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A simple, clinically applicable motor learning protocol to increase push-off during gait: A proof-of-concept
Michaël Bertrand-Charette1, Jens Bo Nielsen2, Laurent J Bouyer1,3
1Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, Quebec, Canada.
Plos One
|January 19, 2021
Summary
This study demonstrates a simple, low-cost elastic resistance protocol to retrain ankle push-off during overground walking. The task-specific training method shows potential for improving gait kinematics in rehabilitation settings.
Area of Science:
- Biomechanics
- Rehabilitation Science
- Motor Control
Background:
- Task-specific training is crucial for functional rehabilitation in neurological populations, particularly for improving gait and locomotor tasks.
- Push-off impairment is a common issue in patients with neurological conditions, affecting gait speed and normalization.
- Overground gait retraining using functional approaches shows promise for normalizing gait patterns and enhancing walking speed.
Purpose of the Study:
- To validate a simple, low-cost push-off retraining protocol using task-specific training in healthy participants.
- To assess the feasibility of implementing this protocol during overground walking for clinical rehabilitation.
- To investigate the effects of elastic resistance on ankle push-off kinematics.
Main Methods:
- Thirty healthy participants walked in a corridor under three conditions: before, during, and after applying elastic resistance to the right ankle.
- Elastic tubing connected to a modified ankle-foot orthosis provided resistance during the push-off phase of gait.
- Bilateral ankle joint angular displacements were continuously recorded throughout the walking trials.
Main Results:
- Participants exhibited significant aftereffects on the resisted side, with increased peak plantarflexion angle (13.4±4.2° to 20.0±6.4°, p<0.0001) and peak plantarflexion angular velocity (145.8±22.7°/s to 174.4±37.4°/s, p<0.0001).
- Aftereffects on the non-resisted side were substantially smaller, indicating that the motor learning was primarily specific to the trained leg.
- The elastic resistance effectively modified push-off kinematics during overground walking.
Conclusions:
- The study successfully demonstrated the feasibility of modifying ankle push-off kinematics using elastic resistance during overground walking.
- This task-specific training approach is a promising and low-cost method for gait rehabilitation.
- The findings suggest potential applications for improving gait patterns and function in individuals with push-off impairments.
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