Locomotor Training for Neurological Disease

Principal Investigator: Amy Bastian

For this pilot study our aims are to: 

  1. Understand basic brain mechanisms of inter-limb control and adaptation during locomotion to determine the paradigm to be used for improving interlimb coordination
  2. Determine how the pattern (e.g. which leg is made to move fast) influences after-effects in over-ground locomotion, and then use the paradigm that improves the asymmetry most effectively
  3. Determine whether different schedules and types of long-term training on a custom split-belt treadmill are likely to change/improve walking symmetry.
  4. Determining whether split belt treadmill training should be pursued as a rehabilitation intervention for people with hemiparesis. 

We will study controls and patients with cerebral damage. Controls will simply be trained daily for 2 weeks to understand how they learn a new pattern on the treadmill for comparison with patients. Patients will undergo training daily for 2 weeks or the same dose of training, spread over 4 weeks. Training for the patients will either be conventional treadmill walking or split-belt treadmill walking with one leg moving faster than the other. We will study children and adults with hemiparesis. These studies will provide important new information about normal mechanisms of locomotor adaptation, as well as providing a new rehabilitation tool for people with asymmetric gait patterns. Note that this study is not an aerobic conditioning program since subjects will work well below their age-adjusted target heart rate; it is instead a retraining program aimed at teaching people a new inter-limb coordination pattern. This study is also critical for developing procedural reliability processes, calculating effect sizes, training clinical staff, and determining other salient clinical variables in preparation for a randomized clinical trial.