Spatial and Temporal Asymmetries in Gait Predict Split-Belt Adaptation Behavior in Stroke

BACKGROUND: Step asymmetries during gait in persons after stroke can occur in temporal or spatial domains. Prior studies have shown that split-belt locomotor adaptation can temporarily mitigate these asymmetries. OBJECTIVE: . We investigated whether baseline gait asymmetries affected how patients adapt and store new walking patterns. METHODS: Subjects with stroke and age-matched controls were studied walking at a 2:1 speed ratio on the split-belt during adaptation and assessed for retention of the learned pattern (the after-effect) with both belts at the same speed. RESULTS: Those with stroke adapted more slowly (P .17). Temporal coordination (ie, phasing) after-effects showed a significant effect only from phasing baseline (F = 26.92, P .33). CONCLUSION: This work demonstrates that stroke patients adapt toward their baseline temporal and spatial asymmetries of walking independently of one another. We define how a given split-belt training session would affect asymmetries in these domains, which must be considered when developing rehabilitation interventions for stroke patients.