The Effect Of Split-belt Treadmill Training On Gait Efficiency In Hip Osteoarthritis Patients: Preliminary Study

Abstract

Reduced gait efficiency has been found in hip osteoarthritis (OA) measured as decreased mechanical energy exchange (MEE) or increased metabolic energy expenditure. Step length asymmetry (SLA) is commonly reported in hip OA patients and could potentially influence gait efficiency. Modifying step length through split-belt treadmill training may improve gait efficiency in hip OA patients. PURPOSE: To determine the effect of split-belt treadmill training modifying step length on gait efficiency in hip OA patients. METHODS: We evaluated 5 women with hip OA (66.8 ± 6.0 yrs; 33.6 ± 7.2 kg/m2) who provided informed consent for this IRB-approved study. We conducted split-belt treadmill testing with 4 periods: Warm-up (3 minutes), Baseline (1 minute), Adaptation (10 minutes), and Post-adaptation (1 minute) with motion analysis and metabolic energy analysis. During the adaptation period, the involved limb was assigned to the slow speed belt (half of the self-selected walking speed), and the uninvolved limb was assigned to the fast speed belt (self-selected walking speed). Both belts were at the self-selected speed during the other periods. Repeated measures ANOVA was used to determine the effect of the training period on SLA, MEE, and O2 rate in each period. LSD post hoc test was used to compare each condition. RESULTS: There was a significant effect of training period (Wilks’ Lambda = 0.17, F (9, 24.5) = 2.88, p = 0.02) in the multivariate test. There were no significant differences between the periods in SLA (p > 0.05). MEE significantly increased from the baseline period (24.68 ± 3.37) to the end of adaptation period (31.51 ± 4.00) (p = 0.01). MEE significantly decreased from the end of adaptation period to post-adaptation period (25.21 ± 5.10) (p = 0.04). O2 rate significantly increased from the end of adaptation period (7.77 ± 2.60) to post-adaptation period (9.22 ± 1.65) (p = 0.04). CONCLUSIONS: Although SLA did not change significantly through split-belt treadmill training, beneficial modifications in MEE and O2 rate were seen. Split-belt treadmill training could potentially become a rehabilitation strategy to improve gait efficiency in hip OA patients. Support from a National Institute on Aging Roybal Center for Health and Promotion and Translation Doctoral Pilot Grant.