Locomotor adaptation on a split-belt treadmill in adults with stroke:a systematic review

Authors

  • Paula Fragoso Espinosa Centro Europeo de Neurociencias. Madrid. España.
  • Isabel Mª Alguacil Diego Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación, Medicina Física. Facultad de Ciencias de la Salud. Universidad Rey Juan Carlos. Alcorcón, Madrid. España. https://orcid.org/0000-0002-2054-3622
  • Francisco Molina Rueda Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación, Medicina Física. Facultad de Ciencias de la Salud. Universidad Rey Juan Carlos. Alcorcón, Madrid. España. https://orcid.org/0000-0002-8616-5505

DOI:

https://doi.org/10.23938/ASSN.1035

Keywords:

Stroke, Central nervous system diseases, Gait, Motor skills, Postural balance

Abstract

This systematic review aimed to assess the efficacy of motor adaptation during walking on a split-belt treadmill (SBT) under different learning conditions in adults with stroke.

We searched randomized clinical trials and case studies that used SBT under different learning conditions published between January 2011 and April 2022 in four databases: Pubmed, Scopus, Web of Science, and Brain-URJC. The following data were extracted: objectives, interventions, population, number of sessions, outcome measures, and results. The methodological quality of quantitative studies was evaluated using the Critical Review Form.

We identified 79 studies, from which six met the criteria for this systematic review (four randomized clinical trials and two case series). The six selected studies included 156 patients with chronic stroke; 62.8% men, age 21-85 years. Walking on a SBT can generate artifacts in the gait pattern depending on the experimental conditions. Two series of cases and one trial reported that the dual motor task - the inclination of the slope of the SBT or the gradual change of speed - promotes the retention of the artifacts generated by the disturbances, resulting in the learning of a new motor pattern.

However, combining physical exercise of different intensity and at different times with SBT, maximizing or minimizing errors, or including variable or constant speed disturbances do not seem to affect the locomotor adaptation process.

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Author Biographies

Isabel Mª Alguacil Diego , Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación, Medicina Física. Facultad de Ciencias de la Salud. Universidad Rey Juan Carlos. Alcorcón, Madrid. España.

1 Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación, Medicina Física. Facultad de Ciencias de la Salud. Universidad Rey Juan Carlos. Alcorcón, Madrid. España.

2 Laboratorio de Análisis del Movimiento, Biomecánica, Ergonomía y Control Motor (LAMBECOM). Universidad Rey Juan Carlos. Alcorcón, Madrid. España.

Francisco Molina Rueda , Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación, Medicina Física. Facultad de Ciencias de la Salud. Universidad Rey Juan Carlos. Alcorcón, Madrid. España.

1 Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación, Medicina Física. Facultad de Ciencias de la Salud. Universidad Rey Juan Carlos. Alcorcón, Madrid. España.

2 Laboratorio de Análisis del Movimiento, Biomecánica, Ergonomía y Control Motor (LAMBECOM). Universidad Rey Juan Carlos. Alcorcón, Madrid. España.

References

SANJUAN E, PANCORBO O, SANTANA K, MIÑARRO O, SALA V, MUCHADA M et al. Manejo del ictus agudo. Tratamientos y cuidados específicos de enfermería en la Unidad de Ictus. Neurol (Engl Ed). 2020. http://doi.org/10.1016/j.nrl.2020.07.025

NOE-SEBASTIAN E, BALASCH-BERNAT M, COLOMER-FONT C, MOLINER-MUNOZ B, RODRIGUEZ SANCHEZ-LEIVA C, UGART P et al. Ictus y discapacidad: estudio longitudinal en pacientes con discapacidad moderada-grave tras un ictus incluidos en un programa de rehabilitación multidisciplinar. Rev Neurol 2017; 64(9): 385-392. https://doi.org/10.33588/rn.6409.2016527

DZEWALTOWSKI AC, HEDRICK EA, LEUTZINGER TJ, REMSKI LE, ROSEN AB. The effect of split-belt treadmill interventions on step length asymmetry in individuals poststroke: A systematic review with meta-analysis. Neurorehabil Neural Repair 2021; 35(7): 563-575. https://doi.org/10.1177/15459683211011226

TORRES-OVIEDO G, VASUDEVAN E, MALONE L, BASTIAN AJ. Locomotor adaptation. Prog Brain Res 2011; 191: 65–74. http://doi.org/10.1016/B978-0-444-53752-2.00013-8

SERRANO MORENO JI, DEL CASTILLO SOBRINO MD, OLIVEIRA BARROSO FA, TORRICELLI D, TORRES-OVIEDO G. Nuevos métodos de evaluación de la marcha humana. En: Molina Rueda F, Carratalá Tejada M. La marcha humana. Biomecánica, evaluación y patología. 1º ed. Madrid: Médica Panamericana, 2020; 94-96.

HELM EE, REISMAN DS. The split-belt walking paradigm: Exploring motor learning and spatiotemporal asymmetry poststroke. Phys Med Rehabil Clin N Am 2015; 26(4): 703-713. http://doi.org/10.1016/j.pmr.2015.06.010

BASTIAN AJ. Understanding sensorimotor adaptation and learning for rehabilitation. Curr Opin Neurol 2008; 21(6): 628-633. http://doi.org/10.1097/WCO.0b013e328315a293

TYRELL CM, HELM E, REISMAN DS. Locomotor adaptation is influenced by the interaction between perturbation and baseline asymmetry after stroke. J Biomech 2015; 48(11): 2849-2857. http://doi.org/10.1016/j.jbiomech.2015.04.027

REISMAN DS, WITYK R, SILVER K, BASTIAN AJ. Split-belt treadmill adaptation transfers to overground walking in persons poststroke. Neurorehabil Neural Repair 2009; 23(7): 735-744. https://doi.org/10.1177/1545968309332

HINTON DC, CONRADSSON DM, PAQUETTE C. Understanding human neural control of short-term gait adaptation to the split-belt treadmill. Neuroscience 2020; 451:36-50. http://doi.org/10.1016/j.neuroscience.2020.09.055

HOOGKAMER W. Perception of gait asymmetry during split-belt walking. Exerc Sport Sci Rev 2017; 45(1): 34–40. http://doi.org/10.1249/JES.0000000000000094

REISMAN DS, WITYK R, SILVER K, BASTIAN AJ. Locomotor adaptation on a split-belt treadmill can improve walking symmetry post-stroke. Brain 2007; 130(7): 1861–1872. http://doi.org/10.1093/brain/awm035

PAGE MJ, MCKENZIE JE, BOSSUYT PM, BOUTRON I, HOFFMANN TC, MULROW CD et al. Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Rev Esp Cardiol 2021; 74(9): 790–799. http://doi.org/10.1016/j.recesp.2021.06.016

LAW M, STEWART D, POLLOCK N, LETTS L, BOSCH J, WESTMORLAND M. Critical Review Form -Quantitative Studies Law. Hamilton: McMaster University, 1998. https://www.unisa.edu.au/siteassets/episerver-6-files/global/health/sansom/documents/icahe/cats/mcmasters_quantitative-review.pdf

MELLA SOUSA M, ZAMORA NAVAS P, MELLA LABORDE M, BALLESTER ALFARO JJ, UCEDA CARRASCOSA P. Niveles de evidencia clínica y grados de recomendación. Rev. S. And. Traumatología y Ortopedia 2012; 29(1): 59-72. https://www.portalsato.es/documentos/revista/Revista12-1/Rev.%202012-1-07.pdf

CHERRY-ALLEN KM, STATTON MA, CELNIK PA, BASTIAN AJ. A dual-learning paradigm simultaneously improves multiple features of gait post-stroke. Neurorehabil Neural Repair 2018; 32(9): 810–820. http://doi.org/10.1177/1545968318792623

SOMBRIC CJ, TORRES-OVIEDO G. Augmenting propulsion demands during split-belt walking increases locomotor adaptation of asymmetric step lengths. J Neuroeng Rehabil 2020; 17(1): 69. http://doi.org/10.1186/s12984-020-00698-y

LEWEK MD, BRAUN CH, WUTZKE C, GIULIANI C. The role of movement errors in modifying spatiotemporal gait asymmetry post stroke: a randomized controlled trial. Clin Rehabil 2018; 32(2): 161-172. http://doi.org/10.1177/0269215517723056

CHARALAMBOUS CC, ALCANTARA CC, FRENCH MA, LI X, MATT KS, KIM HE et al. A single exercise bout and locomotor learning after stroke: physiological, behavioural, and computational outcomes. J Physiol 2018; 596(10): 1999-2016. http://doi.org/10.1113/JP275881

HELM EE, POHLIG RT, KUMAR DS, REISMAN DS. Practice structure and locomotor learning after stroke. J Neurol Phys Ther 2019; 43(2): 85-93. http://doi.org/10.1097/NPT.0000000000000260

ALCÂNTARA CC, CHARALAMBOUS CC, MORTON SM, RUSSO TL, REISMAN DS. Different error size during locomotor adaptation affects transfer to overground walking poststroke. Neurorehabil Neural Repair 2018; 32(12): 1020-1030. http://doi.org/10.1177/1545968318809921

KAO P-C, SRIVASTAVA S, AGRAWAL SK, SCHOLZ JP. Effect of robotic performance-based error-augmentation versus error-reduction training on the gait of healthy individuals. Gait Posture 2013; 37(1): 113-120. http://doi.org/10.1016/j.gaitpost.2012.06.025

VAN VLIET PM, WULF G. Extrinsic feedback for motor learning after stroke: what is the evidence? Disabil Rehabil 2006; 28(13–14): 831-840. http://doi.org/10.1080/09638280500534937

THOMAS R, BECK MM, LIND RR, KORSGAARD JOHNSEN L, GEERTSEN SS, CHRISTIANSEN L et al. Acute exercise and motor memory consolidation: The role of exercise timing. Neural Plast 2016; 2016:1-11. http://doi.org/10.1155/2016/6205452

THOMAS R, JOHNSEN LK, GEERTSEN SS, CHRISTIANSEN L, RITZ C, ROIG M et al. Acute exercise and motor memory consolidation: The role of exercise intensity. PLoS One 2016; 11(7): e0159589. http://doi.org/10.1371/journal.pone.0159589

NEPVEU J-F, THIEL A, TANG A, FUNG J, LUNDBYE-JENSEN J, BOYD LA et al. A single bout of high-intensity interval training improves motor skill retention in individuals with stroke. Neurorehabil Neural Repair 2017; 31(8): 726-735. http://doi.org/10.1177/1545968317718269

HELM EE, MATT KS, KIRSCHNER KF, POHLIG RT, KOHL D, REISMAN DS. The influence of high intensity exercise and the Val66Met polymorphism on circulating BDNF and locomotor learning. Neurobiol Learn Mem 2017; 144:77-85. http://doi.org/10.1016/j.nlm.2017.06.003

TAYLOR JA, IVRY RB. The role of strategies in motor learning. Ann N Y Acad Sci 2012; 1251(1): 1-12. http://doi.org/10.1111/j.1749-6632.2011.06430.x

HANLON RE. Motor learning following unilateral stroke. Arch Phys Med Rehabil 1996; 77(8): 811-815. http://doi.org/10.1016/s0003-9993(96)90262-2

DOYA K. Complementary roles of basal ganglia and cerebellum in learning and motor control. Curr Opin Neurobiol 2000; 10(6): 732-739. http://doi.org/10.1016/s0959-4388(00)00153-7

SCHWEIGHOFER N, LEE J-Y, GOH H-T, CHOI Y, KIM SS, STEWART JC et al. Mechanisms of the contextual interference effect in individuals poststroke. J Neurophysiol 2011; 106(5): 2632-2641. http://doi.org/10.1152/jn.00399.2011

CAURAUGH JH, KIM SB. Stroke motor recovery: active neuromuscular stimulation and repetitive practice schedules. J Neurol Neurosurg Psychiatry 2003; 74(11): 1562-1566. http://doi.org/10.1136/jnnp.74.11.1562

LAUZIÈRE S, MIÉVILLE C, BETSCHART M, DUCLOS C, AISSAOUI R, NADEAU S. Plantarflexion moment is a contributor to step length after-effect following walking on a split-belt treadmill in individuals with stroke and healthy individuals. J Rehabil Med 2014; 46(9): 849-857. http://doi.org/10.2340/16501977-1845

BETSCHART M, LAUZIÈRE S, MIÉVILLE C, MCFADYEN BJ, NADEAU S. Changes in lower limb muscle activity after walking on a split-belt treadmill in individuals post-stroke. J Electromyogr Kinesiol 2017; 32: 93-100. http://doi.org/10.1016/j.jelekin.2016.12.007

SOMBRIC CJ, CALVERT JS, TORRES-OVIEDO G. Large propulsion demands increase locomotor adaptation at the expense of step length symmetry. Front Physiol 2019; 10:60. http://doi.org/10.3389/fphys.2019.00060

AWAD LN, REISMAN DS, KESAR TM, BINDER-MACLEOD SA. Targeting paretic propulsion to improve poststroke walking function: a preliminary study. Arch Phys Med Rehabil 2014; 95(5): 840-848. http://doi.org/10.1016/j.apmr.2013.12.012

HSIAO H, HIGGINSON JS, BINDER-MACLEOD SA. Baseline predictors of treatment gains in peak propulsive force in individuals poststroke. J Neuroeng Rehabil 2016; 13(1): 2. http://doi.org/10.1186/s12984-016-0113-1

HSIAO H, KNARR BA, HIGGINSON JS, BINDER-MACLEOD SA. Mechanisms to increase propulsive force for individuals poststroke. J Neuroeng Rehabil 2015; 12(1). http://doi.org/10.1186/s12984-015-0030-8

HSIAO H, ZABIELSKI TM JR, PALMER JA, HIGGINSON JS, BINDER-MACLEOD SA. Evaluation of measurements of propulsion used to reflect changes in walking speed in individuals poststroke. J Biomech 2016; 49(16): 4107-4112. http://doi.org/10.1016/j.jbiomech.2016.10.003

KESAR TM, REISMAN DS, PERUMAL R, JANCOSKO AM, HIGGINSON JS, RUDOLPH KS et al. Combined effects of fast treadmill walking and functional electrical stimulation on post-stroke gait. Gait Posture 2011; 33(2): 309-313. http://doi.org/10.1016/j.gaitpost.2010.11.019

TYRELL CM, HELM E, REISMAN DS. Learning the spatial features of a locomotor task is slowed after stroke. J Neurophysiol 2014; 112(2): 480-489. http://doi.org/10.1152/jn.00486.2013

STATTON MA, TOLIVER A, BASTIAN AJ. A dual-learning paradigm can simultaneously train multiple characteristics of walking. J Neurophysiol 2016; 115(5): 2692-2700. http://doi.org/10.1152/jn.00090.2016

KRAKAUER JW, GHILARDI MF, GHEZ C. Independent learning of internal models for kinematic and dynamic control of reaching. Nat Neurosci 1999; 2(11): 1026-1031. http://doi.org/10.1038/14826

BAYS PM, FLANAGAN JR, WOLPERT DM. Interference between velocity-dependent and position-dependent force-fields indicates that tasks depending on different kinematic parameters compete for motor working memory. Exp Brain Res 2005; 163(3): 400-405. http://doi.org/10.1007/s00221-005-2299-5

MALONE LA, BASTIAN AJ. Spatial and temporal asymmetries in gait predict split-belt adaptation behavior in stroke. Neurorehabil Neural Repair 2014; 28(3): 230-240. http://doi.org/10.1177/1545968313505912

WOOLLACOTT M, SHUMWAY-COOK A. Attention and the control of posture and gait: a review of an emerging area of research. Gait Posture 2002; 16(1): 1-14. http://doi.org/10.1016/s0966-6362(01)00156-4

HOLTZER R, STERN Y, RAKITIN BC. Age-related differences in executive control of working memory. Mem Cognit 2004; 32(8): 1333–1345. http://doi.org/10.3758/bf03206324

PLUMMER-D’AMATO P, ALTMANN LJP, SARACINO D, FOX E, BEHRMAN AL, MARSISKE M. Interactions between cognitive tasks and gait after stroke: a dual task study. Gait Posture 2008; 27(4): 683-688. http://doi.org/10.1016/j.gaitpost.2007.09.001

TORRES-OVIEDO G, BASTIAN AJ. Natural error patterns enable transfer of motor learning to novel contexts. J Neurophysiol 2012; 107(1): 346-356. http://doi.org/10.1152/jn.00570.2011

BERNIKER M, KORDING K. Estimating the sources of motor errors for adaptation and generalization. Nat Neurosci 2008; 11(12): 1454-1461. http://doi.org/10.1038/nn.2229

WEI K, KÖRDING K. Relevance of error: what drives motor adaptation? J Neurophysiol 2009; 101(2): 655-664. http://doi.org/10.1152/jn.90545.2008

Published

2023-04-27

How to Cite

Fragoso-Espinosa, P., Alguacil-Diego, I. M., & Molina-Rueda, F. (2023). Locomotor adaptation on a split-belt treadmill in adults with stroke:a systematic review. Anales Del Sistema Sanitario De Navarra, 46(1), e1035. https://doi.org/10.23938/ASSN.1035

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