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1. Split-Belt walking induces changes in active, but not passive, perception of step length

   https://doi.org/10.1038/s41598-019-52860-9  

   Sombric, Carly ; Gonzalez-Rubio, Marcela ; Torres-Oviedo, Gelsy ( December 2019 , Scientific Reports)

   null (Ed.)

   Abstract Successful motor control requires accurate estimation of our body in space for planning, executing, and evaluating the outcome of our actions. It has been shown that the estimation of limb position is susceptible to motor adaptation. However, a similar effect has not been found in locomotion, possibly due to how it was tested. We hypothesized that split-belt walking with the legs moving at different speeds changes the estimation of the legs’ position when taking a step. Thus, we assessed young subjects’ perception of step length (i.e., inter-feet distance at foot landing) when they moved their legs (active perception) or when the legs were moved by the experimenter (passive perception). We found that the active perception of step length was substantially altered following split-belt walking, whereas passive perception exhibited minor changes. This suggests that split-belt walking induced the adaptation of efferent signals, without altering sensory signals. We also found that active perceptual shifts were sensitive to how they were tested: they were most salient in the trailing leg and at short step lengths. Our results suggest that split-belt walking could modulate the deficient perception of step length post-stroke, which may contribute to gait asymmetries impairing patients’ mobility. 

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2. Real-time feedback control of split-belt ratio to induce targeted step length asymmetry

   https://doi.org/10.1186/s12984-022-01044-0  

   Carr, Sean ; Rasouli, Fatemeh ; Kim, Seok Hun ; Reed, Kyle B. ( December 2022 , Journal of NeuroEngineering and Rehabilitation)

   Abstract Introduction Split-belt treadmill training has been used to assist with gait rehabilitation following stroke. This method modifies a patient’s step length asymmetry by adjusting left and right tread speeds individually during training. However, current split-belt training approaches pay little attention to the individuality of patients by applying set tread speed ratios (e.g., 2:1 or 3:1). This generalization results in unpredictable step length adjustments between the legs. To customize the training, this study explores the capabilities of a live feedback system that modulates split-belt tread speeds based on real-time step length asymmetry. Materials and methods Fourteen healthy individuals participated in two 1.5-h gait training sessions scheduled 1 week apart. They were asked to walk on the Computer Assisted Rehabilitation Environment (CAREN) split-belt treadmill system with a boot on one foot to impose asymmetrical gait patterns. Each training session consisted of a 3-min baseline, 10-min baseline with boot, 10-min feedback with boot (6% asymmetry exaggeration in the first session and personalized in the second), 5-min post feedback with boot, and 3-min post feedback without boot. A proportional-integral (PI) controller was used to maintain a specified step-length asymmetry by changing the tread speed ratios during the 10-min feedback period. After the first session, a linear model between baseline asymmetry exaggeration and post-intervention asymmetry improvement was utilized to develop a relationship between target exaggeration and target post-intervention asymmetry. In the second session, this model predicted a necessary target asymmetry exaggeration to replace the original 6%. This prediction was intended to result in a highly symmetric post-intervention step length. Results and discussion Eleven out of 14 participants (78.6%) developed a successful relationship between asymmetry exaggeration and decreased asymmetry in the post-intervention period of the first session. Seven out of the 11 participants (63.6%) in this successful correlation group had second session post-intervention asymmetries of < 3.5%. Conclusions The use of a PI controller to modulate split-belt tread speeds demonstrated itself to be a viable method for individualizing split-belt treadmill training. 

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3. Can a passive unilateral hip exosuit diminish walking asymmetry? A randomized trial

   https://doi.org/10.1186/s12984-023-01212-w  

   Kowalczyk, Kayla ; Mukherjee, Mukul ; Malcolm, Philippe ( July 2023 , Journal of NeuroEngineering and Rehabilitation)

   Asymmetric walking gait impairs activities of daily living in neurological patient populations, increases their fall risk, and leads to comorbidities. Accessible, long-term rehabilitation methods are needed to help neurological patients restore symmetrical walking patterns. This study aimed to determine if a passive unilateral hip exosuit can modify an induced asymmetric walking gait pattern. We hypothesized that a passive hip exosuit would diminish initial- and post-split-belt treadmill walking after-effects in healthy young adults.

   We divided 15 healthy young adults evenly between three experimental groups that each completed a baseline trial, an adaptation period with different interventions for each group, and a post-adaptation trial. To isolate the contribution of the exosuit we compared a group adapting to the exosuit and split-belt treadmill (Exo-Sb) to groups adapting to exosuit-only (Exo-only) and split-belt only (Sb-only) conditions. The independent variables step length, stance time, and swing time symmetry were analyzed across five timepoints (baseline, early- and late adaptation, and early- and late post-adaptation) using a 3 × 5 mixed ANOVA.

   We found significant interaction and time effects on step length, stance time and swing time symmetry. Sb-only produced increased step length asymmetry at early adaptation compared to baseline (p < 0.0001) and an after-effect with increased asymmetry at early post-adaptation compared to baseline (p < 0.0001). Exo-only increased step length asymmetry (in the opposite direction as Sb-only) at early adaptation compared to baseline (p = 0.0392) but did not influence the participants sufficiently to result in a post-effect. Exo-Sb produced similar changes in step length asymmetry in the same direction as Sb-only (p = 0.0014). However, in contrast to Sb-only there was no significant after-effect between early post-adaptation and baseline (p = 0.0885).

   The passive exosuit successfully diminished asymmetrical step length after-effects induced by the split-belt treadmill in Exo-Sb. These results support the passive exosuit’s ability to alter walking gait patterns.

    

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4. Kinematic Trajectories in Response to Speed Perturbations in Walking Suggest Modular Task-Level Control of Leg Angle and Length

   https://doi.org/10.1093/icb/icac057  

   Schwaner, M. J. ; Nishikawa, K. C. ; Daley, M. A. ( May 2022 , Integrative And Comparative Biology)

   Navigating complex terrains requires dynamic interactions between the substrate, musculoskeletal, and sensorimotor systems. Current perturbation studies have mostly used visible terrain height perturbations, which do not allow us to distinguish among the neuromechanical contributions of feedforward control, feedback-mediated, and mechanical perturbation responses. Here, we use treadmill-belt speed perturbations to induce a targeted perturbation to foot speed only, and without terrain-induced changes in joint posture and leg loading at stance onset. Based on previous studies suggesting a proximo-distal gradient in neuromechanical control, we hypothesized that distal joints would exhibit larger changes in joint kinematics, compared to proximal joints. Additionally, we expected birds to use feedforward strategies to increase the intrinsic stability of gait. To test these hypotheses, seven adult guinea fowl were video recorded while walking on a motorized treadmill, during both steady and perturbed trials. Perturbations consisted of repeated exposures to a deceleration and acceleration of the treadmill-belt speed. Surprisingly, we found that joint angular trajectories and center of mass fluctuations remain very similar, despite substantial perturbation of foot velocity by the treadmill belt. Hip joint angular trajectories exhibit the largest changes, with the birds adopting a slightly more flexed position across all perturbed strides. Additionally, we observed increased stride duration across all strides, consistent with feedforward changes in the control strategy. The speed perturbations mainly influenced the timing of stance and swing, with the largest kinematic changes in the strides directly following a deceleration. Our findings do not support the general hypothesis of a proximo-distal gradient in joint control, as distal joint kinematics remain largely unchanged. Instead, we find that leg angular trajectory and the timing of stance and swing are most sensitive to this specific perturbation, and leg length actuation remains largely unchanged. Our results are consistent with modular task-level control of leg length and leg angle actuation, with different neuromechanical control and perturbation sensitivity in each actuation mode. Distal joints appear to be sensitive to changes in vertical loading but not foot fore-aft velocity. Future directions should include in vivo studies of muscle activation and force–length dynamics to provide more direct evidence of the sensorimotor control strategies for stability in response to belt-speed perturbations.

    

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5. Taking advantage of external mechanical work to reduce metabolic cost: the mechanics and energetics of split‐belt treadmill walking

   https://doi.org/10.1113/JP277725  

   Sánchez, Natalia ; Simha, Surabhi N. ; Donelan, J. Maxwell ; Finley, James M. ( July 2019 , The Journal of Physiology)

   The neuromotor system generates flexible motor patterns that can adapt to changes in our bodies or environment and also take advantage of assistance provided by the environment.

   We ask how energy minimization influences adaptive learning during human locomotion to improve economy when walking on a split‐belt treadmill. We use a model‐based approach to predict how people should adjust their walking pattern to take advantage of the assistance provided by the treadmill, and we validate these predictions empirically.

   We show that adaptation to a split‐belt treadmill can be explained as a process by which people reduce step length asymmetry to take advantage of the work performed by the treadmill to reduce metabolic cost.

   Our results also have implications for the evaluation of devices designed to reduce effort during walking, as locomotor adaptation may serve as a model approach to understand how people learn to take advantage of external assistance.

   In everyday tasks such as walking and running, we often exploit the work performed by external sources to reduce effort. Recent research has focused on designing assistive devices capable of performing mechanical work to reduce the work performed by muscles and improve walking function. The success of these devices relies on the user learning to take advantage of this external assistance. Although adaptation is central to this process, the study of adaptation is often done using approaches that seem to have little in common with the use of external assistance. We show in 16 young, healthy participants that a common approach for studying adaptation, split‐belt treadmill walking, can be understood from a perspective in which people learn to take advantage of mechanical work performed by the treadmill. Initially, during split‐belt walking, people step further forward on the slow belt than the fast belt which we measure as a negative step length asymmetry, but this asymmetry is reduced with practice. We demonstrate that reductions in asymmetry allow people to extract positive work from the treadmill, reduce the positive work performed by the legs, and reduce metabolic cost. We also show that walking with positive step length asymmetries, defined by longer steps on the fast belt, minimizes metabolic cost, and people choose this pattern after guided experience of a wide range of asymmetries. Our results suggest that split‐belt adaptation can be interpreted as a process by which people learn to take advantage of mechanical work performed by an external device to improve economy.

    

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