Error variability affects the after effects following motor learning of lateral balance control during walking in people with spinal cord injury.

Abstract

People with incomplete spinal cord injury (iSCI) usually show impairments in lateral balance control during walking. Effective interventions for improving balance control are still lacking, probably due to limited understanding of motor learning mechanisms. The objective of this study was to determine how error size and error variability impact the motor learning of lateral balance control during walking in people with iSCI. Fifteen people with iSCI were recruited. A controlled assistance force was applied to the pelvis in the medial-lateral direction using a customized cable-driven robotic system. Participants were tested using 3 conditions, including abrupt, gradual, and varied forces. In each condition, participants walked on a treadmill with no force for 1min (baseline), with force for 9min (adaptation), and then with no force for additional 2min (post-adaptation). The margin of stability at heel contact (MoS_HC) and minimum value moment (MoS_Min) were calculated to compare the learning effect across different conditions. Electromyogram signals from the weaker leg were also collected. Participants showed an increase in MoS_Min (after effect) following force release during the post-adaptation period for all three conditions. Participants showed a faster adaptation and a shorter lasting of after effect in MoS_Min for the varied condition in comparison with the gradual and abrupt force conditions. Increased error variability may facilitate motor learning in lateral balance control during walking in people with iSCI, although a faster learning may induce a shorter lasting of after effect. Error size did not show an impact on the lasting of after effect.