Differential gait adaptation patterns in Parkinson's disease - a split belt treadmill pilot study

Area of Science:

• Neuroscience
• Biomechanics
• Movement Disorders

Background:

• Split belt treadmills (SBTM) are used to enhance gait symmetry (GA) in Parkinson's disease (PD).
• Systematic comparisons of different SBTM conditions are lacking.
• This study investigated gait adaptation effects based on manipulated belt speed and side in PD.

Purpose of the Study:

• To compare the effects of different split belt treadmill (SBTM) configurations on gait adaptation in individuals with Parkinson's disease (PD).
• To determine if manipulating the speed of the 'best' or 'worst' affected leg's treadmill belt yields differential gait symmetry improvements.

Main Methods:

• Eight individuals with PD underwent four SBTM trials.
• Each trial included baseline, split belt (speed increase/decrease on worst or best side), and final tied belt conditions.
• Participants were categorized into 'worst' (WS) and 'best' (BS) sides based on motor symptoms.

Main Results:

• Initial gait adaptation (GA) was significant across all SBTM conditions (p ≤ 0.02).
• Decreasing the best side (BS-decrease) belt speed resulted in more pronounced GA than increasing the worst side (WS-increase) belt speed (p = 0.016).
• Returning to tied belts showed significant GA changes for BS-decrease and WS-increase conditions (p = 0.04).

Conclusions:

• Reducing the best leg's belt speed demonstrated stronger gait adaptation effects compared to increasing the worst leg's belt speed in PD.
• Methodological planning of SBTM interventions, considering belt speed manipulation on specific sides, may maximize therapeutic outcomes.
• Further research with larger samples and focus on post-adaptation effects is needed to optimize SBTM interventions for PD.