Kinematic and EMG Responses to Pelvis and Leg Assistance Force during Treadmill Walking in Children with Cerebral Palsy

Wu, Ming; Kim, Janis; Arora, Pooja; Gaebler-Spira, Deborah; Zhang, Yunhui

doi:10.1155/2016/5020348

Cited by 12 publications

(9 citation statements)

References 39 publications

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“…In contrast, for children who underwent assistance training, the central nervous system may adapt to the assistance force applied to the leg(s) during the swing phase of gait by reducing the motor output of the leg muscles [33], probably due to optimization of the energy cost [34]. Thus, a leg assistance force that is too large may encourage passive rather than active training.…”

Section: Discussionmentioning

confidence: 99%

Robotic Resistance Treadmill Training Improves Locomotor Function in Children With Cerebral Palsy: A Randomized Controlled Pilot Study

Kim

Gaebler-Spira

et al. 2017

Archives of Physical Medicine and Rehabilitation

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Objective To determine whether applying controlled resistance forces to the legs during the swing phase of gait may improve the efficacy of treadmill training compared to applying controlled assistance forces in children with cerebral palsy (CP). Design Randomized controlled study. Setting Research unit of rehabilitation hospital. Participants Children with spastic CP (n = 23, average age 10.6 years old, ranged from 6–14, GMFCS levels: I to IV). Interventions Participants were randomly assigned to receive controlled assistance (n=11) or resistance (n=12) loads applied to the legs at the ankle. Participants underwent robotic treadmill training 3 times a week for 6 weeks (18 sessions). A controlled swing assistance/resistance load was applied to both legs starting from toe-off to mid-swing phase of gait during training. Main outcome measures Outcome measures consisted of overground walking speed, 6 minute walking distance, and GMFM scores, and were assessed pre, post 6 weeks of training, and 8 weeks after the end of training. Results Following 6 weeks of treadmill training for participants from the resistance training group, fast walking speed and 6 minute walking distance significantly improved (18% and 30% increases, respectively), and 6 minute walking distance was still significantly greater than baseline (35% increase) 8 weeks after the end of training. In contrast, overground gait speed and 6 minute walking distance had no significant changes after robotic assistance training. Conclusion Results from the current study indicated that robotic resistance treadmill training is more effective than assistance training in improving locomotor function in children with CP.

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Section: Discussionmentioning

confidence: 99%

Robotic Resistance Treadmill Training Improves Locomotor Function in Children With Cerebral Palsy: A Randomized Controlled Pilot Study

Kim

Gaebler-Spira

et al. 2017

Archives of Physical Medicine and Rehabilitation

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“…The center of mass (CoM) lateral distance, margin of stability (MoS), step length, and single leg support time (SLST) were calculated using ankle and pelvis position signals recorded when participants walked on the treadmill. CoM lateral distance was used to quantify weight shifting and was defined as the medial‐lateral distance between the ankle of the standing leg to the projection of the CoM, which was estimated using the position of the pelvis . A smaller value of the CoM lateral distance means that the participant shifts more weight on the standing leg during the stance phase.…”

Section: Methodsmentioning

confidence: 99%

Motor Adaptation to Weight Shifting Assistance Transfers to Overground Walking in People with Spinal Cord Injury

Lin

Hsu

Dee

et al. 2019

PM&R

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Background Locomotor training has been used to improve walking function in people with incomplete spinal cord injury (iSCI), but functional gains are relatively small for some patients, which may be due to the lack of weight shifting training. Objective To determine whether applying a pelvis assistance force in the coronal plane during walking would improve weight shifting and stepping in people with iSCI. Design Repeated measures study. Setting Rehabilitation hospital. Participants Seventeen people with iSCI. Interventions A controlled assistance force was bilaterally applied to the pelvis in the medial‐lateral direction to facilitate weight shifting, which gradually increased during the course of treadmill walking. Main Outcome Measures Weight shifting, step length, margin of stability, and muscle activities of the weaker leg were used to quantify gait performance. The spatial‐temporal gait parameters during overground walking were collected pre, post, and 10 minutes after treadmill training. Results During treadmill walking, participants significantly improved weight shifting (ie, center of mass [CoM] lateral distance reduced from 0.16 ± 0.06 m to 0.12 ± 0.07 m, P = .012), and increased step length (from 0.35 ± 0.08 m to 0.37 ± 0.09 m, P = .037) on the stronger side when the force was applied, which were partially retained (ie, CoM distance was 0.14 ± 0.06, P = .019, and step length was 0.37 ± 0.09 m, P = .005) during the late postadaptation period when the force was removed. In addition, weight shifting and step length on the weaker side during overground walking also improved (support base reduced from 0.13 ± 0.06 m to 0.12 ± 0.06 m, P = .042, and step length increased from 0.48 ± 0.12 m to 0.51 ± 0.09 m, P = .045) after treadmill training. Conclusions Applying pelvis assistance during treadmill walking may facilitate weight shifting and improve step length in people with SCI, which may partially transfer to overground walking. Level of Evidence III.

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“…The randomization was conducted by research physical therapists through concealed envelopes, which was chosen by each subject for the determination of his/her group assignment. For participants who were assigned in the robotic training group, a bilateral pelvis assistance load was applied to the pelvis from heel strike to mid-stance on the ipsilateral leg for facilitating weight shifting 13 . The peak force was set at ~9% of body weight (a constant magnitude force was applied during the loading period), although adjusted based on the tolerance of participants.…”

Section: Methodsmentioning

confidence: 99%

Facilitating Weight Shifting During Treadmill Training Improves Walking Function in Humans With Spinal Cord Injury

Kim

Wei

2018

Am J Phys Med Rehabil

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Kinematic and EMG Responses to Pelvis and Leg Assistance Force during Treadmill Walking in Children with Cerebral Palsy

Cited by 12 publications

References 39 publications

Robotic Resistance Treadmill Training Improves Locomotor Function in Children With Cerebral Palsy: A Randomized Controlled Pilot Study

Robotic Resistance Treadmill Training Improves Locomotor Function in Children With Cerebral Palsy: A Randomized Controlled Pilot Study

Motor Adaptation to Weight Shifting Assistance Transfers to Overground Walking in People with Spinal Cord Injury

Facilitating Weight Shifting During Treadmill Training Improves Walking Function in Humans With Spinal Cord Injury

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