Long Term Split Belt Treadmill Training for Stroke Recovery
Condition: Stroke; Hemiparesis
MeSH terms: Stroke; Paresis
Study type: Interventional

Summary: 
      The purpose of this study is to determine whether split belt or conventional treadmill
      training can be used to treat walking pattern deficits from stroke and to determine whether
      this improves gait asymmetry and metabolic efficiency.
    

Detailed description: 
      Coordination between the legs during walking is often disrupted after neurological injury,
      resulting in asymmetric gait patterns. Recent data shows that walking patterns can be altered
      through treadmill training, even after central nervous system damage. The investigators have
      studied short-term adaptation of inter-limb coordination during walking using a split-belt
      treadmill to control speed of the two legs independently. Our findings demonstrate that
      walking patterns are adaptable. The investigators have also shown that people with cerebral
      damage from stroke can benefit in the short-term to correct asymmetric walking patterns.
      Since all of our previous work has focused on single training sessions or up to 4 week
      training sessions, the investigators would like to study long-term effects of split belt
      treadmill training. Therefore, the purpose of this study is to prepare for a clinical trial
      of split-belt treadmill training to treat walking pattern deficits from cerebral damage. The
      investigators will gather data to determine whether different types of treadmill training on
      a custom split-belt treadmill are likely to change/improve walking symmetry as well as
      metabolic efficiency.

      The investigators will study adults with cerebral damage due to stroke. Subjects with
      hemiparesis will undergo training 3 times a week for a total of 33 training session. These 33
      sessions will be broken into 3 blocks of 11 sessions. After each block of 11 sessions an
      evaluation will be done to record any gait improvements. Training for the subjects with
      hemiparesis will either be conventional treadmill walking (both legs moving at the same
      speed) or split-belt treadmill walking (with one leg moving faster than the other). 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 as well as to determine
      whether this training can influence the subject's body's ability to use its intake of oxygen
      more efficiently. 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.
    

Intervention name(s): Split belt treadmill
Intervention type(s): Behavioral
Intervention description(s): A split belt treadmill is like a typical treadmill that is seen in the gym, except that this treadmill has two belts that move instead of just one. One leg goes on one belt and the other leg uses the other belt. The belt speeds can be set to move at the same speed, making this treadmill similar to any regular treadmill, but, belt speeds can also be set so that one belt moves a little faster than the other. The belts are never set at a running or jogging speed, only a self-paced walking speed regardless of whether the belts are both going the same or slightly different speeds.
Other intervention name(s): Woodway Split Belt Treadmill; Company: Woodway USA, Inc
Intervention model: Single Group Assignment
Intervention model description: Split belt treadmill
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: stroke; treadmill; walking; hemiparesis; training