Cardiorespiratory fitness, balance and walking improvements in an adolescent with cerebral palsy (GMFCS II) and autism after motor-assisted elliptical training

Cesar, Guilherme M.; Buster, Thad W.; Burnfield, Judith M.

doi:10.1080/21679169.2018.1536764

Cited by 11 publications

(6 citation statements)

References 68 publications

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“…In addition, a random training (in onset, magnitude, and direction) can be programed. Varied practice in a random order was found to better improve motor learning [ 48 , 49 , 55 , 56 ]. Augmented feedback, implicit training —once a balance perturbation is given, if appropriate balance reactive response is detected, the EPES returns to its horizontal, initial position.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, a random training (in onset, magnitude, and direction) can be programed. Varied practice in a random order was found to better improve motor learning [ 48 , 49 , 55 , 56 ].…”

Section: Discussionmentioning

confidence: 99%

“…We were also inspired by the well-known health advantages gained after adults participated in elliptical training, such as improvement in cardiovascular parameters [ 47 ], increasing muscle power and endurance [ 48 ], and improving executive function [ 49 ] and quality of life [ 50 ]. Moreover, elliptical training improves gait parameters in older adults with lower limb Osteoarthritis [ 51 ], people with stroke [ 52 ], Parkinson’s [ 53 ], multiple sclerosis [ 54 ], and people with cardio-respiratory disease [ 55 , 56 ]. This is not surprising since elliptical walking is a rhythmic task with similar reflex modulation to a regular walking [ 45 , 57 , 58 ], and related neural circuitry may be operating in both tasks [ 46 , 59 ].…”

Section: Introductionmentioning

confidence: 99%

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Development of an Elliptical Perturbation System that provides unexpected perturbations during elliptical walking (the EPES system)

Sade,

Pickholz,

Melzer

et al. 2023

J NeuroEngineering Rehabil

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Background ‘Perturbation-based balance training’ (PBBT) is a training method that was developed to improve balance reactive responses to unexpected balance loss. This training method is more effective in reducing fall rates than traditional balance training methods. Many PBBTs are performed during standing or treadmill walking which targeted specifically step reactive responses, we however, aimed to develop and build a mechatronic system that can provide unexpected perturbation during elliptical walking the Elliptical Perturbation System (the EPES system), with the aim of improving specifically the trunk and upper limbs balance reactive control. Methods This paper describes the development, and building of the EPES system, using a stationary Elliptical Exercise device, which allows training of trunk and upper limbs balance reactive responses in older adults. Results The EPES system provides 3-dimensional small, controlled, and unpredictable sudden perturbations during stationary elliptical walking. We developed software that can identify a trainee’s trunk and arms reactive balance responses using a stereo camera. After identifying an effective trunk and arms reactive balance response, the software controls the EPES system motors to return the system to its horizontal baseline position after the perturbation. The system thus provides closed-loop feedback for a person’s counterbalancing trunk and arm responses, helping to implement implicit motor learning for the trainee. The pilot results show that the EPES software can successfully identify balance reactive responses among participants who are exposed to a sudden unexpected perturbation during elliptical walking on the EPES system. Conclusions EPES trigger reactive balance responses involving counter-rotation action of body segments and simultaneously evoke arms, and trunk reactive response, thus reactive training effects should be expected.

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Section: Discussionmentioning

confidence: 99%

“…In addition, a random training (in onset, magnitude, and direction) can be programed. Varied practice in a random order was found to better improve motor learning [ 48 , 49 , 55 , 56 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Development of an Elliptical Perturbation System that provides unexpected perturbations during elliptical walking (the EPES system)

Sade,

Pickholz,

Melzer

et al. 2023

J NeuroEngineering Rehabil

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show abstract

“…Additionally, some children with weakness and movement control challenges may lack the strength required to override the motor's assistance. While previous research has demonstrated that speed can be used to manipulate lower extremity muscle demands (Burnfield et al, 2017) and cardiorespiratory challenge (Burnfield et al, 2018;Burnfield et al, 2019;Cesar et al, 2020), yet to be determined is whether these parameters can be fine-tuned sufficiently during VRenhanced training to sustain appropriate engagement and physiologic challenge.…”

Section: Discussionmentioning

confidence: 99%

Combining a non-immersive virtual reality gaming with motor-assisted elliptical exercise increases engagement and physiologic effort in children

Huang

Buster

Siu

et al. 2022

Front. Virtual Real.

Self Cite

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Virtual reality (VR) gaming is promising in sustaining children’s participation during intensive physical rehabilitation. This study investigated how integration of a custom active serious gaming with a robot-motorized elliptical impacted children’s perception of engagement (Intrinsic Motivation Inventory), physiologic effort (i.e., exercise speed, heart rate, lower extremity muscle activation), and joint kinematics while overriding the motor’s assistance. Compared to Non-VR condition, during the VR-enhanced condition participants’ perceived engagement was 23% greater (p = 0.01), self-selected speed was 10% faster (p = 0.02), heart rate was 7% higher (p = 0.08) and muscle demands increased. Sagittal plane kinematics demonstrated only a small change at the knee. This study demonstrated that VR plays an essential role in promoting greater engagement and physiologic effort in children performing a cyclic locomotor rehabilitation task, without causing any adverse events or substantial disruption in lower extremity joint kinematics. The outcomes of this study provide a foundation for understanding the role of future VR-enhanced interventions and research studies that weigh/balance the need to physiologically challenge a child during training with the value of promoting task-related training to help promote recovery of walking.

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“…We were also inspired by the well-known health advantages gained after adult people participated in elliptical training, such as improvement in cardiovascular parameters [32], increasing muscle power and endurance [33], and improving executive function [34] and quality of life [35]. Moreover, elliptical training improves gait parameters in older adults with lower limb Osteoarthritis [36], people with stroke [37], Parkinson's [38], multiple sclerosis [39], and people with cardio-respiratory disease [40,41]. This is not surprising since in place walking is a rhythmic task with similar re ex modulation to a regular walking [30,42,43], and related neural circuitry may be operating in both tasks [31,44].…”

Section: Introductionmentioning

confidence: 99%

Development of an Elliptical Perturbation System that provides unexpected perturbations during in-place walking (the EPES system)

Sade,

Pickholtz,

Melzer

et al. 2023

Preprint

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Background: ‘Perturbation-based balance training’ (PBBT) is a training method that was developed to improve balance reactive responses to unexpected balance loss. This training method is more effective in reducing fall rates than traditional balance training methods. Many PBBTs are performed during standing or treadmill walking which targeted specifically step reactive responses, we however, aimed to develop and build a mechatronic system that can provide unexpected perturbation during in-place walking the Elliptical Perturbation System (the EPES system), with the aim of improving specifically the trunk and upper limbs balance reactive control. Methods: This paper describes the development, and building of the EPES system, using a stationary Elliptical Exercise device, which allows training of trunk and upper limbs balance reactive responses in older adults. Results: The EPES system provides 3-dimensional small, controlled, and unpredictable sudden perturbations during stationary in-place walking. We developed software that is able to identify a trainee's trunk and arms reactive balance responses using a stereo camera. After identifying an effective trunk and arms reactive balance response, the software controls the EPES system motors to return the system to its horizontal baseline position after the perturbation. The system thus provides closed-loop feedback for a person's counterbalancing trunk and arm responses, helping to implement implicit motor learning for the trainee. The pilot results show that the EPES software is able to successfully identify balance reactive responses among participants who are exposed to a sudden unexpected perturbation during in-place walking on the EPES system. Conclusions: EPES trigger reactive balance responses involving counter-rotation action of body segments and simultaneously evoke arms, and trunk reactive response, thus reactive training effects should be expected.

show abstract

Cardiorespiratory fitness, balance and walking improvements in an adolescent with cerebral palsy (GMFCS II) and autism after motor-assisted elliptical training

Cited by 11 publications

References 68 publications

Development of an Elliptical Perturbation System that provides unexpected perturbations during elliptical walking (the EPES system)

Development of an Elliptical Perturbation System that provides unexpected perturbations during elliptical walking (the EPES system)

Combining a non-immersive virtual reality gaming with motor-assisted elliptical exercise increases engagement and physiologic effort in children

Development of an Elliptical Perturbation System that provides unexpected perturbations during in-place walking (the EPES system)

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