Split-Belt Gait Retraining in Subacute Stroke

University of British Columbia

Status: Not yet enrolling

Conditions: Stroke

Treatments: Behavioral: Split-belt walking training

Study type: Interventional

Funder types: Other

Identifiers

NCT07601633

H21-02171

Details and patient eligibility

About

Stroke is a leading cause of long-term disability in adults. Although many individuals regain independent walking ability following stroke, nearly 50% experience persistent gait impairments characterized by asymmetrical walking patterns, slower walking speed, impaired balance, and increased fall risk. These persistent mobility limitations highlight the continued need for innovative rehabilitation strategies that improve gait function during stroke recovery. Split-belt treadmill walking (SBTW), in which each leg walks at a different belt speed, has demonstrated potential to improve step length symmetry in individuals with chronic stroke. However, the effects of SBTW during the subacute stage of stroke recovery, within the first 9 months post-stroke when neuroplasticity may be heightened, remain largely unknown. In addition, previous SBTW studies have not integrated active physiotherapist-led gait retraining into the intervention, despite physiotherapist-led gait rehabilitation representing standard clinical care following stroke. The purpose of this randomized controlled trial is to compare physiotherapist-led gait retraining using a traditional treadmill training protocol to physiotherapist-led gait retraining integrated with a split-belt treadmill training protocol during the first 9 months post-stroke. The study aims to examine the effectiveness of the use of split-belt treadmill training to augment physiotherapist-led gait retraining to improve between-leg gait symmetry and overground walking speed.

Enrollment: 30 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• unilateral stroke resulting in hemiparesis
• less than 9 months post-stroke
• ability to walk ten metres with or without walking aids
• ability to stand without support for five minutes
• English speaking

Exclusion criteria

• medically unfit to participate e.g. cardiac or respiratory disease limiting ability to perform walking tasks
• neuromuscular impairment, other than stroke, limiting mobility, e.g. ankle sprain, joint disease such as severe arthritis
• cognitive/communication impairment impacting ability to follow instructions
• diagnosis of clinical depression or anxiety disorders requiring medication

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

---

30 participants in 2 patient groups

Split-belt treadmill training

Experimental group

Description:

Participants will complete 12 gait training sessions over 4 weeks (3 sessions/week) on an instrumented split-belt treadmill involving both split-belt and tied-belt walking conditions. A physiotherapist will provide gait retraining during each training session.

Treatment:

Behavioral: Split-belt walking training

Traditional treadmill training

No Intervention group

Description:

Participants will complete 12 gait training sessions over 4 weeks (3 sessions/week) on an instrumented treadmill under tied-belt walking conditions only. A physiotherapist will provide gait retraining during each training session.