Verbal feedback enhances motor learning during post-stroke gait retraining

Area of Science:

• Neurorehabilitation
• Biomechanics
• Motor Learning

Background:

• Fast treadmill walking with functional electrical stimulation (FastFES) is a proven gait intervention for post-stroke recovery.
• The impact of individualized verbal feedback and variable practice on motor learning in FastFES is not well understood.

Purpose of the Study:

• To investigate if adding individualized verbal feedback or variable practice to FastFES training enhances motor learning of specific gait patterns.
• To compare the effects of different training structures on gait biomechanics post-stroke.

Main Methods:

• A crossover study involving nine individuals with post-stroke hemiparesis.
• Three dose-matched gait training conditions were tested: FastFES (FF), FF with physical therapist feedback (FF+PT), and FF with variable practice (FF+Var).
• Gait biomechanics were assessed pre-training, immediately post-training, and at 24-hour retention.

Main Results:

• FastFES with physical therapist feedback (FF+PT) led to significant improvements in trailing limb angle and a trend for better paretic push-off compared to standard FF.
• FastFES with variable practice (FF+Var) did not show superior learning of biomechanical variables compared to FF.
• FF+PT demonstrated enhanced within-session and retention gains in targeted gait variables.

Conclusions:

• Individualized verbal feedback, when added to FastFES, may improve motor learning of gait variables in individuals post-stroke.
• Further research is warranted to explore the benefits of incorporating verbal cues into gait rehabilitation protocols.
• Variable practice structure did not enhance gait learning in this FastFES intervention.