TY - JOUR
T1 - The Effect of Split-Belt Treadmill Interventions on Step Length Asymmetry in Individuals Poststroke
T2 - A Systematic Review With Meta-Analysis
AU - Dzewaltowski, Alex C.
AU - Hedrick, Erica A.
AU - Leutzinger, Todd J.
AU - Remski, Lindsey E.
AU - Rosen, Adam B.
N1 - Publisher Copyright:
© The Author(s) 2021.
PY - 2021/7
Y1 - 2021/7
N2 - Background: Individuals poststroke experience gait asymmetries that result in decreased community ambulation and a lower quality of life. A variety of studies have utilized split-belt treadmill training to investigate its effect on gait asymmetry, but many employ various methodologies that report differing results. Objective: The purpose of this meta-analysis was to determine the effects of split-belt treadmill walking on step length symmetry in individuals poststroke both during and following training. Methods: A comprehensive search of PubMed/MEDLINE, CINAHL, Web of Science, and Scopus was conducted to find peer-reviewed journal articles that included individuals poststroke that participated in a split-belt treadmill walking intervention. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used to assess risk of bias. Pooled Hedge’s g with random effects models were used to estimate the effect of split-belt training on step length symmetry. Results: Twenty-one studies were assessed and included in the systematic review with 11 of them included in the meta-analysis. Included studies had an average STROBE score of 16.2 ± 2.5. The pooled effects for step length asymmetry from baseline to late adaptation were not significant (g = 0.060, P =.701). Large, significant effects were found at posttraining after a single session (g = 1.04, P <.01), posttraining after multiple sessions (g = −0.70, P =.01), and follow-up (g = −0.718, P =.023). Conclusion: Results indicate split-belt treadmill training with the shorter step length on the fast belt has the potential to improve step length symmetry in individuals poststroke when long-term training is implemented, but randomized controlled trials are needed to confirm the efficacy of split-belt treadmill training.
AB - Background: Individuals poststroke experience gait asymmetries that result in decreased community ambulation and a lower quality of life. A variety of studies have utilized split-belt treadmill training to investigate its effect on gait asymmetry, but many employ various methodologies that report differing results. Objective: The purpose of this meta-analysis was to determine the effects of split-belt treadmill walking on step length symmetry in individuals poststroke both during and following training. Methods: A comprehensive search of PubMed/MEDLINE, CINAHL, Web of Science, and Scopus was conducted to find peer-reviewed journal articles that included individuals poststroke that participated in a split-belt treadmill walking intervention. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used to assess risk of bias. Pooled Hedge’s g with random effects models were used to estimate the effect of split-belt training on step length symmetry. Results: Twenty-one studies were assessed and included in the systematic review with 11 of them included in the meta-analysis. Included studies had an average STROBE score of 16.2 ± 2.5. The pooled effects for step length asymmetry from baseline to late adaptation were not significant (g = 0.060, P =.701). Large, significant effects were found at posttraining after a single session (g = 1.04, P <.01), posttraining after multiple sessions (g = −0.70, P =.01), and follow-up (g = −0.718, P =.023). Conclusion: Results indicate split-belt treadmill training with the shorter step length on the fast belt has the potential to improve step length symmetry in individuals poststroke when long-term training is implemented, but randomized controlled trials are needed to confirm the efficacy of split-belt treadmill training.
KW - adaptation
KW - gait rehabilitation
KW - locomotion
KW - stroke
KW - training
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U2 - 10.1177/15459683211011226
DO - 10.1177/15459683211011226
M3 - Review article
C2 - 33978525
AN - SCOPUS:85105725582
SN - 1545-9683
VL - 35
SP - 563
EP - 575
JO - Neurorehabilitation and Neural Repair
JF - Neurorehabilitation and Neural Repair
IS - 7
ER -