# Movement Amplification Training to Enhance Walking Balance Post-Stroke

> **NIH NIH R21** · NORTHWESTERN UNIVERSITY · 2023 · $426,137

## Abstract

Project Summary
People with chronic stroke (PwCS) have substantial walking balance dysfunctions that limit independence and
participation in walking activities. There is a pressing need to develop effective methods to enhance walking
balance in PwCS. Interventions that amplify self-generated movements may accelerate motor learning by
enhancing an individual’s perception of movement errors. This method could potentially be applied to help PwCS
improve walking balance. To this end, we have developed a cable-driven robot to create a Movement
Amplification Environment (MAE) during treadmill walking. The MAE challenges walking balance by applying
lateral forces to the pelvis that are proportional in magnitude to real-time lateral center of mass (COM) velocity.
Here we propose to evaluate the effects of gait training in a MAE on walking balance in PwCS. Aim 1 will quantify
locomotor adaptations that PwCS make to maintain walking balance in a MAE and evaluate the impact of MAE
strength, a key gait training variable. We will also examine short-term changes in the ability of PwCS to control
their lateral COM excursion during walking (a quantifiable walking balance measure) immediately after MAE
training. Aim 2 will evaluate long-term changes in walking balance and daily walking following a 5-week high-
intensity gait training intervention performed in a MAE. For Aim 1, we will conduct a single-session cross sectional
study wherein twenty PwCS will each participate in two experiments evaluating gait biomechanics (whole body
center of mass dynamics and stepping patterns) during and immediately following MAE training. Locomotor
adaptations during walking in a MAE and the effect of MAE strength (low, medium, and high) will be examined.
We will measure changes in the ability of PwCS to control their lateral COM excursion during walking immediately
before and after walking in a MAE. Outcomes will assess if short-term walking balance is enhanced immediately
following MAE exposure. For Aim 2, we will employ a pre-post study design wherein ten PwCS will participate in
10-sessions of high intensity gait training performed in a MAE. We will assess pre- to post- changes in walking
balance using clinical gait and balance measures, biomechanical assessments, and participation in daily walking
(steps/day). Outcomes will assess if long-term walking balance is enhanced following MAE gait training. Our
innovative training paradigm, amplifying individuals own self-generated movements, is a radical departure from
current practice and could substantially enhance walking balance in PwCS. This study will provide valuable
insights about the mechanisms employed by PwCS to maintain their walking balance in a MAE and if beneficial
behaviors persist following MAE training. Successful outcomes will motivate a randomized controlled trial to
assess efficacy of MAE training on walking balance in PwCS. The broad aim of our proposal aligns closely with
the mission of NINDS/NIMH Explorator...

## Key facts

- **NIH application ID:** 10725856
- **Project number:** 1R21HD112813-01
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** Keith Edward Gordon
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $426,137
- **Award type:** 1
- **Project period:** 2023-08-01 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10725856

## Citation

> US National Institutes of Health, RePORTER application 10725856, Movement Amplification Training to Enhance Walking Balance Post-Stroke (1R21HD112813-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10725856. Licensed CC0.

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