Perturbations During Gait on a Split-Belt Treadmill: A Scoping Review

Background: Humans encounter disturbances like slips, pushes, and trips while walking, mainly from external forces. Technological advances have improved methods to study these impacts on gait, with split-belt treadmills being particularly effective. This scoping review aims to examine the types of perturbations used during split-belt treadmill gait, explore the methods used to induce them, and consolidate current knowledge on the effects of split-belt treadmill-induced gait perturbations. Methods: The review included publications from January 2015 to May 2024, as searched via PubMed, EBSCO, and ScienceDirect. Results: The review examined 33 studies on split-belt treadmills, focusing on perturbations like slip-like, trip-like, lateral displacements, and tilts, with speed changes being the most common. Perturbations were mainly applied during initial contact. The results show that young, healthy adults adapt quickly to anticipatory and reactive adjustments, while older adults and those with neurological impairments use less efficient strategies like increased muscular co-contraction. Asymmetrical gait adaptations persist after perturbations, highlighting motor learning and the role of the central nervous system and sensory feedback. Conclusions: Despite their precision, split-belt and tilting treadmills may not fully replicate real-world walking complexities. The review highlights the strengths and limitations of split-belt treadmills, emphasizing the need to integrate diverse methods to enhance rehabilitation and improve gait stability.