Trading Symmetry for Energy Cost During Walking in Healthy Adults and Persons Poststroke.
Ryan T Roemmich, Kristan A Leech, Anthony J Gonzalez and 1 others
PMID 31208276WHAT IT FOUND
People walk asymmetrically if it saves energy.
Stroke survivors changed gait symmetry when a controller made new patterns less costly, but they did not spontaneously prefer symmetric walking. This suggests rehabilitation must make desired movements energetically beneficial to be adopted.
Key findings
01Healthy adults adopted asymmetric gaits when those patterns cost less energy than symmetric walking.
02Persons post-stroke changed foot placement symmetry to adopt less costly patterns when an energy landscape was reshaped to favor them.
03Symmetry itself did not reduce energy cost in stroke survivors; only the artificially created energy landscapes drove the change in gait.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Sample sizes were small, especially for the stroke group (n=7). Stroke participants had mild-to-moderate disability and could walk relatively fast; results may not apply to those with severe balance issues or low fitness. The study used a treadmill with a novel controller, which does not replicate real-world walking conditions. In the stroke group, the energy landscape was artificially manipulated. It is unknown if patients would spontaneously adopt these patterns without such external control.
Declared interests
None reported.
The easy way to misread this
Do not conclude that symmetric walking is inherently more efficient for stroke survivors. The study found that symmetry did not reduce energy cost naturally; participants only changed their gait because the researchers artificially made asymmetric or new patterns less costly via a treadmill controller.