# A novel, comprehensive approach to post-stroke gait rehabilitation

> **NIH NIH R03** · UNIVERSITY OF SOUTHERN CALIFORNIA · 2021 · $165,000

## Abstract

PROJECT SUMMARY
The goal of this project is to determine the feasibility and optimal parameters of a novel, comprehensive approach
to gait training in individuals with chronic stroke. Current post-stroke gait training follows two distinct approaches
that target different domains of gait dysfunction (as defined by the International Classification of Functioning,
Health, and Disability). Biofeedback-based gait training is typically employed to treat walking pattern impairments
(e.g., kinematic deviations relative to able-bodied controls); whereas, aerobic exercise intensity-based gait
training is the current gold-standard to treat walking activity limitations (e.g., slow walking speeds). Here, we
propose to test the impact of combining these approaches into a single intervention to work toward the
development of a more effective, comprehensive approach to gait rehabilitation for persons post-stroke. The
central hypothesis is that individuals with chronic stroke have the capacity to use biofeedback to reduce kinematic
gait deviations while walking at a range of recommended aerobic exercise intensity zones. Aim 1 will identify the
gait biofeedback variable that elicits the largest reduction in interlimb asymmetry in persons post-stroke. Aim 2
will determine the capacity for persons post-stroke to make biofeedback-driven reductions in their interlimb
asymmetry while walking at three different aerobic exercise intensities. Participants with chronic stroke in Aim 1
will each complete three experimental sessions and participants in Aim 2 will complete 1 experimental session.
Biomechanical analyses and physiologic assessments will be used across both aims to test our working
hypotheses. We expect to show that biofeedback of paretic propulsion leads to the greatest reduction in interlimb
asymmetry and that participants have the capacity to make biofeedback-driven interlimb asymmetry reductions
while walking at all three aerobic intensities, but the magnitude of reduction will be the largest at a moderate
aerobic walking intensity. The proposed work is innovative because it will be the first to test the relative effects
of different gait biofeedback variables on whole lower extremity kinematics in persons post-stroke and test a
novel combination of two well-established gait training approaches (biofeedback- and intensity-based) for
neurologic patient populations. This is a critical next step in moving the post-stroke gait rehabilitation field
forward. The results are expected to have a high impact because it will provide foundational evidence to support
a subsequent R01 proposal aimed to assess the mechanisms of action and long-term efficacy associated with
this novel, comprehensive gait rehabilitation protocol. If successful, this line of work stands to significantly
improve the current standard of care in gait rehabilitation post-stroke.

## Key facts

- **NIH application ID:** 10133367
- **Project number:** 1R03HD104217-01
- **Recipient organization:** UNIVERSITY OF SOUTHERN CALIFORNIA
- **Principal Investigator:** Kristan A. Leech
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $165,000
- **Award type:** 1
- **Project period:** 2021-05-15 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10133367

## Citation

> US National Institutes of Health, RePORTER application 10133367, A novel, comprehensive approach to post-stroke gait rehabilitation (1R03HD104217-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10133367. Licensed CC0.

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