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

> **NIH NIH R03** · UNIVERSITY OF SOUTHERN CALIFORNIA · 2022 · $100,423

## Abstract

Information from PI-Prime Award
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 interventions follow
into two distinct approaches that target different domains of gait dysfunction (as defined by the International
Classification of Functioning, Health, and Disability). Biofeedback-based training is typically employed to treat
walking pattern impairments (e.g., kinematic deviations relative to able-bodied controls). Whereas, aerobic
exercise intensity-based 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, carefully crafted approach to gait
rehabilitation or 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 intensity levels. 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
reduce their interlimb asymmetry while walking at three different levels of aerobic intensity. Participants with
chronic stroke in Aims 1 will each complete in 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 post-stroke and that participants have the capacity to make
biofeedback-driven interlimb asymmetry reductions in 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 providing biofeedback of different gait variables on whole lower
extremity kinematics in persons post-stroke and test a novel combination of two well-established gait training
methods (biofeedback- and intensity-based training) 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 long-
term learning effects and potential mechanisms of action of a combinatory post-stroke gait rehabilitation
approach. 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:** 10488408
- **Project number:** 3R03HD104217-01S1
- **Recipient organization:** UNIVERSITY OF SOUTHERN CALIFORNIA
- **Principal Investigator:** Kristan A. Leech
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $100,423
- **Award type:** 3
- **Project period:** 2021-05-15 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10488408

## Citation

> US National Institutes of Health, RePORTER application 10488408, A novel, comprehensive approach to post-stroke gait rehabilitation (3R03HD104217-01S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10488408. Licensed CC0.

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