A reinforcement learning approach to gait training improves retention

Many gait training programs are based on supervised learning principles: an individual is guided towards a desired gait pattern with directional error feedback. While this results in rapid adaptation, improvements quickly disappear. This study tested the hypothesis that a reinforcement learning approach improves retention and transfer of a new gait pattern. The results of a pilot study and larger experiment are presented. Healthy subjects were randomly assigned to either a supervised group, who received explicit instructions and directional error feedback while they learned a new gait pattern on a treadmill, or a reinforcement group, who was only shown whether they were close to or far from the desired gait. Subjects practiced for 10 min, followed by immediate and overnight retention and over-ground transfer tests. The pilot study showed that subjects could learn a new gait pattern under a reinforcement learning paradigm. The larger experiment, which had twice as many subjects (16 in each group) showed that the reinforcement group had better overnight retention than the supervised group (a 32% vs. 120% error increase, respectively), but there were no differences for over-ground transfer. These results suggest that encouraging participants to find rewarding actions through self-guided exploration is beneficial for retention.