Background: Gait retraining is an integral part of stroke rehabilitation. Therapists frequently provide feedback to elicit a more typical gait pattern. There is limited understanding of optimal feedback strategies to promote learning of gait-related skills in individuals with and without stroke.
Purpose: To evaluate the impact of feedback-frequency and self-evaluation of performance on learning an unfamiliar gait pattern in healthy individuals.
Methods: Convenience sample (n=66) of healthy adults completed baseline testing on GaitRite walkway and preferred Walk Ratio (WR=step length/cadence) was calculated. Participants were then asked to alter their gait pattern in a manner that resulted in a new, target WR (90% preferred WR); and completed one 60-minute training session with feedback (WR-value). Participants assigned to one of 4 conditions: High-frequency feedback (100% trials) with Self-evaluation, Low-Frequency (33% trials) with Self-Evaluation, High-frequency without Self-evaluation, and Low-frequency without Self-evaluation. Retention and transfer (concurrent cognitive task) testing was completed 24-48 hours post-training. Primary outcome: absolute error = (Target WR - Performed WR)*100 at Delayed Retention.
Results: Participants in all groups learned to walk with novel step-length-to-cadence relationship after 1-practice session (p <0.001). Those encouraged to self-evaluate their performance prior to feedback had less error at retention 
(p <0.05).   
Conclusions: It is possible to elicit a durable change in gait pattern through practice and feedback. Self-evaluation of performance appears to enhance retention of novel gait-related skills. Ongoing research will evaluate the impact of feedback and self-evaluation on gait relearning in individuals with stroke and conditions affecting gait and mobility.

IMPACT OF FEEDBACK FREQUENCY AND SELF-EVALUATION ON LEARNING AN UNFAMILIAR GAIT PATTERN: A PILOT STUDY