# A novel mechanics-based intervention to improve post-stroke gait stability

> **NIH VA I01** · RALPH H JOHNSON VA MEDICAL CENTER · 2020 · —

## Abstract

Independent mobility, the ability of an individual to successfully and safely navigate through their environment,
is a primary contributor to quality of life. Unfortunately, mobility often decreases following a stroke, preventing
many stroke survivors from returning to typical levels of activity participation. A major contributor to reduced
mobility is gait instability, which can limit function either by increasing the risk of falls or by increasing the fear
of falling. Several existing rehabilitation techniques have been demonstrated to improve certain aspects of
post-stroke gait function, such as increasing self-selected walking speed. However, these interventions have
generally failed to address gait instability, as evidenced by a lack of improvement in fall risk. A likely reason for
the limited effectiveness of current rehabilitation approaches is that they are not based on the unique
mechanisms underlying post-stroke gait instability.
A longer-term goal of this general line of research is to develop clinically-available, mechanism-based
interventions to improve post-stroke gait stability. As a step toward accomplishing this goal, the project will
focus on a potential mechanistic cause of instability suggested by preliminary work investigating how gait is
stabilized among uninjured controls and stroke survivors. This approach contrasts with typical investigations of
gait instability, which largely focus on quantifying non-causal indicators of stability rather than understanding
the underlying mechanisms.
The central hypothesis is that post-stroke disruptions in gait stability are often caused by a lack of
mechanically-appropriate adjustments in foot placement location. While individuals with stable gait patterns
actively control their foot placement based on the mechanical state of their center of mass, this evidence of
active stabilization is often lacking after a stroke. The disruption of the typical gait stabilization strategy has
motivated the recent construction of a prototype rehabilitation robotics device able to manipulate foot
placement location. The objective of this proposal is to further develop this device and conduct initial testing of
its ability to improve post-stroke gait stability, based on principles of motor learning. This will be accomplished
through three Specific Aims.
The first Specific Aim is to identify the simplest force-field control method able to effectively modulate foot
placement. Several candidate control methods will be compared in terms of their ability to increase
mechanically-appropriate foot placement modulation. The second Specific Aim is to determine whether the
typical gait stabilization strategy can be restored by repeated gait practice while the force-field either: 1)
encourages mechanically-appropriate foot placement; or 2) amplifies errors away from mechanically-
appropriate target locations. These two intervention strategies are based on distinct theoretical frameworks.
The “challenge point framew...

## Key facts

- **NIH application ID:** 9823784
- **Project number:** 5I01RX002256-04
- **Recipient organization:** RALPH H JOHNSON VA MEDICAL CENTER
- **Principal Investigator:** JESSE C. DEAN
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-01-01 → 2021-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9823784

## Citation

> US National Institutes of Health, RePORTER application 9823784, A novel mechanics-based intervention to improve post-stroke gait stability (5I01RX002256-04). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/9823784. Licensed CC0.

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