Background-Task-specific loading of the limbs-termed as functional resistance training-is commonly used in gait rehabilitation; however, the biomechanical and neuromuscular effects of various forms of functional resistance training have not been studied systematically. This information is crucial for correctly selecting the appropriate mode of functional resistance training when treating individuals with gait disorders.Research question-To comprehensively evaluate the biomechanical (i.e., joint moment and power) and muscle activation changes with different forms of functional resistance training that are commonly used in clinics and research using biomechanical simulation-based analyses.Methods-We developed simulations of functional resistance training during walking using OpenSim (Gait2354, 23 degrees of freedom and 54 muscles) and custom MATLAB scripts. We investigated five modes of functional resistance training that have been commonly used in clinics or in research: (1) a weight attached at the ankle, (2) an elastic band attached at the ankle, (3) a viscous device attached to the hip and knee, (4) a weight attached at the pelvis, and (5) a constant backwards pulling force at the pelvis. Lower-extremity joint moments and powers were computed using inverse dynamics and muscle activations were estimated using computed muscle control while walking with each device under multiple resistance levels: normal walking with no resistance, and walking with 30, 60, and 90 Newtons of resistance. Results-The results indicate that the way in which resistance is applied during gait training differentially affects the internal joint moments, powers, and muscle activations as well as the joints and phase of the gait cycle where the resistance was experienced.

The use of motor learning strategies may enhance rehabilitation outcomes of individuals with neurological injuries (e.g., stroke or cerebral palsy). A common strategy to facilitate learning of challenging tasks is to use sequential progression-i.e., initially reduce task difficulty and slowly increase task difficulty until the desired difficulty level is reached. However, the evidence related to the use of such sequential progressions to improve learning is mixed for functional skill learning tasks, especially considering situations where practice duration is limited. Here, we studied the benefits of sequential progression using a functional motor learning task that has been previously used in gait rehabilitation. Three groups of participants (N=43) learned a novel motor task during treadmill walking using different learning strategies. Participants in the specific group (n=21) practiced only the criterion task (i.e., matching a target template that was scaled-up by 30%) throughout the training. Participants in the sequential group (n=11) gradually progressed to the criterion task (from 3% to 30% in increments of 3%), whereas participants in the random group (n=11) started at 3% and progressed in random increments (involving both increases and decreases in task difficulty) to the criterion task. At the end of training, kinematic tracking performance on the criterion task was evaluated in all participants both with and without visual feedback. Results indicated that the tracking error was significantly lower in the specific group, and no differences were observed between the sequential and the random progression groups. The findings indicate

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