Energy Expenditure During Walking With a Novel Treadmill Controller That Induces Gait Asymmetry

Gait asymmetry is a common manifestation of walking impairment among clinical populations. We recently developed a novel treadmill walking approach called dynamic treadmill walking that can provide asymmetric gait training by changing the treadmill speed between fast and slow speeds within a single stride. Here, we studied the energy expenditure associated with a variety of dynamic treadmill walking conditions. We hypothesized that the metabolic power required for dynamic treadmill walking in all conditions would approximate the metabolic power associated with conventional walking at the mean of the fast and slow speeds employed in the task. Eleven young adults without gait impairment walked on an instrumented treadmill and breathed into a metabolic measurement system. During dynamic treadmill walking, the treadmill fluctuated between 0.75m/s and 1.50m/s, each for 50% of an individuals stride time. We used a metronome to synchronize participants right heel-strikes with four different timing conditions. Net metabolic power during dynamic treadmill walking was significantly greater than normal walking at the mean speed of the task (1.125m/s) and generally lower than walking at the fast speed (1.5m/s). We did not observe any significant associations between net metabolic power and several measures of gait asymmetry during dynamic treadmill walking. These findings establish dynamic treadmill walking as a promising technique for improving gait symmetry in individuals who cannot tolerate fast treadmill walking, a common gait rehabilitation approach. Future work will assess the feasibility, metabolic demands, and clinical efficacy of using dynamic treadmill walking to improve gait symmetry in clinical populations. Key Points SummaryO_LIDynamic treadmill walking (i.e., walking with oscillating treadmill speeds) has previously been shown to drive gait asymmetries, but little is known about the energy expenditure required to complete the task. C_LIO_LIOur hypothesis was that dynamic treadmill walking would have similar metabolic power requirements to normal walking at a speed that is intermediate between the two dynamic treadmill walking speeds. C_LIO_LIWe found that dynamic treadmill walking actually requires metabolic power that is greater than the average of the two belt speeds, but less than that used for fast walking. C_LIO_LIDynamic treadmill walking is a promising and clinically translatable technique for rehabilitating populations with gait asymmetries that is not more energetically costly than fast treadmill walking, a common gait rehabilitation approach. C_LI