Augmenting propulsion demands during split-belt walking increases locomotor adaptation of asymmetric step lengths.

Only 12 participants were studied, all chronic stroke and mildly to moderately impaired, so this does not show what would happen in more severely affected or acute patients. The flat session was always performed first, so practice, fatigue, or expectation could have influenced the incline session. Incline angle and adaptation duration were tailored to each participant's fatigue, not standardized. The outcomes were treadmill step lengths, leg positions, and propulsion forces, not overground walking, balance, function, or patient-reported mobility. The post-adaptation period was short, and the researchers used baseline as a proxy for late post-adaptation, so the size of carry-over changes may be uncertain. Propulsion force analysis used 11 participants because one participant's kinetic data were lost.

The study was funded by the National Science Foundation, CRDF Global, and the American Heart Association. The supplied text does not report other conflicts of interest.

Do not conclude this improves overground walking or daily mobility. The study only measured treadmill step-length adaptation and carry-over changes in 12 chronic stroke patients, and the authors say transfer to overground walking remains to be tested.