ArticleJournal of neuroengineering and rehabilitation2020
Self-selected step length asymmetry is not explained by energy cost minimization in individuals with chronic stroke.
Article in Journal of neuroengineering and rehabilitation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 15 citations in OpenAlex.
- Neuromechanical gait signatures reveal holistic biomechanical responses to walking speed modulation in stroke survivors.Scientific reports · 2026Article
- Walking with increased step length variability increases the metabolic cost of walking in young adults.The Journal of experimental biology · 2025Article
- Behavioural energetics in human locomotion: how energy use influences how we move.The Journal of experimental biology · 2025Review
- Multi-Site Identification and Generalization of Clusters of Walking Behaviors in Individuals With Chronic Stroke and Neurotypical Controls.Neurorehabilitation and neural repair · 2023Article
- Multi-site identification and generalization of clusters of walking behaviors in individuals with chronic stroke and neurotypical controls.bioRxiv : the preprint server for biology · 2023Article
- Gait speed and individual characteristics are related to specific gait metrics in neurotypical adults.Scientific reports · 2023Article
- Autonomous Control of Music to Retrain Walking After Stroke.Neurorehabilitation and neural repair · 2023Article
- Effects of Bilateral Assistance for Hemiparetic Gait Post-Stroke Using a Powered Hip Exoskeleton.Annals of biomedical engineering · 2023Article
- COMPARING GAIT AND HIP SCORES IN FEMORAL NECK AND INTERTROCHANTERIC FRACTURES.Acta ortopedica brasileira · 2023Article
- Patterns of asymmetry and energy cost generated from predictive simulations of hemiparetic gait.PLoS computational biology · 2022Article
- A test of the effort equalization hypothesis in children with cerebral palsy who have an asymmetric gait.PloS one · 2022Article
- Reduced joint motion supersedes asymmetry in explaining increased metabolic demand during walking with mechanical restriction.Journal of biomechanics · 2021Article
- Using Biofeedback to Reduce Step Length Asymmetry Impairs Dynamic Balance in People Poststroke.Neurorehabilitation and neural repair · 2021Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundAsymmetric gait post-stroke is associated with decreased mobility, yet individuals with chronic stroke often self-select an asymmetric gait despite being capable of walking more symmetrically. The purpose of this study was to test whether self-selected asymmetry could be explained by energy cost minimization. We hypothesized that short-term deviations from self-selected asymmetry would result in increased metabolic energy consumption, despite being associated with long-term rehabilitation benefits. Other studies have found no difference in metabolic rate across different levels of enforced asymmetry among individuals with chronic stroke, but used methods that left some uncertainty to be resolved.
methodsIn this study, ten individuals with chronic stroke walked on a treadmill at participant-specific speeds while voluntarily altering step length asymmetry. We included only participants with clinically relevant self-selected asymmetry who were able to significantly alter asymmetry using visual biofeedback. Conditions included targeting zero asymmetry, self-selected asymmetry, and double the self-selected asymmetry. Participants were trained with the biofeedback system in one session, and data were collected in three subsequent sessions with repeated measures. Self-selected asymmetry was consistent across sessions. A similar protocol was conducted among unimpaired participants.
resultsParticipants with chronic stroke substantially altered step length asymmetry using biofeedback, but this did not affect metabolic rate (ANOVA, p = 0.68). In unimpaired participants, self-selected step length asymmetry was close to zero and corresponded to the lowest metabolic energy cost (ANOVA, p = 6e-4). While the symmetry of unimpaired gait may be the result of energy cost minimization, self-selected step length asymmetry in individuals with chronic stroke cannot be explained by a similar least-effort drive.
conclusionsInterventions that encourage changes in step length asymmetry by manipulating metabolic energy consumption may be effective because these therapies would not have to overcome a metabolic penalty for altering asymmetry.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.