Legs and Walking Lab, Shirley Ryan AbilityLab, Chicago, Illinois.
Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois.
J Neurophysiol. 2022 Jun 1;127(6):1642-1654. doi: 10.1152/jn.00046.2022. Epub 2022 May 18.
Locomotor adaptation to novel walking patterns induced by external perturbation has been tested to enhance motor learning for improving gait parameters in individuals poststroke. However, little is known regarding whether repeated adaptation and de-adaptation to the externally perturbed walking pattern may facilitate or degrade the retention of locomotor learning. In this study, we examined whether the intermittent adaptation to novel walking patterns elicited by external perturbation induces greater retention of the adapted locomotion in stroke survivors, compared with effects of the continuous adaptation. Fifteen individuals poststroke participated in two experimental conditions consisting of ) treadmill walking with intermittent (i.e., interspersed 2 intervals of no perturbation) or continuous (no interval) adaptation to externally perturbed walking patterns and ) overground walking before, immediately, and 10 min after treadmill walking. During the treadmill walking, we applied a laterally pulling force to the pelvis toward the nonparetic side during the stance phase of the paretic leg to disturb weight shifts toward the paretic side. Participants showed improved weight shift toward the paretic side and enhanced muscle activation of hip abductor/adductors immediately after the removal of the pelvis perturbation for both intermittent and continuous conditions ( < 0.05) and showed longer retention of the improved weight shift and enhanced muscle activation for the intermittent condition, which transferred from treadmill to overground walking ( < 0.05). In conclusion, repeated motor adaptation and de-adaptation to the pelvis resistance force during walking may promote the retention of error-based motor learning for improving weight shift toward the paretic side in individuals poststroke. We examined whether the intermittent versus the continuous adaptation to external perturbation induces greater retention of the adapted locomotion in stroke survivors. We found that participants showed longer retention of the improved weight shift and enhanced muscle activation for the intermittent versus the continuous conditions, suggesting that repeated motor adaptation and de-adaptation to the pelvis perturbation may promote the retention of error-based motor learning for improving weight shift toward the paretic side in individuals poststroke.
针对外部干扰引起的新型行走模式的运动适应已被用于增强运动学习，以改善脑卒中患者的步态参数。然而，对于反复适应和去适应外部干扰的行走模式是否会促进或降低运动学习的保持，目前知之甚少。本研究旨在探讨与连续适应相比，外部干扰诱发的新型行走模式的间歇性适应是否会引起脑卒中幸存者更大的运动适应保留。15 名脑卒中患者参与了两项实验条件，分别为）跑步机行走时间歇性（即在无干扰的 2 个间隔中穿插）或连续（无间隔）适应外部干扰的行走模式和）跑步机行走前、立即和行走后 10 分钟的地面行走。在跑步机行走期间，我们在患侧下肢的支撑相期间向非患侧施加侧向拉力，以干扰向患侧的体重转移。在两种间歇性和连续条件下，患者在去除骨盆干扰后立即表现出向患侧更好的体重转移和增强的髋关节外展/内收肌激活（<0.05），并表现出更久的向患侧的改善的体重转移和增强的肌肉激活的保留，这从跑步机转移到地面行走（<0.05）。总之，在行走过程中反复适应和去适应骨盆阻力可能会促进基于错误的运动学习的保留，以改善脑卒中患者向患侧的体重转移。我们检查了间歇性与连续适应外部干扰是否会引起脑卒中幸存者更大的适应性运动保留。我们发现，与连续条件相比，患者表现出更久的向患侧改善的体重转移和增强的肌肉激活的保留，这表明反复适应和去适应骨盆干扰可能会促进基于错误的运动学习的保留，以改善脑卒中患者向患侧的体重转移。
