Locomotor Training for Neurological Disease

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, and that this process is dependent on
cerebellar integrity. 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, 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 schedules and types of long-term training on a custom split-belt treadmill
are likely to change/improve walking symmetry.

The investigators will study subjects with and without cerebral damage. Subjects without
hemiparesis will simply be trained daily for 2 weeks to understand how they learn a new
pattern on the treadmill for comparison with patients. Subjects with hemiparesis will
undergo training daily for 2 weeks or the same dose of training, spread over 4 weeks.
Training for the subjects with hemiparesis will either be conventional treadmill walking or
split-belt treadmill walking with one leg moving faster than the other. The investigators
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.