Abstract
Gait asymmetries are commonly observed in neurological populations and linked to decreased gait velocity, balance decrements, increased fall risk, and heightened metabolic cost. Interventions designed to improve gait asymmetries have varying methods and results. The purpose of this systematic review was to investigate non-pharmacological interventions to improve gait asymmetries in neurological populations. Keyword searches were conducted using PubMed, CINAHL, and Academic Search Complete. The search yielded 14 studies for inclusion. Gait was assessed using 3D motion capture systems (n = 7), pressure-sensitive mats (e.g., GAITRite; n = 5), and positional sensors (n = 2). The gait variables most commonly analyzed for asymmetry were step length (n = 11), stance time (n = 9), and swing time (n = 5). Interventions to improve gait asymmetries predominantly used gait training techniques via a split-belt treadmill (n = 6), followed by insoles/orthoses (n = 3). The literature suggests that a wide range of methods can be used to improve spatiotemporal asymmetries. However, future research should further examine kinematic and kinetic gait asymmetries. Additionally, researchers should explore the necessary frequency and duration of various intervention strategies to achieve the greatest improvement in gait asymmetries, and to determine the best symmetry equation for quantifying gait asymmetries.
Highlights
Musculoskeletal and neurological disorders such as osteoarthritis, amputations, Parkinson’s disease (PD), and stroke may cause decrements in walking and balance, leading to the development of gait asymmetries
161 articles were screened via their title and abstract based on the inclusion/exclusion criteria—resulting in 17 studies assessed by full text
Three articles did not meet the criteria because the studies either did not have a direct intervention to improve gait asymmetries or did not have a clinical diagnosis of gait asymmetry
Summary
Musculoskeletal and neurological disorders such as osteoarthritis, amputations, Parkinson’s disease (PD), and stroke may cause decrements in walking and balance, leading to the development of gait asymmetries. Pharmacological interventions have been shown to alter gait kinematics such as gait speed, gait variability, range of motion, and step length [12,13]. Levodopa—a dopamine replacement therapy—has been shown to be effective in improving scores on the Unified Parkinson’s Disease Rating Scale (UPDRS), including reduced FOG, and in improving stride time and variability [13]. Gait speed increased when using dopaminergic treatment [12]. These findings are not isolated to levodopa, as there are other pharmacological approaches to addressing gait challenges—
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