Abstract

Asymmetric gait is associated with pain, injury, and reduced stability in patient populations. Data from side by side walking suggest that unintentional synchronization with an external cue may reduce gait asymmetry. Two types of asymmetric gait were examined here: (1) mass imbalance between limbs to simulate single limb amputation and (2) restriction of plantarflexion during toe-off to simulate reduced propulsion from neurological impairment. Twenty-five healthy participants walked normally and with simulated gait asymmetry on a custom-designed treadmill that oscillated in the vertical direction via pneumatic actuation (amplitude: 2 cm, frequency: participant’s preferred step frequency). Swing Time Asymmetry (STA) and Phase Coordination Index (PCI) both increased significantly with the application of unilateral mass and plantarflexion restriction (p < 0.001). However, walking with simulated asymmetry did not alter unintentional synchronization with the treadmill motion. Further, oscillation of the treadmill did not improve STA or PCI while walking with simulated asymmetry. Analysis of synchronized step clusters using the Weibull survival function revealed that synchronization with the platform persisted for longer durations when compared with data from side by side walking. These results suggest that walking on a vertically oscillating surface may not be an effective approach for improving gait asymmetry.

Highlights

  • Gait asymmetry is a concern for rehabilitation professionals because it can lead to increased risk of fall by hindering appropriate reactions to perturbation [4,5,6,7,17,18,19,20,21]

  • The results of this study demonstrate that swing time asymmetry (STA), synchronization, and bilateral coordination (PCI) are altered with the addition of a perturbation

  • Swing Time Asymmetry (STA) was unchanged and Phase Coordination Index (PCI) increased with the vertical oscillation of the treadmill, which differed from previous research in side by side walking

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Summary

Introduction

Asymmetry during gait can result from imbalances in physical properties of the extremities such as disproportionate leg lengths or masses [10], imbalances in muscle strength, resting length, and flexibility [11,12,13], or neurological deficits that can occur at several levels of the nervous system [14,15,16]. Gait asymmetry is a concern for rehabilitation professionals because it can lead to increased risk of fall by hindering appropriate reactions to perturbation [4,5,6,7,17,18,19,20,21]

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