ratio on the split-belt during adaptation and assessed for retention of the learned pattern (the after-effect) with both belts at the same speed. Results. Those with stroke adapted more slowly (P <.0001), though just as much as healthy older adults. During split-belt walking, the participants with stroke adapted toward their baseline asymmetry (eg, F = 14.02, P <.01 for step symmetry), regardless of whether the subsequent after-effects improved or worsened their baseline step asymmetries. No correlation was found between baseline spatial and temporal measures of asymmetry (P =.38). Last, the initial spatial and temporal asymmetries predicted after-effects independently of one another. The after-effects in the spatial domain (ie, center of oscillation difference) are only predicted by center of oscillation difference baseline (F = 15.3, P =.001), while all other parameters were nonsignificant (all Ps >.17). Temporal coordination (ie, phasing) after-effects showed a significant effect only from phasing baseline (F = 26.92, P <.001, all others P >.33). Conclusion. This work demonstrates that stroke patients adapt toward their baseline temporal and spatial asymmetries of walking independently of one another. We define how a given split-belt training session would affect asymmetries in these domains, which must be considered when developing rehabilitation interventions for stroke patients.
AB - Background. Step asymmetries during gait in persons after stroke can occur in temporal or spatial domains. Prior studies have shown that split-belt locomotor adaptation can temporarily mitigate these asymmetries. Objective. We investigated whether baseline gait asymmetries affected how patients adapt and store new walking patterns. Methods. Subjects with stroke and age-matched controls were studied walking at a 2:1 speed ratio on the split-belt during adaptation and assessed for retention of the learned pattern (the after-effect) with both belts at the same speed. Results. Those with stroke adapted more slowly (P <.0001), though just as much as healthy older adults. During split-belt walking, the participants with stroke adapted toward their baseline asymmetry (eg, F = 14.02, P <.01 for step symmetry), regardless of whether the subsequent after-effects improved or worsened their baseline step asymmetries. No correlation was found between baseline spatial and temporal measures of asymmetry (P =.38). Last, the initial spatial and temporal asymmetries predicted after-effects independently of one another. The after-effects in the spatial domain (ie, center of oscillation difference) are only predicted by center of oscillation difference baseline (F = 15.3, P =.001), while all other parameters were nonsignificant (all Ps >.17). Temporal coordination (ie, phasing) after-effects showed a significant effect only from phasing baseline (F = 26.92, P <.001, all others P >.33). Conclusion. This work demonstrates that stroke patients adapt toward their baseline temporal and spatial asymmetries of walking independently of one another. We define how a given split-belt training session would affect asymmetries in these domains, which must be considered when developing rehabilitation interventions for stroke patients.
KW - kinematics
KW - locomotor rehabilitation
KW - motor adaptation
KW - poststroke
KW - split-belt treadmill
KW - walking
UR - http://www.scopus.com/inward/record.url?scp=84894178966&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84894178966&partnerID=8YFLogxK
U2 - 10.1177/1545968313505912
DO - 10.1177/1545968313505912
M3 - Article
C2 - 24243917
AN - SCOPUS:84894178966
SN - 1545-9683
VL - 28
SP - 230
EP - 240
JO - Neurorehabilitation and neural repair
JF - Neurorehabilitation and neural repair
IS - 3
ER -