Speed and temporal-distance adaptations during non-motorized treadmill walking in stroke and non-disabled individuals

BACKGROUND: Treadmill training has received widespread attention to facilitate gait retraining and allow gait analysis in the stroke population in recent decades. While previous studies have used motorized treadmills for gait analysis or training, no study has investigated the use of non-motorized treadmill (NMT) in a rehabilitation setting. AIM: The aim of this study was to compare the speed between overground (OG) and NMT walking and measure the adaptation of the gait pattern from comfortable to maximal walking speeds during NMT walking in participants with stroke and non-disabled individuals. DESIGN: Cross-sectional study. SETTING: Tertiary care center. POPULATIO N: Twenty chronic hemiplegic stroke patients and 20 non-disabled controls. METHODS: The speeds attained OG and on a NMT were compared within each group. Cadence and stride length were measured while walking on the NMT. Adaptations of the gait pattern from comfortable to maximal walking speeds during NMT walking were measured in both groups. RESULTS: In both groups, when walking on the NMT, participants walked with significantly lower speed than on the ground. While on the NMT, the non-disabled individuals significantly increased the cadence and stride length simultaneously as the speed increased. The participants with stroke significantly increased the cadence but showed little increase in stride length with increased speed. CONCLUSIONS: Participants ambulated with significantly lower speeds on the NMT than during OG. Participants with stroke use a different strategy to increase walking velocity during NMT walking, relying mostly on increasing the cadence. CLINICAL REHABILITATIO N IMPACT : Lower speed during NMT walking indicated that lesser total distance covered with NMT training when compared to OG gait training, which may inadvertently impact training amount. This is an important obstacle to overcome in order for NMT to be used effectively in the retraining of gait in patients with stroke.