Abstract
Background.
Humans typically walk in ways that minimize energy cost. Recent work
has found that healthy adults will even adopt new ways of walking when a
new pattern costs less energy. This suggests potential for
rehabilitation to drive changes in walking by altering the energy costs
of walking patterns so that the desired pattern becomes energetically
optimal (ie, costs least energy of all available patterns).
Objective.
We aimed to change gait symmetry in healthy adults and persons
poststroke by creating environments where changing symmetry allowed the
participants to save energy.
Methods. Across 3 experiments, we
tested healthy adults (n = 12 in experiment 1, n = 20 in experiment 2)
and persons poststroke (n = 7 in experiment 3) in a novel treadmill
environment that linked asymmetric stepping and gait speed—2 factors
that influence energy cost—to create situations where walking with one’s
preferred gait symmetry (or asymmetry, in the case of the persons
poststroke) was no longer the least energetically costly way to walk.
Results.
Across the 3 experiments, we found that most participants changed their
gait when experiencing the new energy landscape. Healthy adults often
adopted an asymmetric gait if it saved energy, and persons poststroke
often began to step more symmetrically than they prefer to walk in daily
life.
Conclusions. We used a novel treadmill environment to show
that people with and without stroke change clinically relevant features
of walking to save energy. These findings suggest that rehabilitation
approaches aimed at making symmetric walking energetically “easier” may
promote gait symmetry after stroke.
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