Abstract

There is an interest to identify factors facilitating locomotor adaptation induced by split-belt walking (i.e., legs moving at different speeds) because of its clinical potential. We hypothesized that augmenting braking forces, rather than propulsion forces, experienced at the feet would increase locomotor adaptation during and after split-belt walking. To test this, forces were modulated during split-belt walking with distinct slopes: incline (larger propulsion than braking), decline (larger braking than propulsion), and flat (similar propulsion and braking). Step length asymmetry was compared between groups because it is a clinically relevant measure robustly adapted on split-belt treadmills. Unexpectedly, the group with larger propulsion demands (i.e., the incline group) changed their gait the most during adaptation, reached their final adapted state more quickly, and had larger after-effects when the split-belt perturbation was removed. We also found that subjects who experienced larger disruptions of propulsion forces in early adaptation exhibited greater after-effects, which further highlights the catalytic role of propulsion forces on locomotor adaptation. The relevance of mechanical demands on shaping our movements was also indicated by the steady state split-belt behavior, during which each group recovered their baseline leg orientation to meet leg-specific force demands at the expense of step length symmetry. Notably, the flat group was nearly symmetric, whereas the incline and decline group overshot and undershot step length symmetry, respectively. Taken together, our results indicate that forces propelling the body facilitate gait changes during and after split-belt walking. Therefore, the particular propulsion demands to walk on a split-belt treadmill might explain the gait symmetry improvements in hemiparetic gait following split-belt training.

Highlights

  • There is an interest in increasing the extent of locomotor adaptation induced by split-belt walking because repeated exposure to this task can lead to gait improvements post-stroke

  • We investigated the influence of anterior–posterior forces on gait adaptation and after-effects induced by split-belt walking at different slopes, which naturally altered leg orientation and forces when feet were in contact with the ground

  • Each inclination group recovered their baseline leg orientation at the expense of step length symmetry, which was a profound finding given that step length asymmetry is considered a biomarker of inefficient gait (Finley et al, 2013; Bhounsule et al, 2014; Awad et al, 2015; Finley and Bastian, 2017)

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Summary

Introduction

There is an interest in increasing the extent of locomotor adaptation induced by split-belt walking because repeated exposure to this task can lead to gait improvements post-stroke. Promising studies have shown that walking with the legs moving at different speeds (i.e., splitbelt walking) results in long-lasting reduction of step length asymmetry post-stroke when walking overground (Reisman et al, 2013; Betschart et al, 2018; Lewek et al, 2018). The increased mechanical work (Selgrade et al, 2017), step length asymmetry (Reisman et al, 2005), and metabolic effort (Finley et al, 2013), upon introducing the split-belt environment are thought to drive locomotor adaptation These three factors are large during the initial steps of splitbelt walking and are minimized as subjects learn to walk in the split-belt context (Finley et al, 2013; Selgrade et al, 2017). We proposed that braking forces could facilitate subject-specific locomotor adaptation and increasing these forces would augment the extent of gait changes during and after this task (i.e., after-effects)

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