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Can practice make perfect? A novel gait training device improves gait patterns

Authors:
Chi Na Moua
Chi Na Moua
Chi Na Moua
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Nicole Szyszka at St. Catherine University
Nicole Szyszka
Courtney Kirkeide
Courtney Kirkeide
Courtney Kirkeide
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Marcella J Myers at St. Catherine University
Marcella J Myers
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Abstract and Figures

This study compared changes in gait patterns and walking speed over 3 weeks of training with a novel gait training device (Vizziq Neuromuscular Trainer) to changes observed in women 55 and older walking an equivalent amount without the device.
Experimental Design: The goal of this study was to determine whether three weeks of repeated practice walking with a novel gait trainer (Vizziq Neuromuscular Trainer) would improve gait variables, such as walking speed and stride length, compared to repeated practice walking without the device. We randomly assigned 27 female participants (ages 55-88) to a control group who practiced normal walking (NW) or a group who practiced walking with the Vizziq gait trainer (VW). For three weeks, under the supervision of a researcher, both groups walked according to their assigned practice mode at a self-selected pace three times per week for 20 minutes. We assessed gait variables for each participant – both before (pre-training) and after (post-training) the 3-week training period – using a GWalk inertial sensor while participants walked with and without the device.
Experimental Design: The goal of this study was to determine whether three weeks of repeated practice walking with a novel gait trainer (Vizziq Neuromuscular Trainer) would improve gait variables, such as walking speed and stride length, compared to repeated practice walking without the device. We randomly assigned 27 female participants (ages 55-88) to a control group who practiced normal walking (NW) or a group who practiced walking with the Vizziq gait trainer (VW). For three weeks, under the supervision of a researcher, both groups walked according to their assigned practice mode at a self-selected pace three times per week for 20 minutes. We assessed gait variables for each participant – both before (pre-training) and after (post-training) the 3-week training period – using a GWalk inertial sensor while participants walked with and without the device.
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Expected Results: Based on literature about conventional assistive devices (walkers) degrading gait variables over time, this graph shows what would happen to walking speed in each study arm if the Vizziq caused speed loss over time comparable to conventional walkers, and if participants in the walking arm improved their speed due to increased stamina.
Expected Results: Based on literature about conventional assistive devices (walkers) degrading gait variables over time, this graph shows what would happen to walking speed in each study arm if the Vizziq caused speed loss over time comparable to conventional walkers, and if participants in the walking arm improved their speed due to increased stamina.
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Training-Specific Learning--Speed: The group who trained with the Vizziq (VW) increased their walking speed while using the Vizziq by 0.11 m/s by the end of the study – a statistically significant improvement (p=0.003). This improvement in speed contrasts with the loss in speed that typically develops when using a conventional walker. The group who did normal walking (NW) training had a 0.04 m/s increase in walking speed, a non-significant difference compared to pre-training speed (p=0.08). Comparing the training groups at the end of the experiment, when we accounted for age as a confounding factor, participants training with the Vizziq and assessed with it walked statistically significantly faster (p=0.04) than the walking trained group assessed while walking unassisted.
Training-Specific Learning--Speed: The group who trained with the Vizziq (VW) increased their walking speed while using the Vizziq by 0.11 m/s by the end of the study – a statistically significant improvement (p=0.003). This improvement in speed contrasts with the loss in speed that typically develops when using a conventional walker. The group who did normal walking (NW) training had a 0.04 m/s increase in walking speed, a non-significant difference compared to pre-training speed (p=0.08). Comparing the training groups at the end of the experiment, when we accounted for age as a confounding factor, participants training with the Vizziq and assessed with it walked statistically significantly faster (p=0.04) than the walking trained group assessed while walking unassisted.
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Training-Specific Learning--Stride Length: The group who trained with the Vizziq (VW) increased their stride length while using the Vizziq by 0.07 m by the end of the study – a statistically significant improvement (p=0.02). The group who did normal walking (NW) training did not significantly increase their stride length while walking (p=0.21). Comparing the training groups at the end of the experiment, when we accounted for age as a confounding factor, participants training with the Vizziq and assessed with it trended toward longer a longer stride length (p=0.06) than the walking trained group assessed while walking unassisted.
Training-Specific Learning--Stride Length: The group who trained with the Vizziq (VW) increased their stride length while using the Vizziq by 0.07 m by the end of the study – a statistically significant improvement (p=0.02). The group who did normal walking (NW) training did not significantly increase their stride length while walking (p=0.21). Comparing the training groups at the end of the experiment, when we accounted for age as a confounding factor, participants training with the Vizziq and assessed with it trended toward longer a longer stride length (p=0.06) than the walking trained group assessed while walking unassisted.
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Cross-Training Learning--Speed: Here we see how well the learning under one training modality can cross over as a pre-to-post improvement in the other modality during the final assessment. We see the Vizziq-training group significantly improved speed, not only when assessed with the Vizziq, but also during unassisted walking (p=0.03). This finding is consistent with our hypothesis that training with the Vizziq facilitates neural pathways through proprioceptive feedback to reinforce a faster locomotor pattern, one that can persist even when walking without the device. Interestingly, the group that trained using normal walking also improved their pre-to-post speed when assessed using the Vizziq (p=0.01). This shows that after only a few interactions with the Vizziq (at assessment sessions), the walking-trained group was able to use the Vizziq efficiently enough to increase their walking speed.
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Cross-Training Learning--Speed: Here we see how well the learning under one training modality can cross over as a pre-to-post improvement in the other modality during the final assessment. We see the Vizziq-training group significantly improved speed, not only when assessed with the Vizziq, but also during unassisted walking (p=0.03). This finding is consistent with our hypothesis that training with the Vizziq facilitates neural pathways through proprioceptive feedback to reinforce a faster locomotor pattern, one that can persist even when walking without the device. Interestingly, the group that trained using normal walking also improved their pre-to-post speed when assessed using the Vizziq (p=0.01). This shows that after only a few interactions with the Vizziq (at assessment sessions), the walking-trained group was able to use the Vizziq efficiently enough to increase their walking speed.
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