Effects of targeted assistance and perturbations on the relationship between pelvis motion and step width in people with chronic stroke
BackgroundPeople with chronic stroke (PwCS) often exhibit a weakened relationship between pelvis motion and paretic step width, a behavior important for gait stabilization. We have developed a force-field able to manipulate this relationship on a step-by-step basis. ObjectiveThe objective of this study was to investigate the effects of a single exposure to our novel force-field on the step-by-step modulation of paretic step width among PwCS, quantified by the partial correlation between mediolateral pelvis displacement at the start of a step and paretic step width (step start paretic {rho}disp). MethodsFollowing a 3-minute period of normal walking, participants were exposed to 5-minutes of either force-field assistance (n=10; pushing the swing leg toward a mechanically-appropriate step width) or perturbations (n=10; pushing the swing leg away from a mechanically-appropriate step width). This period of assistance or perturbations was followed by a 1-minute catch period to identify any after-effects, a sign of sensorimotor adaptation. ResultsWe found that assistance did not have a significant direct effect or after-effect on step start paretic {rho}disp. In contrast, perturbations directly reduced step start paretic {rho}disp (p=0.004), but were followed by an after-effect in which this metric was increased above the baseline level (p=0.02). ConclusionsThese initial results suggest that PwCS have the ability to strengthen the link between pelvis motion and paretic foot placement if exposed to a novel mechanical environment, which may benefit gait stability. Future work is needed to determine whether this effect can be extended with repeated exposure to force-field perturbations.