This study categorizes the response to asymmetric rhythmic cues into distinct levels of adaptation using changes in their step velocity. Motion capture and force data were collected from healthy individuals undergoing split-belt treadmill and rhythmic cueing interventions. This allowed comparative insights into two distinct adaptation mechanisms (sensorimotor and instructional adaptation) corresponding to the interventions and integration of those findings with trade-off mechanisms within spatiotemporal and kinetic gait parameters. Interlimb gait harmony (corresponding to differences between left and right step velocities) was significantly different between the gait interventions, indicating underlying differences in the dominant adaptation mechanisms driving them. The trade-off mechanisms among step length, swing time, and push-off forces were significantly different (i) between the gait interventions and (ii) between adaptable and non-adaptable subject groups to external rhythmic cues. This suggests that an orthogonal linear relationship between propulsion and either spatial or temporal features may indicate the adaptation mechanism that has a greater contribution towards their motor outcome.
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Exploring the Role of Asymmetric Auditory and Tactile Stimulation on Modulating Gait Kinetics
This study explores the influence of Auditory Rhythmic Asymmetric Cueing (A-RAC), Tactile Rhythmic Asymmetric Cueing (T-RAC), and their combination (AT) on key kinetic gait parameters in gait rehabilitation: Vertical Ground Reaction Force Asymmetry (GRF), Push-off Force Asymmetry (POF), and Braking Force Asymmetry (BRK). Utilizing the Computer-Assisted Rehabilitation Environment (CAREN) with 18 participants, this research examines these interventions' effectiveness in generating asymmetric gait. While the results during adaptation indicate that BRK was significantly affected by both A-RAC (p = 0.001) and AT (p = 0.003), only A-RAC had a significant effect on GRF (p = 0.002) during adaptation. None of the interventions significantly altered POF, suggesting its resistance to sensory cue modification. These findings provide valuable insights for enhancing gait rehabilitation strategies, particularly in addressing vertical load
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- Award ID(s):
- 1910434
- PAR ID:
- 10565073
- Publisher / Repository:
- IEEE
- Date Published:
- ISBN:
- 979-8-3503-7149-9
- Page Range / eLocation ID:
- 1 to 6
- Subject(s) / Keyword(s):
- stroke rehabilitation, combination therapy, multimodal cues, neuro-motor deficits
- Format(s):
- Medium: X
- Location:
- Orlando, FL, USA
- Sponsoring Org:
- National Science Foundation
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Escorpizo, Reuben (Ed.)The rate of adjustment in a movement, driven by feedback error, is referred to as the adaptation rate, and the rate of recovery of a newly adapted movement to its unperturbed condition is called the de-adaptation rate. The rates of adaptation and de-adaptation are dependent on the training mechanism and intrinsic factors such as the participant's sensorimotor abilities. This study investigated the facilitation of the motor adaptation and de-adaptation processes for spatiotemporal features of an asymmetric gait pattern by sequentially applying split-belt treadmill (SBT) and asymmetric rhythmic auditory cueing (ARAC). Methods: Two sessions tested the individual gait characteristics of SBT and ARAC, and the remaining four sessions consisted of applying the two interventions sequentially during training. The adjustment process to the second intervention is referred to as “re-adaptation” and is driven by feedback error associated with the second intervention. Results: Ten healthy individuals participated in the randomized six-session trial. Spatiotemporal asymmetries during the adaptation and post-adaptation (when intervention is removed) stages were fitted into a two-component exponential model that reflects the explicit and implicit adaptation processes. A double component was shown to fit better than a single-component model. The decay constants of the model were indicative of the corresponding timescales and compared between trials. Results revealed that the explicit (fast) component of adaptation to ARAC was reduced for step length and step time when applied after SBT. Contrarily, the explicit component of adaptation to SBT was increased when it was applied after ARAC for step length. Additionally, the implicit (slow) component of adaptation to SBT was inhibited when applied incongruently after ARAC for step time. These outcomes show that the role of working motor memory as a translational tool between different gait interventions is dependent on (i) the adaptation mechanisms associated with the interventions, (ii) the targeted motor outcome of the interventions; the effects of factors (i) and (ii) are specific to the explicit and implicit components of the adaptation processes; these effects are unique to spatial and temporal gait characteristics.more » « less
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null (Ed.)Abstract Background Asymmetric gait post-stroke is associated with decreased mobility, yet individuals with chronic stroke often self-select an asymmetric gait despite being capable of walking more symmetrically. The purpose of this study was to test whether self-selected asymmetry could be explained by energy cost minimization. We hypothesized that short-term deviations from self-selected asymmetry would result in increased metabolic energy consumption, despite being associated with long-term rehabilitation benefits. Other studies have found no difference in metabolic rate across different levels of enforced asymmetry among individuals with chronic stroke, but used methods that left some uncertainty to be resolved. Methods In this study, ten individuals with chronic stroke walked on a treadmill at participant-specific speeds while voluntarily altering step length asymmetry. We included only participants with clinically relevant self-selected asymmetry who were able to significantly alter asymmetry using visual biofeedback. Conditions included targeting zero asymmetry, self-selected asymmetry, and double the self-selected asymmetry. Participants were trained with the biofeedback system in one session, and data were collected in three subsequent sessions with repeated measures. Self-selected asymmetry was consistent across sessions. A similar protocol was conducted among unimpaired participants. Results Participants with chronic stroke substantially altered step length asymmetry using biofeedback, but this did not affect metabolic rate (ANOVA, p = 0.68). In unimpaired participants, self-selected step length asymmetry was close to zero and corresponded to the lowest metabolic energy cost (ANOVA, p = 6e-4). While the symmetry of unimpaired gait may be the result of energy cost minimization, self-selected step length asymmetry in individuals with chronic stroke cannot be explained by a similar least-effort drive. Conclusions Interventions that encourage changes in step length asymmetry by manipulating metabolic energy consumption may be effective because these therapies would not have to overcome a metabolic penalty for altering asymmetry.more » « less
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NA (Ed.)Purpose: Current gait rehabilitation protocols for older adults typically attempt to effect changes in leg movements, while the role of arm movements is often ignored despite evidence of the neurological coupling of the upper and lower extremities. In the present work, we examine the effectiveness of a novel wearable haptic cueing system that targets arm swing to improve various gait parameters in older adults. Methods: Twenty participants ( M = 73.4 ± 6.2 years) were recruited to analyze their gait during normal and fast walking without haptic cueing. Vibrotactors attached to the arms were then used to give haptic cues that were designed to either increase or decrease arm swing cycle time. The effects of such cueing on gait symmetry and spatiotemporal parameters were then analyzed. Results: The presentation of the haptic cues significantly altered arm swing cycle time, increasing gait speed by 18.2% when arm cycle time was decreased, and a 12.3% decrease in gait speed when arm cycle time was lengthened. The response to haptic cues was immediate, emphasizing the tight coupling of the arm and legs in the production of gait. Spatiotemporal analysis revealed improvements in gait parameters and symmetry metrics, indicating enhanced coordination between limbs when using tactile cues. Subjective evaluations further supported the system’s potential for gait training. Conclusion: The results reveal the significant potential of the haptic cueing system to modulate gait through arm swing manipulation, leveraging interlimb neural coupling. This aligns with the growing need for home-based gait training solutions, particularly for the older population, and presents a novel approach that could be integrated into current gait rehabilitation practices.more » « less
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