Locomotor Adaptation Training to Prevent Mobility Disability

Mobility disability is prevalent in aging populations. While existing walking interventions improve aspects related to mobility, meaningful and sustained changes leading to preventing and reversing mobility disability have remained elusive. Split-belt treadmills can be used to train gait adaptability and may be a potential long-term rehabilitation tool for those at risk for mobility decline. As adaptability is necessary for community walking, we investigated the feasibility of a small, randomized controlled 16-week gait adaptability training program in a cohort of 38 sedentary older adults at risk for mobility disability. Individuals were randomly assigned to one of three groups: traditional treadmill training, split-belt treadmill training, or no-contact control. Both treadmill interventions included progressive training 3 days a week, focusing on increasing duration and speed of walking. Cognitive, functional, cardiovascular, and gait assessments were completed before and after the intervention. While individuals were able to complete split-belt treadmill training, only Timed Up and Go performance was significantly improved compared to traditional treadmill training. As the stimulus provided by the split-belt training was difficult to control, we did not observe a clear benefit for split-belt treadmill training over traditional treadmill training. Our findings indicate a cautionary tale about the implementation of complex training interventions.