Date of Award

12-2025

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Biomechanics

First Advisor

Dr. Brian A. Knarr

Abstract

People with brain injuries, like stroke, and children experiencing cerebral palsy (CP), tend to experience gait alterations and walking impairments due to injuries to regions of their brains. These impairments negatively affect the ability of affected individuals to function appropriately within their communities, necessitating task-specific gait training, such as underwater treadmill (UT) walking. UT walking is an intervention that leverages the buoyancy and hydrodynamic drag characteristics of water to the advantage of its users. Currently, there is no established baseline principle for applying UT walking mechanisms for rehabilitation.

This dissertation focused on investigating the mechanisms for UT use in persons with stroke and children with Cerebral palsy. Changes in kinematic, spatiotemporal, and muscle activity measures were assessed to identify motor control strategies across different water depths and treadmill speeds compared to dry treadmill (DT) walking, in two study designs. For the first study, seven subacute stroke survivors walked at a pre-established comfortable walking speed on the DT and the UT at the waist and xyphoid water depths. For the second study, eight children with CP and 13 typically developing peers walked on the DT and in the UT at pre-determined fast, normal, and slow treadmill speeds. The results indicated that UT walking demonstrated greater rehabilitative potential compared to conventional DT walking. Specifically, the UT environment increased peak hip and knee joint angles at the waist-depth compared to the other walking conditions, and the xyphoid depth enhanced more limb use. In addition, the children with CP exhibited greater inter-joint coordination variability at slow treadmill speeds than at fast speeds, and in the underwater environment compared to the DT environment. In stroke survivors, qualitative visualization revealed that most participants exhibited more variable gait during UT walking; however, this was not statistically significant, likely due to a limited sample size. This work shows the rehabilitative potential of UT walking. Further research will better guide its prescription in the brain-injured population.

Comments

The author holds the copyright to this work, any reuse or permissions must be obtained from them directly. 

PDF passed Adobe's accessibility checker prior to upload.

Download

Share

COinS