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A simple, clinically applicable motor learning protocol to increase push-off during gait: A proof-of-concept

Michaël Bertrand-Charette, Jens Bo Nielsen,
Published: 19 January 2021
PLOS ONE , Volume 16; doi:10.1371/journal.pone.0245523

Abstract: Objective Task-specific training is often used in functional rehabilitation for its potential to improve performance at locomotor tasks in neurological populations. As push-off impairment are often seen with these patients, this functional approach shows potential to retrain gait overground to normalize the gait pattern and retrain the ability to improve gait speed. The main objective of this project was to validate, in healthy participants, a simple, low-cost push-off retraining protocol based on task-specific training that could be implemented during overground walking in the clinic. Methods 30 healthy participants walked in an 80-meter long corridor before, during, and after the application of an elastic resistance to the right ankle. Elastic tubing attached to the front of a modified ankle-foot orthosis delivered the resistance during push-off. Relative ankle joint angular displacements were recorded bilaterally and continuously during each walking condition. Results On the resisted side, participants presented aftereffects (increased peak plantarflexion angle from 13.4±4.2° to 20.0±6.4°, p Conclusion This study shows the feasibility of modifying push-off kinematics using an elastic resistance applied at the ankle while walking overground. This approach represents an interesting venue for future gait rehabilitation.
Keywords: walking / Legs / kinematics / Ankles / gait analysis / neurorehabilitation / Orthotics / retraining

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