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Online gait corrections are frequently used to restore gait stability and prevent falling. They require shorter response times than voluntary movements which suggests that subcortical pathways contribute to the execution of online gait corrections. To evaluate the potential role of the cerebellum in these pathways we tested the hypotheses that online gait corrections would be less accurate in individuals with focal cerebellar damage than in neurologically intact controls and that this difference would be more pronounced for shorter available response times and for short step gait corrections. We projected virtual stepping stones on an instrumented treadmill while some of the approaching stepping stones were shifted forward or backward, requiring participants to adjust their foot placement. Varying the timing of those shifts allowed us to address the effect of available response time on foot placement error. In agreement with our hypothesis, individuals with focal cerebellar lesions were less accurate in adjusting their foot placement in reaction to suddenly shifted stepping stones than neurologically intact controls. However, the cerebellar lesion group's foot placement error did not increase more with decreasing available response distance or for short step versus long step adjustments compared to the control group. Furthermore, foot placement error for the non-shifting stepping stones was also larger in the cerebellar lesion group as compared to the control group. Consequently, the reduced ability to accurately adjust foot placement during walking in individuals with focal cerebellar lesions appears to be a general movement control deficit, which could contribute to increased fall risk. [ABSTRACT FROM AUTHOR]

The evident ataxic characteristics of gait in patients with cerebellar damage suggest that the cerebellum plays an important role in the neural control of gait. Ataxic features, such as increased gait variability and increased step width, are often related to gait stability. However, the link between these measures and gait stability is not straightforward. Therefore, to gain more insights into relations between gait stability, gait variability and gait ataxia, we quantified gait stability using the short-term maximum Lyapunov exponent. This is a more valid measure of gait stability, derived from dynamical systems theory. Eighteen patients with focal cerebellar lesions after tumor resection walked on an instrumented treadmill at 1.0 m/s for 3 min. The patients displayed relatively mild functional deficits (ICARS = 6.9 ± 6.4, range 0–20) and had a lower overground walking speed as compared to healthy controls (1.12 m/s versus 1.31 m/s). During treadmill walking, the short-term maximum Lyapunov exponent was higher in cerebellar patients, indicating reduced gait stability. Furthermore, step width was increased in the patient group while other spatio-temporal gait parameters were similar. Patients with the largest lesions in the vermis displayed the least stable gait pattern. These observations imply that the short-term maximum Lyapunov exponent is a sensitive measure of gait deficits in mildly ataxic cerebellar patients. [ABSTRACT FROM AUTHOR]