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Gait Training With Visual Feedback and Proprioceptive Input to Reduce Gait Asymmetry in Adults With Cerebral Palsy: A Case Series

Levin, Ilana PT, DPT; Lewek, Michael D. PT, PhD; Feasel, Jeff MS; Thorpe, Deborah E. PT, PhD

doi: 10.1097/PEP.0000000000000362
Research Reports

Purpose: The purpose of this case series was to investigate the feasibility of using visual feedback on gait asymmetry during gait retraining and whether this leads to reduced asymmetry, improvement in gait speed, cost of walking, and dynamic balance in ambulant adults with cerebral palsy (CP).

Methods: Five adults with CP, who were ambulatory and had step length or stance time asymmetry, trained for 18 sessions on a split-belt treadmill with concurrent visual feedback from a virtual environment. Training also included overground gait training to encourage transfer of learning.

Results: All participants reduced gait asymmetry and improved on outcomes at posttest and follow-up.

Conclusions: Outcome measures and training protocols were feasible in this sample of convenience of adults with CP who were ambulatory and who did not have visual impairment. The adults with CP in this study demonstrated individual improvements in gait and balance following training.

This paper examines whether providing visual feedback about gait asymmetry in the form of virtual reality during gait retraining improves gait speed and dynamic balance in adults with cerebral palsy.

Department of Allied Health Sciences, Division of Physical Therapy, Program in Human Movement Science (Drs Levin, Thorpe, and Lewek), and Department of Computer Science (Mr Feasel), University of North Carolina-Chapel Hill, Chapel Hill.

Correspondence: Ilana Levin, PT, DPT, Department of Allied Health Sciences, Division of Physical Therapy, University of North Carolina-Chapel Hill, 3043 Bondurant Hall, CB 7135, Chapel Hill, NC 27599 (

Grant Support: This study was supported by a grant from the UNC-CH University Research Council.

The authors declare no conflicts of interest.

Copyright © 2017 Wolters Kluwer Health, Inc. and Section on Pediatrics of the American Physical Therapy Association. All rights reserved.