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Background: Patients with brain injuries such as Parkinson's disease or stroke exhibit abnormal gait characteristics especially during gait transitions such as step initiation and turning. Since such transitions could precipitate falls and resultant injuries, evaluation and rehabilitation of non-steady state gait in those patients are important. Whereas body weight supported treadmill training (BWSTT) provides a safe and controlled environment for gait training, it is unable to adequately train for gait transitions since the typical linear treadmill does not allow for changes in walking direction and natural fluctuations in speed., Research Question: This paper verifies if the suggested virtual reality (VR) based walking interface combined with the unidirectional treadmill can stimulate the user to initiate turning gait., Methods: To validate whether initiation of turning was successfully achieved with the proposed walking system, we developed the VR-based walking interface combined with the self-paced treadmill and compared kinematics, kinetics, and muscle activation levels during the VR-based turning and over ground (OG) turning as well as between straight walking and turning within conditions., Results: Despite walking on a linear treadmill, subjects showed significant increases in head rotation, pelvic rotation, right hip abduction, left hip adduction, foot progression, medial-lateral ground reaction forces, right medial hamstring activation level, and changes in step width during the VR turn compared to straight walking., Significance: The developed VR-based turning interface can provide a safe and controlled environment for assessment of turning in healthy controls and may have a potential for assessment and training in patients with neurological disorders., Competing Interests: Conflict of interest statement Declarations of interest: none

Treadmills provide a safe and efficient method for gait rehabilitation but treadmill based training paradigms have not been shown to create superior results when compared with traditional physical therapy methods such as overground training. One explanation for this may be that walking at a constant, fixed speed requires little mental engagement from the user, which has been postulated as a key factor in the success of motor learning. To increase mental engagement, we developed a user-driven treadmill control scheme. In this paper we use electroencephalography (EEG) to compare cortical activity during user-driven (active) walking with activity on a normal (passive) treadmill in nine healthy subjects. We used independent component analysis (ICA) to isolate brain activity from artifactual components. We fit equivalent dipole sources to each brain component and clustered these across subjects. Our analysis revealed that relative to the passive treadmill, active walking resulted in statistically significant decreases in spectral power, i.e. desynchronization, in the anterior cingulate, sensorimotor cortices, and posterior parietal lobe of the cortex. These results indicate that user-driven treadmills more fully engage the motor cortex and therefore could facilitate better training outcomes than a traditional treadmill.

A self-paced treadmill that can simulate overground walking has the potential to improve the effectiveness of treadmill training for gait rehabilitation. We have implemented a self-paced treadmill without the need for expensive equipment such as a motion capture system and an instrumented treadmill. For this, an inexpensive depth sensor, ASUS XtionTM, substitutes for the motion capture system, and a low-cost commercial treadmill is considered as the platform of the self-paced treadmill. The proposed self-paced treadmill is also convenient because the depth sensor does not require markers placed on user's body. Through pilot tests with two healthy subjects, it is quantitatively and qualitatively verified that the proposed self-paced treadmill achieves similar performance as one which utilizes a commercial motion capture system (VICON) as well as an instrumented treadmill.

The most common functional motor goal of lower extremity rehabilitation is to improve walking ability. For reasons of feasibility, safety or intensity, devices are frequently used to facilitate or augment gait training. The objective of this study was to compare the muscle activity patterns of the rectus femoris and semitendinosus muscles during four conditions: overground walking, treadmill walking, stationary cycling, and elliptical training. Ten healthy adults (six male, four female; mean age 22.7±2.9 years, range 20-29) participated and surface electromyographic data were recorded. Linear envelope curves were generated and time normalized from 0 to 100% cycle. The mean plus three standard deviations from a static trial was used as the threshold for muscle activity. Repeated measures analysis of variance procedures were used to detect differences between conditions. Elliptical training demonstrated greater rectus femoris activity and greater rectus femoris/semitendinosus coactivation than all other conditions. Consistent with previous work, treadmill walking demonstrated greater rectus femoris activity than overground walking. Minimal differences in semitendinosus activation were observed between conditions, limited to lower peak activity during cycling compared to treadmill walking. These results provide normative values for rectus femoris and semitendinosus activation for different locomotor training methods and may assist in selecting the most appropriate training device for specific patients. Clinicians and researchers should also consider the kinematic and kinetic differences between tasks, which cannot necessarily be inferred from muscle activation patterns., (Copyright © 2010. Published by Elsevier B.V.)