A treadmill and motion coupled virtual reality system for gait training post-stroke.

A virtual reality (VR)-based locomotor training system has been developed for gait rehabilitation post-stroke. The system consists of a self-paced treadmill mounted onto a 6-degrees-of-freedom motion platform. Virtual environments (VEs) that are synchronized with the speed of the treadmill and the motions of the platform are rear-projected onto a screen in front of the walking subject. A feasibility study was conducted to test the capability of two stroke patients and one healthy control to be trained with the system. Three VE scenarios (corridor walking, street crossing, and park stroll) were woven into a gait-training program that provided three levels of complexity (walking speed, slopes, collision avoidances), progression criteria (number of successful trials) and knowledge of results. Results show that, with practice, patients can effectively increase their gait speed as demanded by the task and adapt their gait with respect to the change in physical terrain. However, successful completion of tasks requiring adaptation to increasing demands related to speed and physical terrains does not necessarily predict the patient's ability to anticipate and avoid collision with obstacles during walking. This feasibility study demonstrates that persons with stroke are able to adapt to this novel VR system and be immersed in the VEs for gait training.     

Manipulating perception versus action in recalibration tasks

We conducted six experiments to examine how manipulating perception versus action affects perception–action recalibration in real and imagined blindfolded walking tasks. Participants first performed a distance estimation task (pretest) and then walked through an immersive virtual environment on a treadmill for 10 min. Participants then repeated the distance estimation task (posttest), the results of which were compared with their pretest performance. In Experiments 1a, 2a, and 3a, participants walked at a normal speed during recalibration, but the rate of visual motion was either twice as fast or half as fast as the participants' walking speed. In Experiments 1b, 2b, and 3b, the rate of visual motion was kept constant, but participants walked at either a faster or a slower speed. During pre- and posttest, we used either a blindfolded walking distance estimation task or an imagined walking distance estimation task. Additionally, participants performed the pretest and posttest distance estimation tasks in either the real environment or the virtual environment. With blindfolded walking as the distance estimation task for pre- and posttest, we found a recalibration effect when either the rate of visual motion or the walking speed was manipulated during the recalibration phase. With imagined walking as the distance estimation task, we found a recalibration effect when the rate of visual motion was manipulated, but not when the walking speed was manipulated in both the real environment and the virtual environment. Discussion focuses on how spatial-updating processes operate on perception and action and on representation and action.     

Gaze behaviour during walking in young adults with developmental coordination disorder

BackgroundIndividuals with Developmental Coordination Disorder (DCD) experience difficulty with motor coordination and this affects their daily functioning. Research indicated inferior visuospatial processing and oculomotor control in DCD. As visual information is essential for locomotor control, more insight in the gaze behaviour of this population during walking is required and crucial for gaze training interventions as a possible means to improve daily functioning of children and adults with DCD.AimThis study explored differences and similarities in gaze behaviour during walking between typically developing young adults and those with DCD.Methods and proceduresTen young adults with DCD (age: 22.13 ± 0.64) and ten typically developing individuals (age: 22.00 ± 1.05) completed a walking task in which they had to place their feet on irregularly placed targets wearing eye tracking glasses.Outcomes and resultsIndividuals with DCD walked slower and demonstrated a different gaze strategy compared to their neurotypical peers as they fixated almost each and every target sequentially. Typically developing individuals, on the other hand, directed gaze further along the path and often fixated areas around the targets.Conclusions and implicationsDespite adequate walking performance in daily situations in young adults with DCD, fundamental control deficits persist into adulthood.What this paper adds?This paper is the first to demonstrate differences in gaze behaviour between young adults with DCD and typically developing individuals in a task that resembles a task of daily living, as previous research focused on laboratory tasks. This is a valuable finding as DCD has a clear impact on the daily life. Furthermore, this study demonstrated that the fundamental control deficits of DCD persist into adulthood despite frequent performance and practice of these daily tasks. Lastly, these findings might contribute to the therapeutic potential of gaze training interventions to improve the daily functioning of children and adults with DCD.     

Keep your head down: Maintaining gait stability in challenging conditions

BackgroundPeripheral vision often deteriorates with age, disrupting our ability to maintain normal locomotion. Laboratory based studies have shown that lower visual field loss, in particular, is associated with changes in gaze and gait behaviour whilst walking and this, in turn, increases the risk of falling in the elderly. Separately, gaze and gait behaviours change and fall risk increases when walking over complex surfaces. It seems probable, but has not yet been established, that these challenges to stability interact.Research questionHow does loss of the lower visual field affect gaze and gait behaviour whilst walking on a variety of complex surfaces outside of the laboratory? Specifically, is there a synergistic interaction between the effects on behaviour of blocking the lower visual field and increased surface complexity?MethodsWe compared how full vision versus simulated lower visual field loss affected a diverse range of behavioural measures (head pitch angle, eye angle, muscle coactivation, gait speed and walking smoothness as measured by harmonic ratios) in young participants. Participants walked over a range of surfaces of different complexity, including pavements, grass, steps and pebbles.ResultsIn both full vision and blocked lower visual field conditions, surface complexity influenced gaze and gait behaviour. For example, more complex surfaces were shown to be associated with lowered head pitch angles, increased leg muscle coactivation, reduced gait speed and decreased walking smoothness. Relative to full vision, blocking the lower visual field caused a lowering of head pitch, especially for more complex surfaces. However, crucially, muscle coactivation, gait speed and walking smoothness did not show a significant change between full vision and blocked lower visual field conditions. Finally, head pitch angle, muscle coactivation, gait speed and walking smoothness were all correlated highly with each other.SignificanceOur study showed that blocking the lower visual field did not significantly change muscle coactivation, gait speed or walking smoothness. This suggests that young people cope well when walking with a blocked lower visual field, making minimal behavioural changes. Surface complexity had a greater effect on gaze and gait behaviour than blocking the lower visual field. Finally, head pitch angle was the only measure that showed a significant synergistic interaction between surface complexity and blocking the lower visual field. Together our results indicate that, first, a range of changes occur across the body when people walk over more complex surfaces and, second, that a relatively simple behavioural change (to gaze) suffices to maintain normal gait when the lower visual field is blocked, even in more challenging environments. Future research should assess whether young people cope as effectively when several impairments are simulated, representative of the comorbidities found with age.     

The influence of visual perception of self-motion on locomotor adaptation to unilateral limb loading

Self-perception of motion through visual stimulation may be important for adapting to locomotor conditions. Unilateral limb loading is a locomotor condition that can improve stability and reduce abnormal limb movement. In the present study, the authors investigated the effect of self-perception of motion through virtual reality (VR) on adaptation to unilateral limb loading. Healthy young adults, assigned to either a VR or a non-VR group, walked on a treadmill in the following 3 locomotor task periods--no load, loaded, and load removed. Subjects in the VR group viewed a virtual corridor during treadmill walking. Exposure to VR reduced cadence and muscle activity. During the loaded period, the swing time of the unloaded limb showed a larger increase in the VR group. When the load was removed, the swing time of the previously loaded limb and the stance time of the previously unloaded limb showed larger decrease and the swing time of the previously unloaded limb showed a smaller increase in the VR group. Lack of visual cues may cause the adoption of cautious strategies (higher muscle activity, shorter and more frequent steps, changes in the swing and stance times) when faced with situations that require adaptations. VR technology, providing such perceptual cues, has an important role in enhancing locomotor adaptation.     

Gait complexity is acutely restored in older adults when walking to a fractal-like visual stimulus

Typically, gait rehabilitation uses an invariant stimulus paradigm to improve gait related deficiencies. However, this approach may not be optimal as it does not incorporate gait complexity, or in more precise words, the variable fractal-like nature found in the gait fluctuations commonly observed in healthy populations. Aging which also affects gait complexity, resulting in a loss of adaptability to the surrounding environment, could benefit from gait rehabilitation that incorporates a variable fractal-like stimulus paradigm. Therefore, the present study aimed to investigate the effect of a variable fractal-like visual stimulus on the stride-to-stride fluctuations of older adults during overground walking. Additionally, our study aimed to investigate potential retention effects by instructing the participants to continue walking after turning off the stimulus. Older adults walked 8 min with i) no stimulus (self-paced), ii) a variable fractal-like visual stimulus and iii) an invariant visual stimulus. In the two visual stimuli conditions, the participants walked 8 additional minutes after the stimulus was turned off. Gait complexity was evaluated with the widely used fractal scaling exponent calculated through the detrended fluctuation analysis of the stride time intervals. We found a significant ~20% increase in the scaling exponent from the no stimulus to the variable fractal-like stimulus condition. However, no differences were found when the older adults walked to the invariant stimulus. The observed increase was towards the values found in the past to characterize healthy young adults. We have also observed that these positive effects were retained even when the stimulus was turned off for the fractal condition, practically, acutely restoring gait complexity of older adults. These very promising results should motivate researchers and clinicians to perform clinical trials in order to investigate the potential of visual variable fractal-like stimulus for gait rehabilitation.     

How trunk turns affect locomotion when you are not looking where you go

How well do we maintain heading direction during walking while we look at objects beside our path by rotating our eyes, head, or trunk? Common experience indicates that it may be fairly hazardous not to look where you are going. In the present study, 12 young adults walked on a treadmill while they followed a moving dot along a horizontal line with their gaze by rotating primarily either their eyes, head, or trunk for amplitudes of up to 25 degrees . During walking the movement of the center of pressure (COP) was monitored using force transducers under a treadmill. Under normal light conditions, the participants showed little lateral deviation of the COP from the heading direction when they performed the eye or head movement task during walking, even when optic flow information was limited. In contrast, trunk rotations led to a doubling of the COP deviation in the mediolateral direction. Some of this deviation was attributed to foot rotation. Participants tended to point their feet in the gaze direction when making trunk turns. The tendency of the feet to be aligned with the trunk is likely to be due to a preference to have feet and body in the same orientation. Such alignment is weaker for the feet with respect to head position and it is absent with respect to eye position. It is argued that feet and trunk orientation are normally tightly coupled during gait and that it requires special abilities to move both segments independently when walking.     

Effects of familiar and unfamiliar asynchronous music on treadmill walking endurance

To assess effects of familiarity of music on treadmill endurance, 15 female undergraduates in sports science performed an incremental treadmill walking task on three separate occasions while listening to Familiar Music, Unfamiliar Music, and White Noise. A repeated-measures analysis of variance indicated that participants walked for significantly longer when accompanied by Familiar and Unfamiliar Music in comparison to White Noise (p<.01). Although participants rated Familiar Music as significantly more motivating than Unfamiliar music (p<.05), no significant differences were found between the two music conditions for treadmill endurance. Heart rates did not appear to be influenced by music during treadmill walking or on completion of the task.     

Bodyweight support alters the relationship between preferred walking speed and cost of transport

Humans tend to select a preferred walking speed (PWS) that minimizes the metabolic energy consumed per distance traveled, i.e. the Cost of Transport (CoT). The aims of this study were to: 1. compare PWS overground vs. on a treadmill at 100 and 50% of body weight, and 2. explore whether with body weight support, PWS corresponds to the speed that minimizes CoT. Fifteen healthy adults walked overground and on a lower body positive pressure treadmill with and without bodyweight support. Walking speeds (m^.s⁻¹) were recorded for each condition. Rate of energy expenditure (J^.kg^−1.min⁻¹) and CoT (J^.kg^−1.m⁻¹) were then determined from 5-min walking trials with 50% bodyweight support at PWS and ± 30% of the self-selected walking speed for that condition. PWS did not differ across conditions. With 50% body weight support, for each 30% increase in walking speed, rates of metabolic energy expenditure increased ∼15% while CoT decreased by ∼14%. Thus, with 50% body weight support, PWS did not correspond with the speed that minimized CoT. Bodyweight support decreases cost of maintaining an upright body but does not decrease the metabolic demand of limb advancement, contributing to the linear yet not proportional changes in rates of energy expenditure and CoT. We conclude that bodyweight support via an AlterG® treadmill disconnects the association between PWS and minimum CoT. These findings have implications for clinical populations (e.g., obese, elderly) who may benefit from walking on a bodyweight supporting treadmill but may select speeds incompatible with their physical activity goals.     

Multifractality of Unperturbed and Asymmetric Locomotion

The purpose of this study was to explore the extent of multifractality in unperturbed and constrained locomotion, and to determine if multifractality predicted gait adaptability. Young, healthy participants (n?=?15) walked at preferred and slow speeds, as well as asymmetrically (one leg at half speed) on a split-belt treadmill. Stride time multifractality was assessed via local detrended fluctuation analysis, which evaluates the evolution of fluctuations both spatially and temporally. Unperturbed walking exhibited monofractal behavior. Asymmetric walking displayed greater multifractality in the faster moving limb, indicating more intermittent periods of extreme high or low variance. Multifractality was not associated with adaptation to asymmetric walking. These findings further suggest that unperturbed locomotion is monofractal and establish that perturbed walking yields multifractal behavior.     

Writing while walking: The impact of cognitive-motor multi-tasking on collision avoidance in human locomotion

BackgroundWhen moving in public space, individuals are challenged with having to master multiple cognitive and motor demands, either simultaneously or in short succession. Empirical evidence suggests that cognitive-motor multi-tasking during walking may impact one or both, cognitive and motor performance. These performance changes may result from unintentional task-interference effects, but also from strategic behavioral changes to cope with the multiple task demands. Strategic changes in human walking behavior have been uncovered in experimental scenarios, in which individuals avoid colliding with other individuals or objects in the environment. However, whether collision avoidance behavior is sensitive to cognitive-motor multi-task demands has remained underexplored, yet. Thus, with this study, we aimed at systematically studying cognitive-motor multi-task effects on collision avoidance during human locomotion.MethodsTen healthy participants (23.9 ± 4.3 years, 4 female) were walking at their preferred speed from a predefined start to end position under four experimental conditions: walking only (BL), walking while having to avoid a collision with another person (IO), writing a text message on a mobile phone while walking (cognitive-motor dual-task, DT), and writing while walking with collision avoidance demand (multi-task, MT). Parameters quantifying locomotor as well as collision avoidance behavior (path length, walking speed, minimum distance, path and speed adjustment) were assessed using optical motion tracking. In addition, performance in the writing task (errors, writing speed) was examined.ResultsParticipants' locomotor behavior was significantly affected by experimental conditions, with additive effects of multi-task demands on both path length (BL = DT < IO < MT) and walking speed (BL > IO > DT > MT). Further, participants showed an increased error rate and writing speed in the writing task when walking as compared to when standing still, independent of the presence of an interferer. Importantly, collision avoidance behavior was selectively influenced by cognitive-motor multi-task demands, with an increased minimum distance to the other person in the MT-condition, but no differences in path or speed adjustment.DiscussionOur results suggest significant multi-tasking effects of writing a message on the mobile phone while walking on both locomotor behavior and writing task performance. Collision avoidance behavior seems to be selectively affected by multi-task demands, reflected in an increased minimum passing distance, without overt changes in path or speed adjustments. This may be indicative for a strategic change in collision avoidance behavior towards a more cautious strategy to account for altered attention allocation and less visual feedback when writing while walking.     

The effect of a five-step cognitive learning strategy on the acquisition of a complex motor task

Abstract

Investigated was the effectiveness of the Five-Step Learning Strategy in facilitating the learning of a complex self-paced motor task. Thirty undergraduate students were randomly assigned to one of three conditions, after being stratified as to number and sex: (1) a strategy group, that was administered the Strategy, (2) a preview group, that previewed the location of the targets, and (3) a control group. All subjects performed 48 trials in an attempt to learn a task that required speed and accuracy in mastering a sequence of responses. ANOVA analyses indicated that the Strategy group performed significantly faster than the other two groups, and not at the expense of a greater number of errors. These findings indicate that cognitive processes involved in learning a complex skill are likely to benefit from the utilization of the Five-Step Strategy.     

Comparing the effect of haptic modalities on walking balance control: Is using one or two arms better?

BackgroundAdding haptic input by lightly touching a railing or using haptic anchors may improve walking balance control. Typical use of the railing(s) and haptic anchors requires the use of one and two arms in an extended position, respectively. It is unclear whether it is arm configuration and/or the number of arms used or the addition of sensory input that affects walking balance control.Research questionThis study examined whether using one arm or two arms to add haptic input through light touch on a railing or using the haptic anchors affects walking balance control.MethodsIn this study, young adults (n = 24) walked while using (actual use) or pretending to use (pretend use) the railing(s) and haptic anchors with one or two arms. Inertial-based sensors (Mobility Lab, APDM) were used to measure stride velocity, relative time spent in double support (%DS), and peak normalized medio-lateral trunk velocity (pnMLTV).ResultsUsing two arms lead to a decrease in pnMLTV compared to using one arm and pnMLTV was lower in the actual use trials compared to the pretend use trials for the anchors only. Stride velocity and %DS did not change between trials when one or two arms were used or when participants actually or pretended to use the haptic tools. Participants walked slower when using the railing compared to the anchors.SignificanceThe importance of considering the number of arms is highlighted in the improved balance control when using two arms with either tool. The augmented sensory input adds to the stabilizing effect of arm configuration for the anchors but not the railings. These results have implications for future research and rehabilitation efforts emphasizing sensorimotor integration to improve walking balance control.     

Everyday tasks impair spatiotemporal variables of gait in older adults with Parkinson's disease

IntroductionAlthough it is known that individuals with Parkinson's disease (PD) have difficulties performing dual-task activities, most of the studies have verified the effect of dual tasks on gait using tasks that are uncommon to perform while walking. However, the realization of tasks involving gait that really represents the daily activities carried out by the participants, allow us to detect real fall risk situations of individuals with PD during their gait.ObjectiveOur aim was to verify the influence of daily-life dual-tasks on gait spatiotemporal variables of the older adults with PD.Methods20 older adults without PD and 20 older adults with PD participated in the study. Gait kinematic was analyzed under three different conditions: walking without dual task, walking carrying bags with weight, and walking talking on the cell phone.ResultsOlder adults with PD presented lower speed (p = .001), cadence (p = .039), and shorter step length (p = .028) than older adults without PD during walking without dual tasks. When walking while carrying bags with weight, older adults with PD had a lower speed (p < .001), cadence (p = .015), shorter step length (p = .008), and greater double support time (p = .021) compared with older adults without PD. During walking while talking on the cell phone, older adults with PD walked with lower speed (p < .001), cadence (p = .013), shorter step length (p = .001) and swing time (p = .013), and increased double support time (p = .008) and support time (p = .014) in relation to older adults without PD.ConclusionDaily-life dual tasks impair the spatiotemporal variables of gait in the older adults with PD, which was most evident during walking talking on the cell phone.     

Bicyclists’ speed adaptation strategies when conducting self-paced vs. system-paced smartphone tasks in traffic

The increasing prevalence of mobile phone usage while cycling has raised concerns, even though the number of cyclists involved in accidents does not increase at a comparable rate. A reason for this may be how cyclists adapt travelling speed and task execution to the current traffic situation. The aim of this study is to investigate speed adaptation among cyclists when conducting self-paced (initiated by the cyclist) vs. system-paced (initiated by somebody else) smartphone tasks in real traffic.Twenty-two cyclists completed a track in real traffic while listening to music, receiving and making calls, receiving and sending text messages, and searching for information on the internet. The route and the types of tasks were controlled, but the cyclists could choose rather freely when and where along the route to carry out the tasks, thus providing semi-naturalistic data on compensatory behaviour.The results clearly show that cyclists use conscious strategies to adapt their speed to accommodate the execution of secondary phone tasks. Regarding tactical behaviour, it was found that cyclists kept on cycling in 80% of the system-paced cases and in 70% of the self-paced cases. In the remaining cases, the cyclists chose to execute the phone task while standing still or when walking. Compared to the baseline (17.6 ± 3.5 km/h), the mean speed was slightly increased when the cyclists listened to music (18.2 ± 3.7 km/h) and clearly decreased when they interacted with the phone (13.0 ± 5.0 km/h). The speed reduction profile differed between self-paced and system-paced tasks with a preparatory speed reduction before task initiation for self-paced tasks.In conclusion, when the cyclists had the chance they either stopped or adapted their speed proactively to accommodate the execution of the phone task. For self-paced tasks, the speed reduction was finalised before task initialisation, and for system-paced tasks the speed adaptation occurred in reaction to the incoming task. It is recommended to investigate whether the observed compensatory behaviour is enough to offset the possible negative effects of smartphone use.     

The pendular mechanism does not determine the optimal speed of loaded walking on gradients

The pendular mechanism does not act as a primary mechanism in uphill walking due to the monotonic behavior of the mechanical energies of the center of mass. Nevertheless, recent evidence shows that there is an important minimization of energy expenditure by the pendular mechanism during walking on uphill gradients. In this study, we analyzed the optimum speed (OPT) of loaded human walking and the pendulum-like determining variables (Recovery R, Instantaneous pendular re-conversion R_int, and Congruity percentage %Cong). Ten young men walked on a treadmill at five different speeds and at three different treadmill incline gradients (0, +7 and +15%), with and without a load carried in their backpacks. We used indirect calorimetry and 3D motion analysis, and all of the data were analyzed by computational algorithms. R_int increased at higher speeds and decreased with increasing gradient. R and %Cong decreased with increasing gradient and increased with speed, independent of load. Thus, energy conversion by the pendular mechanism during walking on a 15% gradient is supported, and although this mechanism can explain the maintenance of OPT at low walking speeds, the pendular mechanism does not fully explain the energy minimization at higher speeds.     

“The threat is in the head,not in the legs”: Activating negative age stereotypes generates extra cognitive load during walking

ObjectiveActivating negative age stereotypes has been consistently shown to impair cognitive performance in older adults, but not motor performance, especially on mobility tasks. We tested the hypothesis that older adults may still experience stereotype threat, even if mobility performance is not affected. To do so, we examined whether inducing negative stereotypes may increase cognitive load during a walking task.MethodThis question was investigated in a dual-task paradigm: older adults performed simultaneously a walking task and a Stroop task, in stereotype and control conditions.ResultsResults showed that the stereotype induction did not affect walking parameters but decreased performance on the Stroop task, indicating that this induction increased cognitive load during walking.DiscussionThese results suggest that negative age stereotypes may be damaging even if walking parameters are not affected, by altering older adults' attention to their walking environment. We conclude by highlighting theoretical and practical implications.     

Errors in the ankle plantarflexor force production are related to the gait deficits of individuals with multiple sclerosis

BackgroundIndividuals with multiple sclerosis (MS) often have limited mobility that is thought to be due to the neuromuscular impairments of the ankle. Greater isometric motor control of the ankle has been associated with better standing postural balance but its relationship to mobility is less understood. The objectives of this investigation were to quantify the motor control of the ankle plantarflexors of individuals with MS during a dynamic isometric motor task, and explore the relationship between the ankle force control and gait alterations.MethodsFifteen individuals with MS and 15 healthy adults participated in both a dynamic isometric ankle plantarflexion force matching task and a biomechanical gait analysis.FindingsOur results displayed that the subjects with MS had a greater amount of error in their dynamic isometric force production, were weaker, walked with altered spatiotemporal kinematics, and had reduced maximal ankle moment at toe-off than the control group. The greater amount of error in the dynamic force production was related to the decreases in strength, step length, walking velocity, and maximal ankle moment during walking.InterpretationAltogether these results imply that errors in the ankle plantarflexion force production may be a limiting factor in the mobility of individuals with MS.     

The effects of the presence of others during a rowing exercise in a virtual reality environment

ObjectivesThe aim of the study was to test the performance, motivational, and affective impact of aerobic exercise within an immersive virtual reality environment experienced alone or with another individual.DesignSixty female participants aged 18–30 years were assigned to one of three conditions: no virtual reality (NVR), individual virtual reality (IVR), or companion virtual reality (CVR).MethodParticipants completed 9 min of self-paced rowing on an ergometer without any visual input or performance feedback (NVR), individually within a virtual reality environment (IVR), or within a virtual reality environment that included a companion depicted as an avatar (CVR).ResultsThe two virtual reality groups rowed a further distance and at a higher power output than the NVR group. Furthermore, the CVR group outperformed the IVR group in distance and had a higher heart rate. Participants in the virtual reality groups did not perceive themselves to be exerting more physical effort and rated the task as more enjoyable than participants in the NVR group.ConclusionsVirtual reality improves performance and the affective response to aerobic exercise, and performance effects are further enhanced by the presence of others in the virtual environment.     

Overground gait training using virtual reality aimed at gait symmetry

This study investigated if training in a virtual reality (VR) environment that provides visual and audio biofeedback on foot placement can induce changes to spatial and temporal parameters of gait during overground walking. Eighteen healthy young adults walked for 23 min back and forth on an instrumented walkway in three different conditions: (i) real environment (RE), (ii) virtual environment (VE) with no biofeedback, and (iii) VE with biofeedback. Visual and audio biofeedback while stepping on virtual footprint targets appearing along a straight path encouraged participants to walk with an asymmetrical step length (SL). A repeated-measures, one-way ANOVA, followed by a pairwise comparison post-hoc analysis with Bonferroni's correction, was performed to compare the step length difference (SLD), stance phase percentage difference (SPPD), and double-support percentage difference (DSPD) between early and late phases of all walking conditions. The results demonstrate the efficacy of the VE biofeedback system for training asymmetrical gait patterns. Participants temporarily adapted an asymmetrical gait pattern immediately post-training in the VE. Induced asymmetries persisted significantly while later walking in the RE. Asymmetry was significant in the spatial parameters of gait (SLD) but not in the temporal parameters (SPPD and DSPD). This paper demonstrates a method to induce unilateral changes in spatial parameters of gait using a novel VR tool. This study provides a proof-of-concept validation that VR biofeedback training can be conducted directly overground and could potentially provide a new method for treatment of hemiplegic gait or asymmetrical walking.