Physical Therapists Use A Split-belt Treadmill To Help Stroke Patients Walk More Easily

Hi. Good Morning. This is very interesting. A split belt treadmill allowing different speed between the two lower extremities. Read on...

"Physical therapists used motion detector cameras to analyze how patients move on a specially designed split-belt treadmill--the belt is divided to move together or at independent speeds. When the legs move at speeds different from one another, the brain receives an error signal and the brain and nervous system use the feedback to adjust. The cerebellum recalls this message even after the treadmill stops and for a few minutes, stroke patients can walk easier."

http://www.sciencedaily.com/videos/2008/1207-retrain_your_brain_after_stroke.htm

Here is the PUBMED link and abstract:

http://www.ncbi.nlm.nih.gov/pubmed/21084921

J Neurol Phys Ther. 2010 Dec;34(4):202-7.

Split-belt treadmill training poststroke: a case study.

Reisman DS, McLean H, Bastian AJ.

Department of Physical Therapy, University of Delaware, Newark, Delaware 19716, USA. dreisman@udel.edu

Abstract

BACKGROUND AND PURPOSE: Even after rehabilitation, many individuals with strokes have residual gait deviations and limitations in functional walking. Applying the principles of motor adaptation through a split-belt treadmill walking paradigm can lead to short-term improvements in step length asymmetry after stroke. The focus of this case study was to determine whether it is possible to capitalize on these improvements for long-term gain.

CASE DESCRIPTION: The participant was a 36-year-old woman who was 1.6 years poststroke. She had a slow walking speed and multiple specific gait deviations, including step length asymmetry.

INTERVENTION: The participant walked on a split-belt treadmill 3 d/wk for 4 weeks, with the paretic leg on the slower of the two treadmill belts. The goal was 30 minutes of split-belt treadmill walking each day, followed by overground walking practice to reinforce improvements in step length symmetry.

OUTCOMES: With training, step length asymmetry decreased from 21% to 9% and decreased further to 7% asymmetry 1 month after training. Self-selected walking speed increased from 0.71 m/s to 0.81 m/s after training and 0.86 m/s 1 month later. Percent recovery, measured by the Stroke Impact Scale (SIS), increased from 40% to 50% posttraining and to 60% 1 month later.

DISCUSSION: Improvements in step length symmetry were observed following training and these improvements were maintained 1 month later. Concomitant changes in clinical measures were also observed, although these improvements were modest. The outcomes for this participant are encouraging given the relatively small dose of training. They suggest that after stroke, short-term adaptation can be capitalized on through repetitive practice and can lead to longer-term improvements stroke.

PMID: 21084921 [PubMed - indexed for MEDLINE]