Abstract
BackgroundDue to increased interest in treadmill gait training, recent research has focused on the similarities and differences between treadmill and overground walking. Most of these studies have tested healthy, young subjects rather than impaired populations that might benefit from such training. These studies also do not include optic flow, which may change how the individuals integrate sensory information when walking on a treadmill. This study compared overground walking to treadmill walking in a computer assisted virtual reality environment (CAREN) in individuals with and without transtibial amputations (TTA).MethodsSeven individuals with traumatic TTA and 27 unimpaired controls participated. Subjects walked overground and on a treadmill in a CAREN at a normalized speed. The CAREN applied optic flow at the same speed that the subject walked. Temporal-spatial parameters, full body kinematics, and kinematic variability were collected during all trials.ResultsBoth subject groups decreased step time and control subjects decreased step length when walking in the CAREN. Differences in lower extremity kinematics were small (< 2.5○) and did not exceed the minimal detectable change values for these measures. Control subjects exhibited decreased transverse and frontal plane range of motion of the pelvis and trunk when walking in the CAREN, while patients with TTA did not. Both groups exhibited increased step width variability during treadmill walking in the CAREN, but only minor changes in kinematic variability.ConclusionsThe results of this study suggest that treadmill training in a virtual environment should be similar enough to overground that changes should carry over. Caution should be made when comparing step width variability and step time results from studies utilizing a treadmill to those overground.
Highlights
Due to increased interest in treadmill gait training, recent research has focused on the similarities and differences between treadmill and overground walking
Subjects with transtibial amputations (TTA) took longer steps on their intact limb when walking on the treadmill than walking overground
There were no changes in step width between the two conditions, there was a tendency for both control and TTA subjects to increase step width on the treadmill (Controls: pCond = 0.082, TTA: pCond = 0.110)
Summary
Due to increased interest in treadmill gait training, recent research has focused on the similarities and differences between treadmill and overground walking. Most of these studies have tested healthy, young subjects rather than impaired populations that might benefit from such training. These studies do not include optic flow, which may change how the individuals integrate sensory information when walking on a treadmill. For one,they allow for continuous collection of data within a small capture volume They can be integrated with virtual reality systems to provide visual cues, including optic flow and real-time feedback. When optic flow was added during treadmill walking, the knee flexion angle was indistinguishable from overground walking [20]
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