External Mechanical Work and Pendular Energy Transduction of Overground and Treadmill Walking in Adolescents with Unilateral Cerebral Palsy

PubMed Central

Zollinger, Marie; Degache, Francis; Currat, Gabriel; Pochon, Ludmila; Peyrot, Nicolas; Newman, Christopher J.; Malatesta, Davide

2016-01-01

Purpose: Motor impairments affect functional abilities and gait in children and adolescents with cerebral palsy (CP). Improving their walking is an essential objective of treatment, and the use of a treadmill for gait analysis and training could offer several advantages in adolescents with CP. However, there is a controversy regarding the similarity between treadmill and overground walking both for gait analysis and training in children and adolescents. The aim of this study was to compare the external mechanical work and pendular energy transduction of these two types of gait modalities at standard and preferred walking speeds in adolescents with unilateral cerebral palsy (UCP) and typically developing (TD) adolescents matched on age, height and body mass. Methods: Spatiotemporal parameters, external mechanical work and pendular energy transduction of walking were computed using two inertial sensors equipped with a triaxial accelerometer and gyroscope and compared in 10 UCP (14.2 ± 1.7 year) and 10 TD (14.1 ± 1.9 year) adolescents during treadmill and overground walking at standard and preferred speeds. Results: The treadmill induced almost identical mechanical changes to overground walking in TD adolescents and those with UCP, with the exception of potential and kinetic vertical and lateral mechanical works, which are both significantly increased in the overground-treadmill transition only in UCP (P < 0.05). Conclusions: Adolescents with UCP have a reduced adaptive capacity in absorbing and decelerating the speed created by a treadmill (i.e., dynamic stability) compared to TD adolescents. This may have an important implication in rehabilitation programs that assess and train gait by using a treadmill in adolescents with UCP. PMID:27148062

External Mechanical Work and Pendular Energy Transduction of Overground and Treadmill Walking in Adolescents with Unilateral Cerebral Palsy.

PubMed

Zollinger, Marie; Degache, Francis; Currat, Gabriel; Pochon, Ludmila; Peyrot, Nicolas; Newman, Christopher J; Malatesta, Davide

2016-01-01

Motor impairments affect functional abilities and gait in children and adolescents with cerebral palsy (CP). Improving their walking is an essential objective of treatment, and the use of a treadmill for gait analysis and training could offer several advantages in adolescents with CP. However, there is a controversy regarding the similarity between treadmill and overground walking both for gait analysis and training in children and adolescents. The aim of this study was to compare the external mechanical work and pendular energy transduction of these two types of gait modalities at standard and preferred walking speeds in adolescents with unilateral cerebral palsy (UCP) and typically developing (TD) adolescents matched on age, height and body mass. Spatiotemporal parameters, external mechanical work and pendular energy transduction of walking were computed using two inertial sensors equipped with a triaxial accelerometer and gyroscope and compared in 10 UCP (14.2 ± 1.7 year) and 10 TD (14.1 ± 1.9 year) adolescents during treadmill and overground walking at standard and preferred speeds. The treadmill induced almost identical mechanical changes to overground walking in TD adolescents and those with UCP, with the exception of potential and kinetic vertical and lateral mechanical works, which are both significantly increased in the overground-treadmill transition only in UCP (P < 0.05). Adolescents with UCP have a reduced adaptive capacity in absorbing and decelerating the speed created by a treadmill (i.e., dynamic stability) compared to TD adolescents. This may have an important implication in rehabilitation programs that assess and train gait by using a treadmill in adolescents with UCP.

Treadmill training with partial body weight support compared with conventional gait training for low-functioning children and adolescents with nonspastic cerebral palsy: a two-period crossover study.

PubMed

Su, Ivan Y W; Chung, Kenny K Y; Chow, Daniel H K

2013-12-01

Partial body weight-supported treadmill training has been shown to be effective in gait training for patients with neurological disorders such as spinal cord injuries and stroke. Recent applications on children with cerebral palsy were reported, mostly on spastic cerebral palsy with single subject design. There is lack of evidence on the effectiveness of such training for nonspastic cerebral palsy, particularly those who are low functioning with limited intellectual capacity. This study evaluated the effectiveness of partial body weight-supported treadmill training for improving gross motor skills among these clients. A two-period randomized crossover design with repeated measures. A crossover design following an A-B versus a B-A pattern was adopted. The two training periods consisted of 12-week partial body weight-supported treadmill training (Training A) and 12-week conventional gait training (Training B) with a 10-week washout in between. Ten school-age participants with nonspastic cerebral palsy and severe mental retardation were recruited. The Gross Motor Function Measure-66 was administered immediately before and after each training period. Significant improvements in dimensions D and E of the Gross Motor Function Measure-66 and the Gross Motor Ability Estimator were obtained. Our findings revealed that the partial body weight-supported treadmill training was effective in improving gross motor skills for low-functioning children and adolescents with nonspastic cerebral palsy. .

Phototherapy during treadmill training improves quadriceps performance in postmenopausal women.

PubMed

Paolillo, F R; Corazza, A V; Paolillo, A R; Borghi-Silva, A; Arena, R; Kurachi, C; Bagnato, V S

2014-06-01

To evaluate the effects of infrared-light-emitting diode (LED) during treadmill training on functional performance. Thirty postmenopausal women aged 50-60 years were randomly assigned to one of three groups and successfully completed the full study. The three groups were: (1) the LED group, which performed treadmill training associated with phototherapy (n = 10); (2) the exercise group, which carried out treadmill training only (n = 10); and (3) the sedentary group, which neither performed physical training nor underwent phototherapy (n = 10). Training was performed over a period of 6 months, twice a week for 45 min per session at 85-90% of maximal heart rate, which was obtained during progressive exercise testing. The irradiation parameters were 100 mW, 39 mW/cm(2) and 108 J/cm(2) for 45 min. Quadriceps performance was measured during isokinetic exercise testing at 60°/s and 300°/s. Peak torque did not differ amongst the groups. However, the results showed significantly higher values of power and total work for the LED group (∆ = 21 ± 6 W and ∆ = 634 ± 156 J, p < 0.05) when compared to both the exercise group (∆ = 13 ± 10 W and = 410 ± 270 J) and the sedentary group (∆ = 10 ± 9 W and ∆ = 357 ± 327 J). Fatigue was also significantly lower in the LED group (∆ = -7 ± 4%, p < 0.05) compared to both the exercise group (∆ = 3 ± 8%) and the sedentary group (∆ = -2 ± 6%). Infrared-LED during treadmill training may improve quadriceps power and reduce peripheral fatigue in postmenopausal women.

Effects of Pedalo® training on balance and fall risk in stroke patients.

PubMed

Kim, Do-Yeon; Lim, Chae-Gil

2017-07-01

[Purpose] This study sought to examine the effects of Pedalo ® training on balance and fall risk in stroke patients. [Subjects and Methods] Thirty-one subjects with stroke were recruited and randomly allocated into two groups: the Pedalo ® group (n=15) and the Treadmill group (n=16). The Pedalo ® group performed conventional physical therapy program with Pedalo ® training for 30 minutes, five times a week, for 8 weeks, while the Treadmill group conducted conventional physical therapy programs and treadmill gait training for 30 minutes, five times a week, for 8 weeks. [Results] After intervention, both groups showed a significant improvement in balance. A significant greater balance improvement was found in the Pedalo ® group compared to the Treadmill group. Also, a significant reduction in risk of fall was seen in both group but this reduction was not significantly different between the two groups. [Conclusion] Pedalo ® training may be used to improve balance and reduce fall risk in stroke patients.

Improving balance skills in patients who had stroke through virtual reality treadmill training.

PubMed

Yang, Saiwei; Hwang, Wei-Hsung; Tsai, Yi-Ching; Liu, Fu-Kang; Hsieh, Lin-Fen; Chern, Jen-Suh

2011-12-01

The aim of this study was to evaluate the effects of virtual reality (VR) treadmill training on the balance skills of patients who have had a stroke. A total of 14 patients with strokes were recruited and randomly assigned to receive VR treadmill or traditional treadmill training. The outcome measures that were included for the study were center of pressure (COP) sway excursion, COP maximum sway in anterior-posterior direction, COP maximum sway in medial-lateral direction, COP sway area, bilateral limb-loading symmetric index, the sway excursion values for the paretic foot (sway excursion/P), paretic limb stance time (stance time/P), number of steps of the paretic limb (number of steps/P), and contact area of the paretic foot (contact A/P) during quiet stance, sit-to-stand transfer, and level walking. There were no significant improvements in COP-related measures and symmetric index during the quiet stance, either in the VR treadmill or traditional treadmill training group (P > 0.05). However, the difference between groups after training in COP maximum sway in medial-lateral direction during the quiet stance was significant (P = 0.038). Traditional treadmill training failed to improve sit-to-stand performance, whereas VR treadmill training improved symmetric index (P = 0.028) and sway excursion (P = 0.046) significantly during sit-to-stand transfer. The changes of symmetric index between groups were markedly different (P = 0.045). Finally, both groups improved significantly in stance time/P, but only VR treadmill training increased contact A/P (P = 0.034) after training during level walking. The difference between groups during level walking was not significant. Neither traditional treadmill nor VR treadmill training had any effect on balance skill during quiet stance, but VR treadmill training improved balance skill in the medial-lateral direction better than traditional training did. VR treadmill training also improved balance skill during sit-to-stand transfers and the involvement of paretic limb in level walking more than the traditional one did.

Treadmill sideways gait training with visual blocking for patients with brain lesions.

PubMed

Kim, Tea-Woo; Kim, Yong-Wook

2014-09-01

[Purpose] The aim of this study was to verify the effect of sideways treadmill training with and without visual blocking on the balance and gait function of patients with brain lesions. [Subjects] Twenty-four stroke and traumatic brain injury subjects participated in this study. They were divided into two groups: an experimental group (12 subjects) and a control group (12 subjects). [Methods] Each group executed a treadmill training session for 20 minutes, three times a week, for 6 weeks. The sideways gait training on the treadmill was performed with visual blocking by the experimental group and with normal vision by the control group. A Biodex Gait Trainer 2 was used to assess the gait function. It was used to measure walking speed, walking distance, step length, and stance time on each foot. The Five-Times-Sit-To-Stand test (FTSST) and Timed Up and Go test (TUG) were used as balance measures. [Results] The sideways gait training with visual blocking group showed significantly improved walking speed, walking distance, step length, and stance time on each foot after training; FTSST and TUG times also significantly improved after training in the experimental group. Compared to the control group, the experimental group showed significant increases in stance time on each foot. [Conclusion] Sideways gait training on a treadmill with visual blocking performed by patients with brain lesions significantly improved their balance and gait function.

Compliance of children with moderate to severe intellectual disability to treadmill walking: a pilot study.

PubMed

Vashdi, E; Hutzler, Y; Roth, D

2008-05-01

Individuals with Intellectual Disability (ID) exhibit reduced levels of compliance to exercise, including treadmill walking. The purpose of this study was to measure the effects of several training conditions on compliance to participation in treadmill walking of children with moderate to severe ID. Criteria for compliance were the averaged number of times participants attempted to discontinue walking during two 5-min exercise sessions of treadmill walking at an intensity of 65-75% of predicted maximal HR. Fifteen children aged 5-11 with moderate to severe ID participated in the study. Training conditions were (a) close supervisor's position, (b) distant supervisor's position, (c) positive reinforcement, and (d) paired modeling. General linear mixed model statistics revealed significant differences in favor of the paired modeling and positive reinforcement compared to the other conditions. Leaning forward was the most frequent type of participants' attempt to stop exercising. Paired modeling and positive reinforcement should be considered within treadmill training programs for children with moderate to severe ID.

Treadmill training and body weight support for walking after stroke.

PubMed

Mehrholz, Jan; Pohl, Marcus; Elsner, Bernhard

2014-01-23

Treadmill training, with or without body weight support using a harness, is used in rehabilitation and might help to improve walking after stroke. This is an update of a Cochrane review first published in 2005. To determine if treadmill training and body weight support, individually or in combination, improve walking ability, quality of life, activities of daily living, dependency or death, and institutionalisation or death, compared with other physiotherapy gait training interventions after stroke. The secondary objective was to determine the safety and acceptability of this method of gait training. We searched the Cochrane Stroke Group Trials Register (last searched June 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) and the Database of Reviews of Effects (DARE) (The Cochrane Library 2013, Issue 7), MEDLINE (1966 to July 2013), EMBASE (1980 to July 2013), CINAHL (1982 to June 2013), AMED (1985 to July 2013) and SPORTDiscus (1949 to June 2013). We also handsearched relevant conference proceedings and ongoing trials and research registers, screened reference lists and contacted trialists to identify further trials. Randomised or quasi-randomised controlled and cross-over trials of treadmill training and body weight support, individually or in combination, for the treatment of walking after stroke. Two authors independently selected trials, extracted data and assessed methodological quality. The primary outcomes investigated were walking speed, endurance and dependency. We included 44 trials with 2658 participants in this updated review. Overall, the use of treadmill training with body weight support did not increase the chances of walking independently compared with other physiotherapy interventions (risk difference (RD) -0.00, 95% confidence interval (CI) -0.02 to 0.02; P = 0.94; I² = 0%). Overall, the use of treadmill training with body weight support in walking rehabilitation for patients after stroke increased the walking velocity and walking endurance significantly. The pooled mean difference (MD) (random-effects model) for walking velocity was 0.07 m/s (95% CI 0.01 to 0.12; P = 0.02; I² = 57%) and the pooled MD for walking endurance was 26.35 metres (95% CI 2.51 to 50.19; P = 0.03; I² = 60%). Overall, the use of treadmill training with body weight support in walking rehabilitation for patients after stroke did not increase the walking velocity and walking endurance at the end of scheduled follow-up significantly. The pooled MD (random-effects model) for walking velocity was 0.04 m/s (95% CI -0.06 to 0.14; P = 0.40; I² = 40%) and the pooled MD for walking endurance was 32.36 metres (95% CI -3.10 to 67.81; P = 0.07; I² = 63%). However, for ambulatory patients improvements in walking endurance lasted until the end of scheduled follow-up (MD 58.88 metres, 95% CI 29.10 to 88.66; P = 0.0001; I² = 0%). Adverse events and drop outs did not occur more frequently in people receiving treadmill training and these were not judged to be clinically serious events. Overall, people after stroke who receive treadmill training with or without body weight support are not more likely to improve their ability to walk independently compared with people after stroke not receiving treadmill training, but walking speed and walking endurance may improve. Specifically, stroke patients who are able to walk (but not people who are not able to walk) appear to benefit most from this type of intervention. This review found that improvements in walking endurance in people able to walk may have persisting beneficial effects. Further research should specifically investigate the effects of different frequencies, durations or intensities (in terms of speed increments and inclination) of treadmill training, as well as the use of handrails, in ambulatory patients, but not in dependent walkers.

Slow Versus Fast Robot-Assisted Locomotor Training After Severe Stroke: A Randomized Controlled Trial.

PubMed

Rodrigues, Thais Amanda; Goroso, Daniel Gustavo; Westgate, Philip M; Carrico, Cheryl; Batistella, Linamara R; Sawaki, Lumy

2017-10-01

Robot-assisted locomotor training on a bodyweight-supported treadmill is a rehabilitation intervention that compels repetitive practice of gait movements. Standard treadmill speed may elicit rhythmic movements generated primarily by spinal circuits. Slower-than-standard treadmill speed may elicit discrete movements, which are more complex than rhythmic movements and involve cortical areas. Compare effects of fast (i.e., rhythmic) versus slow (i.e., discrete) robot-assisted locomotor training on a bodyweight-supported treadmill in subjects with chronic, severe gait deficit after stroke. Subjects (N = 18) were randomized to receive 30 sessions (5 d/wk) of either fast or slow robot-assisted locomotor training on a bodyweight-supported treadmill in an inpatient setting. Functional ambulation category, time up and go, 6-min walk test, 10-m walk test, Berg Balance Scale, and Fugl-Meyer Assessment were administered at baseline and postintervention. The slow group had statistically significant improvement on functional ambulation category (first quartile-third quartile, P = 0.004), 6-min walk test (95% confidence interval [CI] = 1.8 to 49.0, P = 0.040), Berg Balance Scale (95% CI = 7.4 to 14.8, P < 0.0001), time up and go (95% CI = -79.1 to 5.0, P < 0.0030), and Fugl-Meyer Assessment (95% CI = 24.1 to 45.1, P < 0.0001). The fast group had statistically significant improvement on Berg Balance Scale (95% CI = 1.5 to 10.5, P = 0.02). In initial stages of robot-assisted locomotor training on a bodyweight-supported treadmill after severe stroke, slow training targeting discrete movement may yield greater benefit than fast training.

Plasticity and alterations of trunk motor cortex following spinal cord injury and non-stepping robot and treadmill training.

PubMed

Oza, Chintan S; Giszter, Simon F

2014-06-01

Spinal cord injury (SCI) induces significant reorganization in the sensorimotor cortex. Trunk motor control is crucial for postural stability and propulsion after low thoracic SCI and several rehabilitative strategies are aimed at trunk stability and control. However little is known about the effect of SCI and rehabilitation training on trunk motor representations and their plasticity in the cortex. Here, we used intracortical microstimulation to examine the motor cortex representations of the trunk in relation to other representations in three groups of chronic adult complete low thoracic SCI rats: chronic untrained, treadmill trained (but 'non-stepping') and robot assisted treadmill trained (but 'non-stepping') and compared with a group of normal rats. Our results demonstrate extensive and significant reorganization of the trunk motor cortex after chronic adult SCI which includes (1) expansion and rostral displacement of trunk motor representations in the cortex, with the greatest significant increase observed for rostral (to injury) trunk, and slight but significant increase of motor representation for caudal (to injury) trunk at low thoracic levels in all spinalized rats; (2) significant changes in coactivation and the synergy representation (or map overlap) between different trunk muscles and between trunk and forelimb. No significant differences were observed between the groups of transected rats for the majority of the comparisons. However, (3) the treadmill and robot-treadmill trained groups of rats showed a further small but significant rostral migration of the trunk representations, beyond the shift caused by transection alone. We conclude that SCI induces a significant reorganization of the trunk motor cortex, which is not qualitatively altered by non-stepping treadmill training or non-stepping robot assisted treadmill training, but is shifted further from normal topography by the training. This shift may potentially make subsequent rehabilitation with stepping longer or less successful. Copyright © 2014 Elsevier Inc. All rights reserved.

Effects of the Integration of Dynamic Weight Shifting Training Into Treadmill Training on Walking Function of Children with Cerebral Palsy: A Randomized Controlled Study.

PubMed

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

2017-11-01

The aim of the study was to determine whether applying an assistance force to the pelvis and legs during treadmill training can improve walking function in children with cerebral palsy. Twenty-three children with cerebral palsy were randomly assigned to the robotic or treadmill only group. For participants who were assigned to the robotic group, a controlled force was applied to the pelvis and legs during treadmill walking. For participants who were assigned to the treadmill only group, manual assistance was provided as needed. Each participant trained 3 times/wk for 6 wks. Outcome measures included walking speed, 6-min walking distance, and clinical assessment of motor function, which were evaluated before, after training, and 8 wks after the end of training, and were compared between two groups. Significant increases in walking speed and 6-min walking distance were observed after robotic training (P = 0.03), but no significant change was observed after treadmill training only. A greater increase in 6-min walking distance was observed after robotic training than that after treadmill only training (P = 0.01). Applying a controlled force to the pelvis and legs, for facilitating weight-shift and leg swing, respectively, during treadmill training may improve walking speed and endurance in children with cerebral palsy. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) discuss the importance of physical activity at the participation level (sports programs) for children with cerebral palsy; (2) contrast the changes in walking ability and endurance for children in GMFCS level I, II and III following sports programs; and (3) identify the impact of higher frequency of sports program attendance over time on walking ability. Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Effects of a Supported Speed Treadmill Training Exercise Program on Impairment and Function for Children with Cerebral Palsy

ERIC Educational Resources Information Center

Johnston, Therese E.; Watson, Kyle E.; Ross, Sandy A.; Gates, Philip E.; Gaughan, John P.; Lauer, Richard T.; Tucker, Carole A.; Engsberg, Jack R.

2011-01-01

Aim: To compare the effects of a supported speed treadmill training exercise program (SSTTEP) with exercise on spasticity, strength, motor control, gait spatiotemporal parameters, gross motor skills, and physical function. Method: Twenty-six children (14 males, 12 females; mean age 9y 6mo, SD 2y 2mo) with spastic cerebral palsy (CP; diplegia, n =…

Changes in Locomotor Muscle Activity After Treadmill Training in Subjects With Incomplete Spinal Cord Injury

PubMed Central

Gorassini, Monica A.; Norton, Jonathan A.; Nevett-Duchcherer, Jennifer; Roy, Francois D.; Yang, Jaynie F.

2009-01-01

Intensive treadmill training after incomplete spinal cord injury can improve functional walking abilities. To determine the changes in muscle activation patterns that are associated with improvements in walking, we measured the electromyography (EMG) of leg muscles in 17 individuals with incomplete spinal cord injury during similar walking conditions both before and after training. Specific differences were observed between subjects that eventually gained functional improvements in overground walking (responders), compared with subjects where treadmill training was ineffective (nonresponders). Although both groups developed a more regular and less clonic EMG pattern on the treadmill, it was only the tibialis anterior and hamstring muscles in the responders that displayed increases in EMG activation. Likewise, only the responders demonstrated decreases in burst duration and cocontraction of proximal (hamstrings and quadriceps) muscle activity. Surprisingly, the proximal muscle activity in the responders, unlike nonresponders, was three- to fourfold greater than that in uninjured control subjects walking at similar speeds and level of body weight support, suggesting that the ability to modify muscle activation patterns after injury may predict the ability of subjects to further compensate in response to motor training. In summary, increases in the amount and decreases in the duration of EMG activity of specific muscles are associated with functional recovery of walking skills after treadmill training in subjects that are able to modify muscle activity patterns following incomplete spinal cord injury. PMID:19073799

Response of the arterial blood pressure of quadriplegic patients to treadmill gait training.

PubMed

Carvalho, D C L; Cliquet, A

2005-09-01

Blood pressure pattern was analyzed in 12 complete quadriplegics with chronic lesions after three months of treadmill gait training. Before training, blood pressure values were obtained at rest, during treadmill walking and during the recovery phase. Gait training was performed for 20 min twice a week for three months. Treadmill gait was achieved using neuromuscular electrical stimulation, assisted by partial body weight relief (30-50%). After training, blood pressure was evaluated at rest, during gait and during recovery phase. Before and after training, mean systolic blood pressures and heart rates increased significantly during gait compared to rest (94.16 +/- 5.15 to 105 +/- 5.22 mmHg and 74.27 +/- 10.09 to 106.23 +/- 17.31 bpm, respectively), and blood pressure decreased significantly in the recovery phase (86.66 +/- 9.84 and 57.5 +/- 8.66 mmHg, respectively). After three months of training, systolic blood pressure became higher at rest (94.16 +/- 5.15 mmHg before training and 100 +/- 8.52 mmHg after training; P < 0.05) and during gait exercise (105 +/- 5.22 mmHg before and 110 +/- 7.38 mmHg after training; P < 0.05) when compared to the initial values, with no changes in heart rate. No changes occurred in blood pressure during the recovery phase, with the lower values being maintained. A drop in systolic pressure from 105 +/- 5.22 to 86.66 +/- 9.84 mmHg before training and from 110 +/- 7.38 to 90 +/- 7.38 mmHg after training was noticed immediately after exercise, thus resulting in hypotensive symptoms when chronic quadriplegics reach the sitting position from the upright position.

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

PubMed

Wu, Ming; Kim, Janis; Gaebler-Spira, Deborah J; Schmit, Brian D; Arora, Pooja

2017-11-01

To determine whether applying controlled resistance forces to the legs during the swing phase of gait may improve the efficacy of treadmill training as compared with applying controlled assistance forces in children with cerebral palsy (CP). Randomized controlled study. Research unit of a rehabilitation hospital. Children with spastic CP (N=23; mean age, 10.6y; range, 6-14y; Gross Motor Function Classification System levels, I-IV). 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 the toe-off to mid-swing phase of gait during training. Outcome measures consisted of overground walking speed, 6-minute walk distance, and Gross Motor Function Measure scores and were assessed pre and post 6 weeks of training and 8 weeks after the end of training. After 6 weeks of treadmill training in participants from the resistance training group, fast walking speed and 6-minute walk distance significantly improved (18% and 30% increases, respectively), and 6-minute walk distance was still significantly greater than that at baseline (35% increase) 8 weeks after the end of training. In contrast, overground gait speed and 6-minute walk distance had no significant changes after robotic assistance training. The results of the present study indicated that robotic resistance treadmill training is more effective than assistance training in improving locomotor function in children with CP. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Effective robotic assistive pattern of treadmill training for spinal cord injury in a rat model

PubMed Central

Zhao, Bo-Lun; Li, Wen-Tao; Zhou, Xiao-Hua; Wu, Su-Qian; Cao, Hong-Shi; Bao, Zhu-Ren; An, Li-Bin

2018-01-01

The purpose of the present study was to establish an effective robotic assistive stepping pattern of body-weight-supported treadmill training based on a rat spinal cord injury (SCI) model and assess the effect by comparing this with another frequently used assistive stepping pattern. The recorded stepping patterns of both hind limbs of trained intact rats were edited to establish a 30-sec playback normal rat stepping pattern (NRSP). Step features (step length, step height, step number and swing duration), BBB scores, latencies, and amplitudes of the transcranial electrical motor-evoked potentials (tceMEPs) and neurofilament 200 (NF200) expression in the spinal cord lesion area during and after 3 weeks of body-weight-supported treadmill training (BWSTT) were compared in rats with spinal contusion receiving NRSP assistance (NRSPA) and those that received manual assistance (MA). Hind limb stepping performance among rats receiving NRSPA during BWSTT was greater than that among rats receiving MA in terms of longer step length, taller step height, and longer swing duration. Furthermore a higher BBB score was also indicated. The rats in the NRSPA group achieved superior results in the tceMEPs assessment and greater NF200 expression in the spinal cord lesion area compared with the rats in the MA group. These findings suggest NRSPA was an effective assistive pattern of treadmill training compared with MA based on the rat SCI model and this approach could be used as a new platform for animal experiments for better understanding the mechanisms of SCI rehabilitation. PMID:29545846

Robot-Assisted Body-Weight-Supported Treadmill Training in Gait Impairment in Multiple Sclerosis Patients: A Pilot Study.

PubMed

Łyp, Marek; Stanisławska, Iwona; Witek, Bożena; Olszewska-Żaczek, Ewelina; Czarny-Działak, Małgorzata; Kaczor, Ryszard

2018-02-13

This study deals with the use of a robot-assisted body-weight-supported treadmill training in multiple sclerosis (MS) patients with gait dysfunction. Twenty MS patients (10 men and 10 women) of the mean of 46.3 ± 8.5 years were assigned to a six-week-long training period with the use of robot-assisted treadmill training of increasing intensity of the Lokomat type. The outcome measure consisted of the difference in motion-dependent torque of lower extremity joint muscles after training compared with baseline before training. We found that the training uniformly and significantly augmented the torque of both extensors and flexors of the hip and knee joints. The muscle power in the lower limbs of SM patients was improved, leading to corrective changes of disordered walking movements, which enabled the patients to walk with less effort and less assistance of care givers. The torque augmentation could have its role in affecting the function of the lower extremity muscle groups during walking. The results of this pilot study suggest that the robot-assisted body-weight-supported treadmill training may be a potential adjunct measure in the rehabilitation paradigm of 'gait reeducation' in peripheral neuropathies.

Exercise training for intermittent claudication.

PubMed

McDermott, Mary M

2017-11-01

The objective of this study was to provide an overview of evidence regarding exercise therapies for patients with lower extremity peripheral artery disease (PAD). This manuscript summarizes the content of a lecture delivered as part of the 2016 Crawford Critical Issues Symposium. Multiple randomized clinical trials demonstrate that supervised treadmill exercise significantly improves treadmill walking performance in people with PAD and intermittent claudication symptoms. A meta-analysis of 25 randomized trials demonstrated a 180-meter increase in treadmill walking distance in response to supervised exercise interventions compared with a nonexercising control group. Supervised treadmill exercise has been inaccessible to many patients with PAD because of lack of medical insurance coverage. However, in 2017, the Centers for Medicare and Medicaid Services issued a decision memorandum to support health insurance coverage of 12 weeks of supervised treadmill exercise for patients with walking impairment due to PAD. Recent evidence also supports home-based walking exercise to improve walking performance in people with PAD. Effective home-exercise programs incorporate behavioral change interventions such as a remote coach, goal setting, and self-monitoring. Supervised treadmill exercise programs preferentially improve treadmill walking performance, whereas home-based walking exercise programs preferentially improve corridor walking, such as the 6-minute walk test. Clinical trial evidence also supports arm or leg ergometry exercise to improve walking endurance in people with PAD. Treadmill walking exercise appears superior to resistance training alone for improving walking endurance. Supervised treadmill exercise significantly improves treadmill walking performance in people with PAD by approximately 180 meters compared with no exercise. Recent evidence suggests that home-based exercise is also effective and preferentially improves over-ground walking performance, such as the 6-minute walk test. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Individualized treadmill and strength training for chronic stroke rehabilitation: effects of imbalance.

PubMed

Al-Jarrah, Muhammed; Shaheen, Samira; Harries, Netta; Kissani, Najib; Molteni, Franco; Bar Haim, Simona

2014-01-01

Stroke survivors often have significant walking limitations and are at high risk for falling. Treadmill training, as a rehabilitation approach in stroke survivors, and its relationship to balance ability has not been widely studied. The main goal of this study was to investigate the effectiveness of an individualized treadmill-strength training protocol on functional outcomes in chronic stroke survivors. Thirty adult participants with chronic stroke were recruited from 1 European and 4 Middle Eastern countries. Each completed 36 sessions of treadmill-strength training. The rehabilitation protocol was individualized according to each patient's cardiovascular fitness. Ten-meter walk test (10MWT), Berg Balance Scale (BBS), and 6-minute walk test (6MWT) were measured before (T0) and after training (T1) and 6 months later (T2). Paired t tests were used to test differences with training (T1 - T0) and retention after training (T2 - T1). Increases in all 3 measures from T0 to T1 were significant. There were no changes in 10MWT and BBS from T1 to T2, but 6MWT tended to increase. Separate analyses for subjects with BBS scores <41 at T0 demonstrated comparatively greater improvements from T0 to T1 than in those with BBS scores ≯40. Those with low scores also significantly increased from T1 to T2 in both walk tests. These findings suggest that a protocol combining treadmill with strength training has beneficial long-term effects on functional walking measures after chronic stroke, especially in patients who initially have low balance ability.

Effects of treadmill training with load addition on non-paretic lower limb on gait parameters after stroke: A randomized controlled clinical trial.

PubMed

Ribeiro, Tatiana S; Silva, Emília M G S; Silva, Isaíra A P; Costa, Mayara F P; Cavalcanti, Fabrícia A C; Lindquist, Ana R

2017-05-01

The addition of load on the non-paretic lower limb for the purpose of restraining this limb and stimulating the use of the paretic limb has been suggested to improve hemiparetic gait. However, the results are conflicting and only short-term effects have been observed. This study aims to investigate the effects of adding load on non-paretic lower limb during treadmill gait training as a multisession intervention on kinematic gait parameters after stroke. With this aim, 38 subacute stroke patients (mean time since stroke: 4.5 months) were randomly divided into two groups: treadmill training with load (equivalent to 5% of body weight) on the non-paretic ankle (experimental group) and treadmill training without load (control group). Both groups performed treadmill training during 30min per day, for two consecutive weeks (nine sessions). Spatiotemporal and angular gait parameters were assessed by a motion system analysis at baseline, post-training (at the end of 9days of interventions) and follow-up (40days after the end of interventions). Several post-training effects were demonstrated: patients walked faster and with longer paretic and non-paretic steps compared to baseline, and maintained these gains at follow-up. In addition, patients exhibited greater hip and knee joint excursion in both limbs at post-training, while maintaining most of these benefits at follow-up. All these improvements were observed in both groups. Although the proposal gait training program has provided better gait parameters for these subacute stroke patients, our data indicate that load addition used as a restraint may not provide additional benefits to gait training. Copyright © 2017 Elsevier B.V. All rights reserved.

[Potential analysis for research on physiotherapy-led treadmill training in Parkinson's disease].

PubMed

Lohkamp, Monika; Braun, Cordula; Wasner, Mieke; Voigt-Radloff, Sebastian

2014-01-01

Parkinson's disease is one of the major neurodegenerative disorders with prevalence rates between 0.1 and 0.2 % in the global population and 1.8 % in people aged 64 years and over. Future incidence rates are estimated to increase within aging societies. The progressive course of Parkinson's disease is clinically characterised by bradykinesia, rigidity and tremor. These limitations in motor functioning reduce the capacity to work, social participation and the clients' quality of life. Parkinson's disease causes incapacity to work and a large number of days off from work. The benefits clients expect from physiotherapy-led treatment include an improvement of gait, a better speed of motion and the decrease of fatigue and rigidity. A recent Cochrane review (Mehrholz et al., 2010) analysed seven randomised comparisons with 153 participants and found that treadmill training compared with no treatment improved gait speed (SMD 0.50; 95 % confidence interval [0.17 to 0.84]). A lack of evidence exists on how to reduce fatigue and rigidity. There is also need to evaluate long-term effects and cost-effectiveness. Furthermore, an updated meta-analysis should include eleven new randomised trials on treadmill training after 2009. Physiotherapy-led treadmill training can easily be transferred into the German healthcare context since the environmental and educational preconditions are met by German physiotherapeutic care. Within the German context, there is need to prepare a randomised clinical trial evaluating the impact of physiotherapy-led treadmill training on motor functioning, quality of life, costs, adverse events und long-term effects. Prior to this, a feasibility study should explore the acceptance and intensity of treadmill training as well as the access of private physiotherapy practices to people suffering from early- to mid-stage Parkinson's disease. Copyright © 2014. Published by Elsevier GmbH.

The effect of anti-gravity treadmill training for prosthetic rehabilitation of a case with below-knee amputation.

PubMed

Mikami, Yukio; Fukuhara, Kouki; Kawae, Toshihiro; Kimura, Hiroaki; Ochi, Mitsuo

2015-12-01

The aim of this case study was to verify the efficacy and safety of anti-gravity treadmill training for prosthetic rehabilitation following below-knee amputation. The patient underwent left below-knee amputation as a result of diabetic foot gangrene. Since his physical strength and vitality had declined during the perioperative period, anti-gravity treadmill training was introduced for his outpatient prosthetic rehabilitation. Stable prosthetic gait exercise could be carried out under guidance on the anti-gravity treadmill, quickly resulting in improved gait. Furthermore, the patient's self-efficacy and exercise tolerance were elevated after the period of anti-gravity treadmill training. At the final evaluation following 6 weeks of rehabilitation with the anti-gravity treadmill, he had acquired prosthetic gait with the assistance of a T-cane. The anti-gravity treadmill was found to be a useful instrument for prosthetic rehabilitation following below-knee amputation. Anti-gravity treadmill training has the potential to support the prosthetic rehabilitation of below-knee amputees, especially for patients whose physical strength and vitality are decreased. © The International Society for Prosthetics and Orthotics 2014.

Robot-assisted walking with the Lokomat: the influence of different levels of guidance force on thorax and pelvis kinematics.

PubMed

Swinnen, Eva; Baeyens, Jean-Pierre; Knaepen, Kristel; Michielsen, Marc; Clijsen, Ron; Beckwée, David; Kerckhofs, Eric

2015-03-01

Little attention has been devoted to the thorax and pelvis movements during gait. The aim of this study is to compare differences in the thorax and pelvis kinematics during unassisted walking on a treadmill and during walking with robot assistance (Lokomat-system (Hocoma, Volketswil, Switzerland)). 18 healthy persons walked on a treadmill with and without the Lokomat system at 2kmph. Three different conditions of guidance force (30%, 60% and 100%) were used during robot-assisted treadmill walking (30% body weight support). The maximal movement amplitudes of the thorax and pelvis were measured (Polhemus Liberty™ (Polhemus, Colchester, Vermont, USA) (240/16)). A repeated measurement ANOVA was conducted. Robot-assisted treadmill walking with different levels of guidance force showed significantly smaller maximal movement amplitudes for thorax and pelvis, compared to treadmill walking. Only the antero-posterior tilting of the pelvis was significantly increased during robot-assisted treadmill walking compared to treadmill walking. No significant changes of kinematic parameters were found between the different levels of guidance force. With regard to the thorax and pelvis movements, robot-assisted treadmill walking is significantly different compared to treadmill walking. It can be concluded that when using robot assistance, the thorax is stimulated in a different way than during walking without robot assistance, influencing the balance training during gait. Copyright © 2015 Elsevier Ltd. All rights reserved.

Step training with body weight support: effect of treadmill speed and practice paradigms on poststroke locomotor recovery.

PubMed

Sullivan, Katherine J; Knowlton, Barbara J; Dobkin, Bruce H

2002-05-01

To investigate the effect of practice paradigms that varied treadmill speed during step training with body weight support in subjects with chronic hemiparesis after stroke. Randomized, repeated-measures pilot study with 1- and 3-month follow-ups. Outpatient locomotor laboratory. Twenty-four individuals with hemiparetic gait deficits whose walking speeds were at least 50% below normal. Participants were stratified by locomotor severity based on initial walking velocity and randomly assigned to treadmill training at slow (0.5mph), fast (2.0mph), or variable (0.5, 1.0, 1.5, 2.0mph) speeds. Participants received 20 minutes of training per session for 12 sessions over 4 weeks. Self-selected overground walking velocity (SSV) was assessed at the onset, middle, and end of training, and 1 and 3 months later. SSV improved in all groups compared with baseline (P<.001). All groups increased SSV in the 1-month follow-up (P<.01) and maintained these gains at the 3-month follow-up (P=.77). The greatest improvement in SSV across training occurred with fast training speeds compared with the slow and variable groups combined (P=.04). Effect size (ES) was large between fast compared with slow (ES=.75) and variable groups (ES=.73). Training at speeds comparable with normal walking velocity was more effective in improving SSV than training at speeds at or below the patient's typical overground walking velocity. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Treadmill training and body weight support for walking after stroke.

PubMed

Mehrholz, Jan; Thomas, Simone; Elsner, Bernhard

2017-08-17

Treadmill training, with or without body weight support using a harness, is used in rehabilitation and might help to improve walking after stroke. This is an update of the Cochrane review first published in 2003 and updated in 2005 and 2014. To determine if treadmill training and body weight support, individually or in combination, improve walking ability, quality of life, activities of daily living, dependency or death, and institutionalisation or death, compared with other physiotherapy gait-training interventions after stroke. The secondary objective was to determine the safety and acceptability of this method of gait training. We searched the Cochrane Stroke Group Trials Register (last searched 14 February 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) and the Database of Reviews of Effects (DARE) (the Cochrane Library 2017, Issue 2), MEDLINE (1966 to 14 February 2017), Embase (1980 to 14 February 2017), CINAHL (1982 to 14 February 2017), AMED (1985 to 14 February 2017) and SPORTDiscus (1949 to 14 February 2017). We also handsearched relevant conference proceedings and ongoing trials and research registers, screened reference lists, and contacted trialists to identify further trials. Randomised or quasi-randomised controlled and cross-over trials of treadmill training and body weight support, individually or in combination, for the treatment of walking after stroke. Two review authors independently selected trials, extracted data, and assessed risk of bias and methodological quality. The primary outcomes investigated were walking speed, endurance, and dependency. We included 56 trials with 3105 participants in this updated review. The average age of the participants was 60 years, and the studies were carried out in both inpatient and outpatient settings. All participants had at least some walking difficulties and many could not walk without assistance. Overall, the use of treadmill training did not increase the chances of walking independently compared with other physiotherapy interventions (risk difference (RD) -0.00, 95% confidence interval (CI) -0.02 to 0.02; 18 trials, 1210 participants; P = 0.94; I² = 0%; low-quality evidence). Overall, the use of treadmill training in walking rehabilitation for people after stroke increased the walking velocity and walking endurance significantly. The pooled mean difference (MD) (random-effects model) for walking velocity was 0.06 m/s (95% CI 0.03 to 0.09; 47 trials, 2323 participants; P < 0.0001; I² = 44%; moderate-quality evidence) and the pooled MD for walking endurance was 14.19 metres (95% CI 2.92 to 25.46; 28 trials, 1680 participants; P = 0.01; I² = 27%; moderate-quality evidence). Overall, the use of treadmill training with body weight support in walking rehabilitation for people after stroke did not increase the walking velocity and walking endurance at the end of scheduled follow-up. The pooled MD (random-effects model) for walking velocity was 0.03 m/s (95% CI -0.05 to 0.10; 12 trials, 954 participants; P = 0.50; I² = 55%; low-quality evidence) and the pooled MD for walking endurance was 21.64 metres (95% CI -4.70 to 47.98; 10 trials, 882 participants; P = 0.11; I² = 47%; low-quality evidence). In 38 studies with a total of 1571 participants who were independent in walking at study onset, the use of treadmill training increased the walking velocity significantly. The pooled MD (random-effects model) for walking velocity was 0.08 m/s (95% CI 0.05 to 0.12; P < 0.00001; I 2 = 49%). There were insufficient data to comment on any effects on quality of life or activities of daily living. Adverse events and dropouts did not occur more frequently in people receiving treadmill training and these were not judged to be clinically serious events. Overall, people after stroke who receive treadmill training, with or without body weight support, are not more likely to improve their ability to walk independently compared with people after stroke not receiving treadmill training, but walking speed and walking endurance may improve slightly in the short term. Specifically, people with stroke who are able to walk (but not people who are dependent in walking at start of treatment) appear to benefit most from this type of intervention with regard to walking speed and walking endurance. This review did not find, however, that improvements in walking speed and endurance may have persisting beneficial effects. Further research should specifically investigate the effects of different frequencies, durations, or intensities (in terms of speed increments and inclination) of treadmill training, as well as the use of handrails, in ambulatory participants, but not in dependent walkers.

Training Modalities to Increase Sensorimotor Adaptability

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Mulavara, A. P.; Peters, B. T.; Brady, R.; Audas, C.; Cohen, H. S.

2009-01-01

During the acute phase of adaptation to novel gravitational environments, sensorimotor disturbances have the potential to disrupt the ability of astronauts to perform required mission tasks. The goal of our current series of studies is develop a sensorimotor adaptability (SA) training program designed to facilitate recovery of functional capabilities when astronauts transition to different gravitational environments. The project has conducted a series of studies investigating the efficacy of treadmill training combined with a variety of sensory challenges (incongruent visual input, support surface instability) designed to increase adaptability. SA training using a treadmill combined with exposure to altered visual input was effective in producing increased adaptability in a more complex over-ground ambulatory task on an obstacle course. This confirms that for a complex task like walking, treadmill training contains enough of the critical features of overground walking to be an effective training modality. SA training can be optimized by using a periodized training schedule. Test sessions that each contain short-duration exposures to multiple perturbation stimuli allows subjects to acquire a greater ability to rapidly reorganize appropriate response strategies when encountering a novel sensory environment. Using a treadmill mounted on top of a six degree-of-freedom motion base platform we investigated locomotor training responses produced by subjects introduced to a dynamic walking surface combined with alterations in visual flow. Subjects who received this training had improved locomotor performance and faster reaction times when exposed to the novel sensory stimuli compared to control subjects. Results also demonstrate that individual sensory biases (i.e. increased visual dependency) can predict adaptive responses to novel sensory environments suggesting that individual training prescription can be developed to enhance adaptability. These data indicate that SA training can be effectively integrated with treadmill exercise and optimized to provide a unique system that combines multiple training requirements in a single countermeasure system. Learning Objectives: The development of a new countermeasure approach that enhances sensorimotor adaptability will be discussed.

Dose-Response Outcomes Associated with Different Forms of Locomotor Training in Persons with Chronic Motor-Incomplete Spinal Cord Injury.

PubMed

Sandler, Evan B; Roach, Kathryn E; Field-Fote, Edelle C

2017-05-15

Outcomes of training are thought to be related to the amount of training (training dose). Although various approaches to locomotor training have been used to improve walking function in persons with spinal cord injury (SCI), little is known about the relationship between dose of locomotor training and walking outcomes. This secondary analysis aimed to identify the relationship between training dose and improvement in walking distance and speed associated with locomotor training in participants with chronic motor-incomplete spinal cord injury (MISCI). We compared the dose-response relationships associated with each of four different locomotor training approaches. Participants were randomized to either: treadmill-based training with manual assistance (TM = 17), treadmill-based training with stimulation (TS = 18), overground training with stimulation (OG = 15), and treadmill-based training with locomotor robotic device assistance (LR = 14). Subjects trained 5 days/week for 12 weeks, with a target of 60 training sessions. The distance-dose and time-dose were calculated based on the total distance and total time, respectively, participants engaged in walking over all sessions combined. Primary outcome measures included walking distance (traversed in 2 min) and walking speed (over 10 m). Only OG training showed a good correlation between distance-dose and change in walking distance and speed walked over ground (r = 0.61, p = 0.02; r = 0.62, p = 0.01). None of the treadmill-based training approaches were associated with significant correlations between training dose and improvement of functional walking outcome. The findings suggest that greater distance achieved over the course of OG training is associated with better walking outcomes in the studied population. Further investigation to identify the essential elements that determine outcomes would be valuable for guiding rehabilitation.

Robot-assisted gait training versus treadmill training in patients with Parkinson's disease: a kinematic evaluation with gait profile score.

PubMed

Galli, M; Cimolin, V; De Pandis, M F; Le Pera, D; Sova, I; Albertini, G; Stocchi, F; Franceschini, M

2016-01-01

The purpose of this study was to quantitatively compare the effects, on walking performance, of end-effector robotic rehabilitation locomotor training versus intensive training with a treadmill in Parkinson's disease (PD). Fifty patients with PD were randomly divided into two groups: 25 were assigned to the robot-assisted therapy group (RG) and 25 to the intensive treadmill therapy group (IG). They were evaluated with clinical examination and 3D quantitative gait analysis [gait profile score (GPS) and its constituent gait variable scores (GVSs) were calculated from gait analysis data] at the beginning (T0) and at the end (T1) of the treatment. In the RG no differences were found in the GPS, but there were significant improvements in some GVSs (Pelvic Obl and Hip Ab-Add). The IG showed no statistically significant changes in either GPS or GVSs. The end-effector robotic rehabilitation locomotor training improved gait kinematics and seems to be effective for rehabilitation in patients with mild PD.

Treadmill training with partial body-weight support after anterior cruciate ligament reconstruction: a randomized controlled trial.

PubMed

Luo, Yuan; Shen, Weizhong; Jiang, Zhong; Sha, Jiao

2016-12-01

[Purpose] To compare the effects of treadmill training with partial body weight support (TTPBWS) and conventional physical therapy (PT) on subjects with anterior cruciate ligament reconstructions. [Subjects and Methods] A total of 40 subjects were randomly allocated to either a treatment group or a control group. Subjects received either treadmill training with partial body weight support (treatment group) or conventional physical therapy (control group). The circumferences of the lower extremities, Holden classifications, 10-meter walking times and the International Knee Documentation Committee (IKDC) scores were compared at 12 and 24 weeks post-operation. The knee joint stability was tested at 24 weeks post-operation using a KT-1000. [Results] Significant differences were found between the two groups at the 12 weeks post-operation. For most of the measures, there was no significant difference between the groups at 24 weeks post-operation. Interestingly, for most of the measures, there was no significant difference between their values in the treatment group at 12 weeks and their values in the control group at 24 weeks post-operation. [Conclusion] The function of a subject's lower extremities can be improved and the improvement was clearly accelerated by the intervention of treadmill training with partial body weight support, without compromising the stability of the knee joints in a given follow-up period.

Myocardial work during endurance training and resistance training: a daily comparison, from workout session 1 through completion of cardiac rehabilitation

PubMed Central

Hubbard, Matthew; McCullough-Shock, Tiffany; Simms, Kay; Cheng, Dunlei; Hartman, Julie; Strauss, Danielle; Anderson, Valerie; Lawrence, Anne; Malorzo, Emily

2010-01-01

Patients in cardiac rehabilitation are typically advised to complete a period of supervised endurance training before beginning resistance training. In this study, however, we compared the peak rate-pressure product (RPP, a calculated indicator of myocardial work) of patients during two types of exercise—treadmill walking and chest press—from workout session 1 through completion of cardiac rehabilitation. Twenty-one patients (4 women and 17 men, aged 35 to 70 years) were enrolled in the study; they were referred for cardiac rehabilitation after myocardial infarction, percutaneous coronary intervention, or both. The participants did treadmill walking and chest press exercises during each workout session. Peak values for heart rate (HR) and systolic blood pressure (SBP) were recorded, and the peak RPP was calculated (peak HR ⊠ peak SBP). Paired t tests were used to compare the data collected during the two types of exercise across 19 workout sessions. The mean peak values for HR, SBP, and RPP were lower during resistance training than during endurance training; the differences were statistically significant (P < 0.05), with only one exception (the SBP for session 1). Across all 19 workout sessions, the participants performed more myocardial work, as indicated by the peak RPP, during treadmill walking than during the chest press. PMID:20396420

[Russian treadmill BD-1 as a backup of the NASA TVIS].

PubMed

Iarmanova, E N; Kozlovskaia, I B; Bogomolov, V V; Rumiantseva, O N; Sukhachev, V I; Mel'nik, K A

2006-01-01

Already during the early ISS increments malfunctioning of NASA TVIS (treadmill with vibration isolation system) posed major problems for regular crew training and particularly scamper, one of the key exercises on the Russian physical training program. During ISS increment-3, TVIS unscheduled repairs took virtually all the training time. In search for TVIS backup, Russian and NASA engineers considered jointly Russian treadmill BD-1, originally designed for Russian "shuttle" Buran and accepted it as a suitable backup in case of complete TVIS failure. To enter into the "dialogue" with BD-1, i.e., to record and downlink training data, the treadmill speed indicator, a part of the treadmill stand, was replaced by PC.

The comparison of stepping responses following perturbations applied to pelvis during overground and treadmill walking.

PubMed

Zadravec, Matjaž; Olenšek, Andrej; Matjačić, Zlatko

2017-08-09

Treadmills are used frequently in rehabilitation enabling neurologically impaired subjects to train walking while being assisted by therapists. Numerous studies compared walking on treadmill and overground for unperturbed but not also perturbed conditions. The objective of this study was to compare stepping responses (step length, step width and step time) during overground and treadmill walking in a group of healthy subjects where balance assessment robots applied perturbing pushes to the subject's pelvis in sagittal and frontal planes. During walking in both balance assessment robots (overground and treadmill-based) with applied perturbations the stepping responses of a group of seven healthy subjects were assessed with a motion tracking camera. The results show high degree of similarity of stepping responses between overground and treadmill walking for all perturbation directions. Both devices reproduced similar experimental conditions with relatively small standard deviations in the unperturbed walking as well as in perturbed walking. Based on these results we may conclude that stepping responses following perturbations can be studied on an instrumented treadmill where ground reaction forces can be readily assessed which is not the case during perturbed overground walking.

Productivity of transcriptionists using a treadmill desk.

PubMed

Thompson, Warren G; Levine, James A

2011-01-01

Time spent sitting increases all-cause mortality. Sedentary occupations are a major contributor to the obesity epidemic. A treadmill desk offers the potential to increase activity while working; however, it is important to make sure that productivity does not decline. The purpose of this study is to evaluate productivity while using a treadmill desk. Eleven experienced medical transcriptionists participated in the study. Transcriptionists were given 4 hours training in the use of a treadmill desk. They were asked to transcribe tapes for 8 hours both while sitting and while using the treadmill desk. Speed and accuracy of transcription were compared as were the average expended calories per hour. The accuracy of transcription did not differ between sitting and walking transcriptions. The speed of transcription was 16% slower while walking than while sitting (p < 0.001). The transcriptionists expended 100 calories per hour more when they transcribed while walking than when they transcribed while sitting (p < 0.001). The treadmill desk offers a way to reduce sedentariness in the workplace and has potential to reduce employee obesity and health care costs. However, more than 4 hours of training will be necessary to prevent a significant drop in employee productivity.

Comparing interventions and exploring neural mechanisms of exercise in Parkinson disease: a study protocol for a randomized controlled trial.

PubMed

Earhart, Gammon M; Duncan, Ryan P; Huang, John L; Perlmutter, Joel S; Pickett, Kristen A

2015-02-05

Effective treatment of locomotor dysfunction in Parkinson disease (PD) is essential, as gait difficulty is an early and major contributor to disability. Exercise is recommended as an adjunct to traditional treatments for improving gait, balance, and quality of life. Among the exercise approaches known to improve walking, tango and treadmill training have recently emerged as two promising therapies for improving gait, disease severity and quality of life, yet these two interventions have not been directly compared to each other. Prior studies have been helpful in identifying interventions effective in improving gait function, but have done little to elucidate the neural mechanisms underlying functional improvements. The primary objective of the proposed work is to compare the effects of three community-based exercise programs, tango, treadmill training and stretching, on locomotor function in individuals with PD. In addition, we aim to determine whether and how these interventions alter functional connectivity of locomotor control networks in the brain. One hundred and twenty right-handed individuals with idiopathic PD who are at least 30 years of age will be assigned in successive waves to one of three community-based exercise groups: tango dancing, treadmill training or stretching (control). Each group will receive three months of exercise training with twice weekly one-hour group classes. Each participant will be evaluated at three time points: pre-intervention (baseline), post-intervention (3 months), and follow-up (6 months). All evaluations will include assessment of gait, balance, disease severity, and quality of life. Baseline and post-intervention evaluations will also include task-based functional magnetic resonance imaging (fMRI) and resting state functional connectivity MRI. All MRI and behavioral measures will be conducted with participants OFF anti-Parkinson medication, with behavioral measures also assessed ON medication. This study will provide important insights regarding the effects of different modes of exercise on locomotor function in PD. The protocol is innovative because it: 1) uses group exercise approaches for all conditions including treadmill training, 2) directly compares tango to treadmill training and stretching, 3) tests participants OFF medication, and 4) utilizes two distinct neuroimaging approaches to explore mechanisms of the effects of exercise on the brain. ClinicalTrials.gov NCT01768832 .

Treadmill Training with Virtual Reality Improves Gait, Balance, and Muscle Strength in Children with Cerebral Palsy.

PubMed

Cho, Chunhee; Hwang, Wonjeong; Hwang, Sujin; Chung, Yijung

2016-03-01

Independent walking is an important goal of clinical and community-based rehabilitation for children with cerebral palsy (CP). Virtual reality-based rehabilitation therapy is effective in motivating children with CP. This study investigated the effects of treadmill training with virtual reality on gait, balance, muscular strength, and gross motor function in children with CP. Eighteen children with spastic CP were randomly divided into the virtual reality treadmill training (VRTT) group (9 subjects, mean age, 10.2 years) and treadmill training (TT) group (9 subjects, mean age, 9.4 years). The groups performed their respective programs as well as conventional physical therapy 3 times/week for 8 weeks. Muscle strength was assessed using a digitalized manual muscle tester. Gross motor function was assessed using the Gross Motor Functional Measure (GMFM). Balance was assessed using the Pediatric Balance Scale (PBS). Gait speed was assessed using the 10-meter walk test (10MWT), and gait endurance was assessed using the 2-minute walk test (2MWT). After training, gait and balance was improved in the VRTT compared to the TT group (P < 0.05). Muscular strength was significantly greater in the VRTT group than the TT group, except for right hamstring strength. The improvements in GMFM (standing) and PBS scores were greater in the VRTT group than the TT group (P < 0.05). Furthermore, the VRTT group showed the higher values of 10MWT and 2MWT compared to the TT group (P < 0.05). In conclusion, VRTT programs are effective for improving gait, balance, muscular strength, and gross motor function in children with CP.

Generalization of treadmill perturbation to overground slip during gait: Effect of different perturbation distances on slip recovery.

PubMed

Lee, Anna; Bhatt, Tanvi; Pai, Yi-Chung

2016-01-25

Treadmill-perturbation training (TM-training) may improve a person׳s fall-resistance, whereby adjusting slip distance can be a simple way to manipulate training intensity. The purpose of this study was to determine the effects of different slip distances in TM-training (12-cm vs. 18-cm) on its generalization to the recovery from a novel "free" slip during overground walking. Generalization here means the ability to apply learned skill from TM-training to slip recovery during overground walking. Thirty-six young adults in the TM_12 or the TM_18 group underwent either a 12-cm or an 18-cm slip during the treadmill walking for seven times, or in the control group were not exposed to any perturbation. Their responses were also contrasted with previously reported results from overground-perturbation training (OG-training) in which participants received either a 12-cm or an 18-cm slip during level walking with the same number of repetitions. Everyone was then exposed to the same generalization test during a novel "free" slip in overground walking. Their proactive and reactive control of stability was measured and compared. TM-training displayed a significant training effect in comparison to the control group (p<0.05), while most of the improvements were found in the reactive control of stability and were much-limited in comparison to that of OG-training. Also unlike OG-training, no significant differences were found between the results obtained from the TM_12 and the TM_18 groups (p>0.05). These results underscore the further needs to investigate the potential of the treadmill as a convenient instrument that can effectively deliver perturbation training. Published by Elsevier Ltd.

Generalization of treadmill perturbation to overground slip during gait: Effect of different perturbation distances on slip recovery

PubMed Central

Lee, Anna; Bhatt, Tanvi; Pai, Yi-Chung

2016-01-01

Treadmill-perturbation training (TM-training) may improve a person’s fall-resistance, whereby adjusting slip distance can be a simple way to manipulate training intensity. The purpose of this study was to determine the effects of different slip distances in TM-training (12-cm vs. 18-cm) on its generalization to the recovery from a novel “free” slip during overground walking. Generalization here means the ability to apply learned skill from TM-training to slip recovery during overground walking. Thirty-six young adults in the TM_12 or the TM_18 group underwent either a 12-cm or an 18-cm slip during the treadmill walking for seven times, or in the control group were not exposed to any perturbation. Their responses were also contrasted with previously reported results from overground-perturbation training (OG-training) in which participants received either a 12-cm or an 18-cm slip during level walking with the same number of repetitions. Everyone was then exposed to the same generalization test during a novel “free” slip in overground walking. Their proactive and reactive control of stability was measured and compared. TM-training displayed a significant training effect in comparison to the control group (p<0.05), while most of the improvements were found in the reactive control of stability and were much-limited in comparison to that of OG-training. Also unlike OG-training, no significant differences were found between the results obtained from the TM_12 and the TM_18 groups (p>0.05). These results underscore the further needs to investigate the potential of the treadmill as a convenient instrument that can effectively deliver perturbation training. PMID:26653674

A user-driven treadmill control scheme for simulating overground locomotion.

PubMed

Kim, Jonghyun; Stanley, Christopher J; Curatalo, Lindsey A; Park, Hyung-Soon

2012-01-01

Treadmill-based locomotor training should simulate overground walking as closely as possible for optimal skill transfer. The constant speed of a standard treadmill encourages automaticity rather than engagement and fails to simulate the variable speeds encountered during real-world walking. To address this limitation, this paper proposes a user-driven treadmill velocity control scheme that allows the user to experience natural fluctuations in walking velocity with minimal unwanted inertial force due to acceleration/deceleration of the treadmill belt. A smart estimation limiter in the scheme effectively attenuates the inertial force during velocity changes. The proposed scheme requires measurement of pelvic and swing foot motions, and is developed for a treadmill of typical belt length (1.5 m). The proposed scheme is quantitatively evaluated here with four healthy subjects by comparing it with the most advanced control scheme identified in the literature.

Body weight supported treadmill training versus traditional training in patients dependent on walking assistance after stroke: a randomized controlled trial.

PubMed

Høyer, Ellen; Jahnsen, Reidun; Stanghelle, Johan Kvalvik; Strand, Liv Inger

2012-01-01

Treadmill training with body weight support (TTBWS) for relearning walking ability after brain damage is an approach under current investigation. Efficiency of this method beyond traditional training is lacking evidence, especially in patients needing walking assistance after stroke. The objective of this study was to investigate change in walking and transfer abilities, comparing TTBWS with traditional walking training. A single-blinded, randomized controlled trial was conducted. Sixty patients referred for multi-disciplinary primary rehabilitation were assigned into one of two intervention groups, one received 30 sessions of TTBWS plus traditional training, the other traditional training alone. Daily training was 1 hr. Outcome measures were Functional Ambulation Categories (FAC), Walking, Functional Independence Measure (FIM); shorter transfer and stairs, 10 m and 6-min walk tests. Substantial improvements in walking and transfer were shown within both groups after 5 and 11 weeks of intervention. Overall no statistical significant differences were found between the groups, but 12 of 17 physical measures tended to show improvements in favour of the treadmill approach. Both training strategies provided significant improvements in the tested activities, suggesting that similar outcomes can be obtained in the two modalities by systematic, intensive and goal directed training.

Effect of the treadmill training factors on the locomotor ability after space flight

NASA Astrophysics Data System (ADS)

Lysova, Nataliya; Fomina, Elena

Training on the treadmill constitutes the central component of the Russian system of countermeasures against the negative effects of microgravity. Effectiveness of the treadmill training is influenced by three main factors. Namely, these are intensity (velocity and regularity), axial loading with the use of elastic bungee cords and percentage of time for training on the non-motorized treadmill within the overall training program. Previously we have demonstrated the significance of each factor separately: intensity (Kozlovskaya I.B. et al., 2011), passive mode (Fomina E.V. et al., 2012) and axial loading (Fomina E.V. et al., 2013). The Russian system of in-flight countermeasures gives preference to interval training sessions in which walking alternates with short episodes of intensive running. Locomotion on the non-motorized treadmill should make approx. 30% of the total time of locomotor training. The ISS RS treadmill can be utilized with the motor in motion (active mode) or out of motion so that the cosmonaut has to push the belt with his feet (passive mode). Axial loading of the cosmonaut must be 60-70% of his body weight. However, there is a huge variety of strategies cosmonauts choose of when they exercise on the treadmill in the course of long-duration ISS missions. Purpose of the investigation was comparative analysis of different locomotion training regimens from the standpoint of their effectiveness in microgravity. Criteria of effectiveness evaluation were the results of the locomotion test that includes walking along the fixed support at the preset rate of 90 steps/min. Peak amplitude on the m. soleus electromyogram was analyzed. The experiment was performed with participation of 18 Russian members of extended ISS missions. Each locomotion training factors was rated using the score scale from 0 to 10: Intensity (0 to 10), Percentage of passive mode training (recommended 30% was taken as 10 and could go down to 0 if the passive mode was not applied) and Axial loading (10 was taken as recommended 70% of the body weight). Significant differences in the m. soleus peak amplitude were found between groups of cosmonauts with different sums of the rating scores. On the third day post landing, myogram amplitudes in the group with the rating score sums < 11 were much higher in comparison with the group in which the rating score sums exceeded 12. These data strongly supported high preventive effectiveness of the locomotor training with the optimal combination of the factors of intensity, percentage of passive mode training and axial loading. Besides, they brought out the possibility of training regimen individualization by “tailoring” two factors, i.e. passive mode and axial loading.

Human dental pulp stem cells transplantation combined with treadmill training in rats after traumatic spinal cord injury

PubMed Central

Nicola, F.C.; Rodrigues, L.P.; Crestani, T.; Quintiliano, K.; Sanches, E.F.; Willborn, S.; Aristimunha, D.; Boisserand, L.; Pranke, P.; Netto, C.A.

2016-01-01

Spinal cord injury (SCI) is a disabling condition resulting in deficits of sensory and motor functions, and has no effective treatment. Considering that protocols with stem cell transplantation and treadmill training have shown promising results, the present study evaluated the effectiveness of stem cells from human exfoliated deciduous teeth (SHEDs) transplantation combined with treadmill training in rats with experimental spinal cord injury. Fifty-four Wistar rats were spinalized using NYU impactor. The rats were randomly distributed into 5 groups: Sham (laminectomy with no SCI, n=10); SCI (laminectomy followed by SCI, n=12); SHEDs (SCI treated with SHEDs, n=11); TT (SCI treated with treadmill training, n=11); SHEDs+TT (SCI treated with SHEDs and treadmill training; n=10). Treatment with SHEDs alone or in combination with treadmill training promoted functional recovery, reaching scores of 15 and 14, respectively, in the BBB scale, being different from the SCI group, which reached 11. SHEDs treatment was able to reduce the cystic cavity area and glial scar, increase neurofilament. Treadmill training alone had no functional effectiveness or tissue effects. In a second experiment, the SHEDs transplantation reduced the TNF-α levels in the cord tissue measured 6 h after the injury. Contrary to our hypothesis, treadmill training either alone or in combination, caused no functional improvement. However, SHEDs showed to be neuroprotective, by the reduction of TNF-α levels, the cystic cavity and the glial scar associated with the improvement of motor function after SCI. These results provide evidence that grafted SHEDs might be an effective therapy to spinal cord lesions, with possible anti-inflammatory action. PMID:27509306

Human dental pulp stem cells transplantation combined with treadmill training in rats after traumatic spinal cord injury.

PubMed

Nicola, F C; Rodrigues, L P; Crestani, T; Quintiliano, K; Sanches, E F; Willborn, S; Aristimunha, D; Boisserand, L; Pranke, P; Netto, C A

2016-08-08

Spinal cord injury (SCI) is a disabling condition resulting in deficits of sensory and motor functions, and has no effective treatment. Considering that protocols with stem cell transplantation and treadmill training have shown promising results, the present study evaluated the effectiveness of stem cells from human exfoliated deciduous teeth (SHEDs) transplantation combined with treadmill training in rats with experimental spinal cord injury. Fifty-four Wistar rats were spinalized using NYU impactor. The rats were randomly distributed into 5 groups: Sham (laminectomy with no SCI, n=10); SCI (laminectomy followed by SCI, n=12); SHEDs (SCI treated with SHEDs, n=11); TT (SCI treated with treadmill training, n=11); SHEDs+TT (SCI treated with SHEDs and treadmill training; n=10). Treatment with SHEDs alone or in combination with treadmill training promoted functional recovery, reaching scores of 15 and 14, respectively, in the BBB scale, being different from the SCI group, which reached 11. SHEDs treatment was able to reduce the cystic cavity area and glial scar, increase neurofilament. Treadmill training alone had no functional effectiveness or tissue effects. In a second experiment, the SHEDs transplantation reduced the TNF-α levels in the cord tissue measured 6 h after the injury. Contrary to our hypothesis, treadmill training either alone or in combination, caused no functional improvement. However, SHEDs showed to be neuroprotective, by the reduction of TNF-α levels, the cystic cavity and the glial scar associated with the improvement of motor function after SCI. These results provide evidence that grafted SHEDs might be an effective therapy to spinal cord lesions, with possible anti-inflammatory action.

Robot-assisted gait training versus treadmill training in patients with Parkinson’s disease: a kinematic evaluation with gait profile score

PubMed Central

Galli, Manuela; Cimolin, Veronica; De Pandis, Maria Francesca; Le Pera, Domenica; Sova, Ivan; Albertini, Giorgio; Stocchi, Fabrizio; Franceschini, Marco

2016-01-01

Summary The purpose of this study was to quantitatively compare the effects, on walking performance, of end-effector robotic rehabilitation locomotor training versus intensive training with a treadmill in Parkinson’s disease (PD). Fifty patients with PD were randomly divided into two groups: 25 were assigned to the robot-assisted therapy group (RG) and 25 to the intensive treadmill therapy group (IG). They were evaluated with clinical examination and 3D quantitative gait analysis [gait profile score (GPS) and its constituent gait variable scores (GVSs) were calculated from gait analysis data] at the beginning (T0) and at the end (T1) of the treatment. In the RG no differences were found in the GPS, but there were significant improvements in some GVSs (Pelvic Obl and Hip Ab-Add). The IG showed no statistically significant changes in either GPS or GVSs. The end-effector robotic rehabilitation locomotor training improved gait kinematics and seems to be effective for rehabilitation in patients with mild PD. PMID:27678210

Robotically assisted treadmill exercise training for improving peak fitness in chronic motor incomplete spinal cord injury: A randomized controlled trial

PubMed Central

Scott, William; York, Henry; Theyagaraj, Melita; Price-Miller, Naomi; McQuaid, Jean; Eyvazzadeh, Megan; Ivey, Frederick M.; Macko, Richard F.

2016-01-01

Objective To assess the effectiveness of robotically assisted body weight supported treadmill training (RABWSTT) for improving cardiovascular fitness in chronic motor incomplete spinal cord injury (CMISCI). Design Pilot prospective randomized, controlled clinical trial. Setting Outpatient rehabilitation specialty hospital. Participants Eighteen individuals with CMISCI with American Spinal Injury Association (ASIA) level between C4 and L2 and at least one-year post injury. Interventions CMISCI participants were randomized to RABWSTT or a home stretching program (HSP) three times per week for three months. Those in the home stretching group were crossed over to three months of RABWSTT following completion of the initial three month phase. Outcome measures Peak oxygen consumption (peak VO2) was measured during both robotic treadmill walking and arm cycle ergometry: twice at baseline, once at six weeks (mid-training) and twice at three months (post-training). Peak VO2 values were normalized for body mass. Results The RABWSTT group improved peak VO2 by 12.3% during robotic treadmill walking (20.2 ± 7.4 to 22.7 ± 7.5 ml/kg/min, P = 0.018), compared to a non-significant 3.9% within group change observed in HSP controls (P = 0.37). Neither group displayed a significant change in peak VO2 during arm cycle ergometry (RABWSTT, 8.5% (P = 0.25); HSP, 1.76% (P = 0.72)). A repeated measures analysis showed statistically significant differences between treatments for peak VO2 during both robotic treadmill walking (P = 0.002) and arm cycle ergometry (P = 0.001). Conclusion RABWSTT is an effective intervention model for improving peak fitness levels assessed during robotic treadmill walking in persons with CMISCI. PMID:25520035

Pressure-controlled treadmill training in chronic stroke: a case study with AlterG.

PubMed

Lathan, Cherise; Myler, Andrew; Bagwell, Jennifer; Powers, Christopher M; Fisher, Beth E

2015-04-01

Body-weight-supported treadmill training has been shown to be an effective intervention to improve walking characteristics for individuals who have experienced a stroke. A pressure-controlled treadmill utilizes a sealed chamber in which air pressure can be altered in a controlled manner to counteract the effects of gravity. The focus of this case study was to assess the immediate and short-term impact of a pressure-controlled treadmill to improve gait parameters, reduce fall risk, improve participation, and reduce the self-perceived negative impact of stroke in an individual with chronic stroke. The subject was an 81-year-old man (14.5 months poststroke). He had slow walking speed, poor endurance, and multiple gait deviations. The subject trained 4 times per week for 4 weeks (40 minutes per session) on a pressure-controlled treadmill (AlterG M320) to counter the influence of gravity on the lower extremities. Following training, self-selected gait speed increased from 0.50 m/s to 0.96 m/s, as measured by the 10-meter walk test. Stride length increased from 0.58 m to 0.95 m after training and to 1.00 m at 1-month follow-up. Peak hip flexion increased from 3.7° to 24.6° after training and to 19.4° at 1-month follow-up. Peak knee flexion increased from 19.4° to 34.3° after training and to 42.7° at 1-month follow-up. Measures of endurance, fall risk, and percentage of perceived recovery also were found to improve posttraining. Training with a pressure-controlled treadmill may be a viable alternative to traditional body-weight-supported treadmill training for persons poststroke. Additional studies with larger sample sizes are needed to elucidate the role of pressure-controlled treadmill training in this population. Video abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A97).

Effects of robotic treadmill training on functional mobility, walking capacity, motor symptoms and quality of life in ambulatory patients with Parkinson's disease: a preliminary prospective longitudinal study.

PubMed

Paker, Nurdan; Bugdayci, Derya; Goksenoglu, Goksen; Sen, Aysu; Kesiktas, Nur

2013-01-01

Decreased mobility and walking capacity occur frequently in Parkinson's disease (PD). Robotic treadmill training is a novel method to improve the walking capacity in rehabilitation. The primary aim of this study was to investigate the effects of robotic treadmill training on functional mobility and walking capacity in PD. Secondly, we aimed to assess the effects of the robotic treadmill training the motor symptoms and quality of life in patients with PD. Seventy patients with idiopathic Parkinson's disease who admitted to the outpatient clinic of the rehabilitation hospital were screened and 12 ambulatory volenteers who met the study criteria were included in this study. Patients were evaluated by Hoehn Yahr (HY) scale clinically. Two sessions robotic treadmill training per week during 5 weeks was planned for every patient. Patients were evaluated by the Timed Up and Go (TUG) test, 10 meter walking test (10 MWT), Unified Parkinson's Disease Rating Scale (UPDRS) motor section and Parkinson's Disease Questionnaire-39 (PDQ-39) at the baseline, at the 5 and 12 weeks. Cognitive and emotional states of the patients were assessed by Mini Mental State Examination (MMSE) test and Hospital Anxiety and Depression Scale (HADS) at the baseline. All patients were under medical treatment for the PD in this study and drug treatment was not changed during the study. Ten patients completed the study. The mean age was 65.6 ± 6.6 years. Five patients (50%) were women. Disease severity was between the HY stage 1-3. Two patients did not continue the robotic treadmill training after 7 sessions. They also did not want to come for control visits. TUG test, 10 MWT and UPDRS motor subscale scores showed statistically significant improvement after robotic treadmill training (p = 0.02, p = 0.001, p = 0.016). PDQ-39 scores improved significantly after robotic treadmill training (p = 0.03), however, the scores turned back to the baseline level at the 12. week control. As a result of this preliminary study, robotic treadmill training was useful to improve the functional mobility, walking capacity and motor symptoms in mild to moderate PD. Robotic treadmill training provided a transient improvement in the quality of life during the treatment.

Acute Exercise and Oxidative Stress: CrossFit™ vs. Treadmill Bout

PubMed Central

Kliszczewicz, Brian; Quindry, C. John; Blessing, L. Daniel; Oliver, D. Gretchen; Esco, R. Michael; Taylor, J. Kyle

2015-01-01

CrossFit™, a popular high-intensity training modality, has been the subject of scrutiny, with concerns of elevated risk of injury and health. Despite these concerns empirical evidence regarding physiologic stresses including acute oxidative stress is lacking. Therefore, the purpose of this investigation was to examine the acute redox response to a CrossFit™ bout. Furthermore, these findings were compared to a high-intensity treadmill bout as a point of reference. Ten males 26.4 ± 2.7 yrs having three or more months of CrossFit™ experience participated in the present study. Blood plasma was collected at four time points: Pre-exercise (PRE), immediately-post-exercise (IPE), 1 hr-post (1-HP) and 2 hr-post (2-HP), to examine oxidative damage and antioxidant capacity. Regarding plasma oxidative damage, CrossFit™ and Treadmill elicited a time-dependent increase of lipid peroxides 1-HP (CrossFit™=+143%, Treadmill=+115%) and 2-HP (CrossFit™=+256%, Treadmill+167%). Protein Carbonyls were increased IPE in CF only (+5%), while a time-dependent decrease occurred 1-HP (CrossFit™=−16%, Treadmill=−8%) and 2-HP (CF=−16%, TM=−1%) compared to IPE. Regarding antioxidant capacity, Ferric Reducing Antioxidant Power also demonstrated a time-dependent increase within CrossFit™ and Treadmill: IPE (CrossFit™=+25%, Treadmill=+17%), 1-HP (CrossFit™=+26%, Treadmill=+4.8%), 2-HP (CrossFit™=+20%, Treadmill=+12%). Total Enzymatic Antioxidant Capacity showed a time-dependent decrease in IPE (CrossFit™=−10%, Treadmill=−12%), 1-HP (CrossFit™=−12%, Treadmill=−6%), 2-HP (CrossFit™=−7%, Treadmill=−11%). No trial-dependent differences were observed in any biomarker of oxidative stress. The CrossFit™ bout elicited an acute blood oxidative stress response comparable to a traditional bout of high-intensity treadmill running. Results also confirm that exercise intensity and the time course of exercise recovery influence oxidative responses. PMID:26557192

Acute Exercise and Oxidative Stress: CrossFit(™) vs. Treadmill Bout.

PubMed

Kliszczewicz, Brian; Quindry, C John; Blessing, L Daniel; Oliver, D Gretchen; Esco, R Michael; Taylor, J Kyle

2015-09-29

CrossFit(™), a popular high-intensity training modality, has been the subject of scrutiny, with concerns of elevated risk of injury and health. Despite these concerns empirical evidence regarding physiologic stresses including acute oxidative stress is lacking. Therefore, the purpose of this investigation was to examine the acute redox response to a CrossFit(™) bout. Furthermore, these findings were compared to a high-intensity treadmill bout as a point of reference. Ten males 26.4 ± 2.7 yrs having three or more months of CrossFit(™) experience participated in the present study. Blood plasma was collected at four time points: Pre-exercise (PRE), immediately-post-exercise (IPE), 1 hr-post (1-HP) and 2 hr-post (2-HP), to examine oxidative damage and antioxidant capacity. Regarding plasma oxidative damage, CrossFit(™) and Treadmill elicited a time-dependent increase of lipid peroxides 1-HP (CrossFit(™)=+143%, Treadmill=+115%) and 2-HP (CrossFit(™)=+256%, Treadmill+167%). Protein Carbonyls were increased IPE in CF only (+5%), while a time-dependent decrease occurred 1-HP (CrossFit(™)=-16%, Treadmill=-8%) and 2-HP (CF=-16%, TM=-1%) compared to IPE. Regarding antioxidant capacity, Ferric Reducing Antioxidant Power also demonstrated a time-dependent increase within CrossFit(™) and Treadmill: IPE (CrossFit(™)=+25%, Treadmill=+17%), 1-HP (CrossFit(™)=+26%, Treadmill=+4.8%), 2-HP (CrossFit(™)=+20%, Treadmill=+12%). Total Enzymatic Antioxidant Capacity showed a time-dependent decrease in IPE (CrossFit(™)=-10%, Treadmill=-12%), 1-HP (CrossFit(™)=-12%, Treadmill=-6%), 2-HP (CrossFit(™)=-7%, Treadmill=-11%). No trial-dependent differences were observed in any biomarker of oxidative stress. The CrossFit(™) bout elicited an acute blood oxidative stress response comparable to a traditional bout of high-intensity treadmill running. Results also confirm that exercise intensity and the time course of exercise recovery influence oxidative responses.

Human-Robot Interaction: Does Robotic Guidance Force Affect Gait-Related Brain Dynamics during Robot-Assisted Treadmill Walking?

PubMed

Knaepen, Kristel; Mierau, Andreas; Swinnen, Eva; Fernandez Tellez, Helio; Michielsen, Marc; Kerckhofs, Eric; Lefeber, Dirk; Meeusen, Romain

2015-01-01

In order to determine optimal training parameters for robot-assisted treadmill walking, it is essential to understand how a robotic device interacts with its wearer, and thus, how parameter settings of the device affect locomotor control. The aim of this study was to assess the effect of different levels of guidance force during robot-assisted treadmill walking on cortical activity. Eighteen healthy subjects walked at 2 km.h-1 on a treadmill with and without assistance of the Lokomat robotic gait orthosis. Event-related spectral perturbations and changes in power spectral density were investigated during unassisted treadmill walking as well as during robot-assisted treadmill walking at 30%, 60% and 100% guidance force (with 0% body weight support). Clustering of independent components revealed three clusters of activity in the sensorimotor cortex during treadmill walking and robot-assisted treadmill walking in healthy subjects. These clusters demonstrated gait-related spectral modulations in the mu, beta and low gamma bands over the sensorimotor cortex related to specific phases of the gait cycle. Moreover, mu and beta rhythms were suppressed in the right primary sensory cortex during treadmill walking compared to robot-assisted treadmill walking with 100% guidance force, indicating significantly larger involvement of the sensorimotor area during treadmill walking compared to robot-assisted treadmill walking. Only marginal differences in the spectral power of the mu, beta and low gamma bands could be identified between robot-assisted treadmill walking with different levels of guidance force. From these results it can be concluded that a high level of guidance force (i.e., 100% guidance force) and thus a less active participation during locomotion should be avoided during robot-assisted treadmill walking. This will optimize the involvement of the sensorimotor cortex which is known to be crucial for motor learning.

Characterization and validation of a split belt treadmill for measuring hindlimb ground-reaction forces in able-bodied and spinalized felines

PubMed Central

Dimiskovski, Marko; Scheinfield, Richard; Higgin, Dwight; Krupka, Alexander; Lemay, Michel A.

2017-01-01

BACKGROUND The measurement of ground reaction forces (GRFs) in animals trained to locomote on a treadmill after spinal cord injury (SCI) could prove valuable for evaluating training outcomes; however, quantitative measures of the GRFs in spinal felines are limited. NEW METHOD A split belt treadmill was designed and constructed to measure the GRFs of feline hindlimbs during stepping. The treadmill consists of two independent treadmill assemblies, each mounted on a force plate. The design allows measurements of the vertical (Fz), fore-aft (Fy) and mediolateral (Fx) ground-reaction forces for both hindlimbs while the forelimbs are resting on a platform. RESULTS Static and dynamic noise tests revealed little to no noise at frequencies below 6 Hz. Validation of the force plate measurements with a hand-held force sensor force showed good agreement between the two force readings. Peak normalized (to body mass) vertical GRFs for intact cats were 4.89±0.85N/Kg for the left hindlimb and 4.79±0.97N/Kg for the right. In comparison, trained spinalized cats peak normalized vertical GRFs were 2.20±0.94N/Kg for the left hindlimb and 2.85±0.99N/Kg for the right. COMPARISON WITH OTHER EXISTING METHODS Previous methods of measuring GRFs used stationary single force plates or treadmill mounted to single force plate. Using independent treadmills for each hindlimb allows measurement of the individual hindlimb’s GRFs in spinalized cats following body-weight supported treadmill training. CONCLUSIONS The split belt force treadmill enables the simultaneous recording of ground-reaction forces for both hindlimbs in cats prior to spinalization, and following spinalization and body-weight-supported treadmill training (BWST). PMID:28069392

INTENSITY AND GENERALIZATION OF TREADMILL-SLIP TRAINING: HIGH OR LOW; PROGRESSIVELY-INCREASE OR -DECREASE?

PubMed Central

Liu, Xuan; Bhatt, Tanvi; Pai, Yi-Chung (Clive)

2015-01-01

Very little is known how training intensity interacts with the generalization from treadmill-slip to overground slip. The purposes of this study were to determine whether treadmill-slip training improved center-of-mass stability, more so in the reactive than in the proactive control of stability, with high intensity (HI with a trial-to-trial-consistent acceleration of 12 m/s2) better than low intensity training (LO with a consistent acceleration of 6 m/s2), and progressively-increasing intensity (INCR with a block-to-block acceleration varied from 6 to 12 m/s2) better than progressively-decreasing intensity training (DECR with an acceleration varied from 12 to 6 m/s2) in such generalization. Thirty-six young subjects evenly assigned to one of four (HI, LO, INCR, DECR) groups underwent 24 treadmill-slips before their generalization test trial with a novel slip during overground walking. The controls (CTRL, n=9) from existing data only experienced the same novel overground slip without treadmill training but under otherwise identical condition. The results showed that treadmill-slip training did improved balance control on overground slip with a greater impact on subjects’ reactive (44.3%) than proactive control of stability (27.1%) in comparison to the CTRL. HI yielded stronger generalization than LO, while INCR was only marginally better than DECR. Finally, the group means of these four displayed a clear ascending order from CTRL, LO, DECR, INCR, to HI. The results suggested that higher training intensity on treadmill led to a better generalization, while a progressively-increase in intensity had advantage over the progressively-decrease or the low training strategy. (243 words) PMID:26159058

Biofeedback for robotic gait rehabilitation.

PubMed

Lünenburger, Lars; Colombo, Gery; Riener, Robert

2007-01-23

Development and increasing acceptance of rehabilitation robots as well as advances in technology allow new forms of therapy for patients with neurological disorders. Robot-assisted gait therapy can increase the training duration and the intensity for the patients while reducing the physical strain for the therapist. Optimal training effects during gait therapy generally depend on appropriate feedback about performance. Compared to manual treadmill therapy, there is a loss of physical interaction between therapist and patient with robotic gait retraining. Thus, it is difficult for the therapist to assess the necessary feedback and instructions. The aim of this study was to define a biofeedback system for a gait training robot and test its usability in subjects without neurological disorders. To provide an overview of biofeedback and motivation methods applied in gait rehabilitation, previous publications and results from our own research are reviewed. A biofeedback method is presented showing how a rehabilitation robot can assess the patients' performance and deliver augmented feedback. For validation, three subjects without neurological disorders walked in a rehabilitation robot for treadmill training. Several training parameters, such as body weight support and treadmill speed, were varied to assess the robustness of the biofeedback calculation to confounding factors. The biofeedback values correlated well with the different activity levels of the subjects. Changes in body weight support and treadmill velocity had a minor effect on the biofeedback values. The synchronization of the robot and the treadmill affected the biofeedback values describing the stance phase. Robot-aided assessment and feedback can extend and improve robot-aided training devices. The presented method estimates the patients' gait performance with the use of the robot's existing sensors, and displays the resulting biofeedback values to the patients and therapists. The therapists can adapt the therapy and give further instructions to the patients. The feedback might help the patients to adapt their movement patterns and to improve their motivation. While it is assumed that these novel methods also improve training efficacy, the proof will only be possible with future in-depth clinical studies.

Improved Training Program for Fall Prevention of Warfighters with Lower Extremity Trauma

DTIC Science & Technology

2016-10-01

productive, active civilian life. The training program utilizes a microprocessor -controlled treadmill designed to deliver task- specific training...National Military Medical Center (WRNMMC), and Mayo. The fall prevention training program utilizes a microprocessor -controlled treadmill to deliver

Peak Cardiorespiratory Responses of Patients with Subacute Stroke During Land and Aquatic Treadmill Exercise.

PubMed

Lee, Yong Ki; Kim, Bo Ryun; Han, Eun Young

2017-05-01

The aim of this work was to investigate the cardiorespiratory responses of patients with subacute stroke to exercise stress tests with aquatic and land treadmills. Twenty-one consecutive patients who presented with first-ever subacute stroke in 2013-2015. All subjects underwent symptom-limited incremental exercise testing with aquatic and land treadmills. Land treadmill speed started at 1.5 km/h and increased 0.5 km/h every 1 to 2 minutes until maximal tolerable speed was achieved. Thereafter, the grade was elevated by 2% every 2 minutes. In the aquatic treadmill test, subjects were submerged to the xiphoid in 28°C water. Treadmill speed started at 1.5 km/h and was increased 0.5 km/h every 2 minutes thereafter. Cardiorespiratory responses were recorded with aquatic and land treadmills. Compared to land treadmill exercise, aquatic treadmill exercise achieved significantly better peak VO2 (22.0 vs 20.0; P = 0.02), peak metabolic equivalents (6.3 vs 5.8; P = 0.02), and peak rating of perceived exertion (17.6 vs 18.4, P = 0.01). Heart rate and VO2 correlated significantly during both tests (land treadmill: r = 0.96, P < 0.001; aquatic treadmill: r = 0.99, P < 0.001). Aquatic treadmill exercise elicited significantly better peak cardiorespiratory responses than land treadmill exercise and may be as effective for early intensive aerobic training in subacute stroke patients.

Energy expenditure during rest and treadmill gait training in quadriplegic subjects.

PubMed

de Carvalho, D C L; Cliquet, A

2005-11-01

The analysis of oxygen uptake (VO(2)) and energy consumption in quadriplegics after 6 months of treadmill gait with neuromuscular electrical stimulation (NMES). To compare metabolic responses in quadriplegics after 6 months of treadmill training, with NMES (30-50% body weight relief), with quadriplegics who did not perform gait. Ambulatory of University Hospital, Brazil. Quadriplegics were separated into gait and control groups (CGs). On inclusion, all subjects performed VO(2) test. In the gait group (GG) (n=11), the protocol consisted of 8 min of rest, 10 min of treadmill walking using NMES and 10 min of recovery. In the CG (n=10), testing consisted of 8 min rest, 15 min of quadriceps endurance exercise in sitting position with NMES and 10 min recovery. VO(2), carbon dioxide production (VCO(2)) and energy consumption were measured. The GG performed 6 months of treadmill training, using NMES, for 20 min, twice a week. The CG did not practice any activity with NMES, performing conventional physiotherapy only; the CG was stimulated only during the cardiorespiratory test. All parameters increased significantly for the GG: 36% for VO(2) (l/min), 43% for VCO(2) (l/min) and 32.5% for energy consumption (J/kg/s). For the CG, during knee extension exercise, VO(2) increased without changes in the energy consumption (P<0.05); smaller values were obtained for all parameters when compared to those obtained during gait. Quadriplegic gait was efficient towards increasing VO(2) and energy consumption, which can decrease the risk of cardiovascular diseases. Spinal Cord (2005) 43, 658-663. doi:10.1038/sj.sc.3101776; published online 21 June 2005.

Home-based treadmill training improved seminal quality in adults with type 2 diabetes.

PubMed

Rosety-Rodriguez, M; Rosety, J M; Fornieles, G; Rosety, M A; Diaz, A J; Rosety, I; Rodríguez-Pareja, A; Rosety, M; Ordonez, F J; Elosegui, S

2014-11-01

This was the first study conducted to determine the influence of home-based treadmill training on seminal quality in adults with type 2 diabetes. Sixty sedentary adults with type 2 diabetes volunteered for the current study. Thirty were randomly allocated to the intervention group and performed a a 14-week, home-based, treadmill training program, 3 sessions per week, consisting of a warm-up (10-15min), 40min treadmill exercise at a work intensity of 55-70% of peak heart rate (increasing by 2.5% each two weeks) measured during a maximal treadmill test, and cooling-down (5-10min). The control group included 30, age and BMI matched adults with type 2 diabetes who did not take part in any training program. Seminal quality analysis included semen volume, sperm concentration, motility and normal morphologic features. Furthermore, total antioxidant status (TAS) as well as glutathione peroxidase (GPX) activity were assessed in seminal plasma. This protocol was approved by an Institutional Ethics Committee. The home-based treadmill training significantly increased sperm concentration as well as percentages of total sperm motility and normal spermatozoa. Furthermore, TAS and GPX activity were increased after the completion of the training program. No significant changes in any of the measured variables were found in the control group. Home-based treadmill training improved seminal quality in adults with type 2 diabetes. A secondary finding was that seminal antioxidant defense system was significantly increased after being exercised. Copyright © 2013 AEU. Published by Elsevier Espana. All rights reserved.

Training to Facilitate Adaptation to Novel Sensory Environments

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Peters, B. T.; Mulavara, A. P.; Brady, R. A.; Batson, C. D.; Ploutz-Snyder, R. J.; Cohen, H. S.

2010-01-01

After spaceflight, the process of readapting to Earth s gravity causes locomotor dysfunction. We are developing a gait training countermeasure to facilitate adaptive responses in locomotor function. Our training system is comprised of a treadmill placed on a motion-base facing a virtual visual scene that provides an unstable walking surface combined with incongruent visual flow designed to train subjects to rapidly adapt their gait patterns to changes in the sensory environment. The goal of our present study was to determine if training improved both the locomotor and dual-tasking ability responses to a novel sensory environment and to quantify the retention of training. Subjects completed three, 30-minute training sessions during which they walked on the treadmill while receiving discordant support surface and visual input. Control subjects walked on the treadmill without any support surface or visual alterations. To determine the efficacy of training, all subjects were then tested using a novel visual flow and support surface movement not previously experienced during training. This test was performed 20 minutes, 1 week, and 1, 3, and 6 months after the final training session. Stride frequency and auditory reaction time were collected as measures of postural stability and cognitive effort, respectively. Subjects who received training showed less alteration in stride frequency and auditory reaction time compared to controls. Trained subjects maintained their level of performance over 6 months. We conclude that, with training, individuals became more proficient at walking in novel discordant sensorimotor conditions and were able to devote more attention to competing tasks.

Effect of virtual reality training on walking distance and physical fitness in individuals with Parkinson's disease.

PubMed

de Melo, Gileno Edu Lameira; Kleiner, Ana Francisca Rozin; Lopes, Jamile Benite Palma; Dumont, Arislander Jonathan Lopes; Lazzari, Roberta Delasta; Galli, Manuela; Oliveira, Claudia Santos

2018-04-07

To evaluate the effects of gait training with virtual reality (VR) on walking distance and physical fitness in individuals with Parkinson's Disease (PD). Thirty-seven individuals with PD participated in this prospective, randomized, controlled clinical trial. They were randomly allocated to a control group submitted to conventional training (n = 12), a treadmill group submitted to gait training on a treadmill (n = 13) and a VR group submitted to gait training using the XboxTM (n = 12). Clinical measures, gait variables and the Six-Minute Walk Test (6MWT) were evaluated: pre-intervention, after one intervention session, post-intervention and follow up (30 days after intervention). The VR and treadmill groups travelled longer distances on the 6MWT and had faster gait speed in comparison to the control group. The VR and treadmill groups demonstrated an increase in pre-6MWT HR. The VR group had more intense HR after the first session and throughout training, but these gains were not maintained at the follow-up. The present findings demonstrate that gait training with a VR program is as effective as treadmill training with regard to gains in walking distance and improvements in temporal gait variables in individuals with PD.

Should Body Weight–Supported Treadmill Training and Robotic-Assistive Steppers for Locomotor Training Trot Back to the Starting Gate?

PubMed Central

Dobkin, Bruce H.; Duncan, Pamela W.

2014-01-01

Body weight–supported treadmill training (BWSTT) and robotic-assisted step training (RAST) have not, so far, led to better outcomes than a comparable dose of progressive over-ground training (OGT) for disabled persons with stroke, spinal cord injury, multiple sclerosis, Parkinson’s disease, or cerebral palsy. The conceptual bases for these promising rehabilitation interventions had once seemed quite plausible, but the results of well-designed, randomized clinical trials have been disappointing. The authors reassess the underpinning concepts for BWSTT and RAST, which were derived from mammalian studies of treadmill-induced hind-limb stepping associated with central pattern generation after low thoracic spinal cord transection, as well as human studies of the triple crown icons of task-oriented locomotor training, massed practice, and activity-induced neuroplasticity. The authors retrospectively consider where theory and practice may have fallen short in the pilot studies that aimed to produce thoroughbred interventions. Based on these shortcomings, the authors move forward with recommendations for the future development of workhorse interventions for walking. In the absence of evidence for physical therapists to employ these strategies, however, BWSTT and RAST should not be provided routinely to disabled, vulnerable persons in place of OGT outside of a scientifically conducted efficacy trial. PMID:22412172

Should body weight-supported treadmill training and robotic-assistive steppers for locomotor training trot back to the starting gate?

PubMed

Dobkin, Bruce H; Duncan, Pamela W

2012-05-01

Body weight-supported treadmill training (BWSTT) and robotic-assisted step training (RAST) have not, so far, led to better outcomes than a comparable dose of progressive over-ground training (OGT) for disabled persons with stroke, spinal cord injury, multiple sclerosis, Parkinson's disease, or cerebral palsy. The conceptual bases for these promising rehabilitation interventions had once seemed quite plausible, but the results of well-designed, randomized clinical trials have been disappointing. The authors reassess the underpinning concepts for BWSTT and RAST, which were derived from mammalian studies of treadmill-induced hind-limb stepping associated with central pattern generation after low thoracic spinal cord transection, as well as human studies of the triple crown icons of task-oriented locomotor training, massed practice, and activity-induced neuroplasticity. The authors retrospectively consider where theory and practice may have fallen short in the pilot studies that aimed to produce thoroughbred interventions. Based on these shortcomings, the authors move forward with recommendations for the future development of workhorse interventions for walking. In the absence of evidence for physical therapists to employ these strategies, however, BWSTT and RAST should not be provided routinely to disabled, vulnerable persons in place of OGT outside of a scientifically conducted efficacy trial.

Influence of a Locomotor Training Approach on Walking Speed and Distance in People With Chronic Spinal Cord Injury: A Randomized Clinical Trial

PubMed Central

Roach, Kathryn E.

2011-01-01

Background Impaired walking limits function after spinal cord injury (SCI), but training-related improvements are possible even in people with chronic motor incomplete SCI. Objective The objective of this study was to compare changes in walking speed and distance associated with 4 locomotor training approaches. Design This study was a single-blind, randomized clinical trial. Setting This study was conducted in a rehabilitation research laboratory. Participants Participants were people with minimal walking function due to chronic SCI. Intervention Participants (n=74) trained 5 days per week for 12 weeks with the following approaches: treadmill-based training with manual assistance (TM), treadmill-based training with stimulation (TS), overground training with stimulation (OG), and treadmill-based training with robotic assistance (LR). Measurements Overground walking speed and distance were the primary outcome measures. Results In participants who completed the training (n=64), there were overall effects for speed (effect size index [d]=0.33) and distance (d=0.35). For speed, there were no significant between-group differences; however, distance gains were greatest with OG. Effect sizes for speed and distance were largest with OG (d=0.43 and d=0.40, respectively). Effect sizes for speed were the same for TM and TS (d=0.28); there was no effect for LR. The effect size for distance was greater with TS (d=0.16) than with TM or LR, for which there was no effect. Ten participants who improved with training were retested at least 6 months after training; walking speed at this time was slower than that at the conclusion of training but remained faster than before training. Limitations It is unknown whether the training dosage and the emphasis on training speed were optimal. Robotic training that requires active participation would likely yield different results. Conclusions In people with chronic motor incomplete SCI, walking speed improved with both overground training and treadmill-based training; however, walking distance improved to a greater extent with overground training. PMID:21051593

Influence of Systematic Increases in Treadmill Walking Speed on Gait Kinematics After Stroke

PubMed Central

Tyrell, Christine M.; Roos, Margaret A.; Rudolph, Katherine S.

2011-01-01

Background Fast treadmill training improves walking speed to a greater extent than training at a self-selected speed after stroke. It is unclear whether fast treadmill walking facilitates a more normal gait pattern after stroke, as has been suggested for treadmill training at self-selected speeds. Given the massed stepping practice that occurs during treadmill training, it is important for therapists to understand how the treadmill speed selected influences the gait pattern that is practiced on the treadmill. Objective The purpose of this study was to characterize the effect of systematic increases in treadmill speed on common gait deviations observed after stroke. Design A repeated-measures design was used. Methods Twenty patients with stroke walked on a treadmill at their self-selected walking speed, their fastest speed, and 2 speeds in between. Using a motion capture system, spatiotemporal gait parameters and kinematic gait compensations were measured. Results Significant improvements in paretic- and nonparetic-limb step length and in single- and double-limb support were found. Asymmetry of these measures improved only for step length. Significant improvements in paretic hip extension, trailing limb position, and knee flexion during swing also were found as speed increased. No increases in circumduction or hip hiking were found with increasing speed. Limitations Caution should be used when generalizing these results to survivors of a stroke with a self-selected walking speed of less than 0.4 m/s. This study did not address changes with speed during overground walking. Conclusions Faster treadmill walking facilitates a more normal walking pattern after stroke, without concomitant increases in common gait compensations, such as circumduction. The improvements in gait deviations were observed with small increases in walking speed. PMID:21252308

Best facilitated cortical activation during different stepping, treadmill, and robot-assisted walking training paradigms and speeds: A functional near-infrared spectroscopy neuroimaging study.

PubMed

Kim, Ha Yeon; Yang, Sung Phil; Park, Gyu Lee; Kim, Eun Joo; You, Joshua Sung Hyun

2016-01-01

Robot-assisted and treadmill-gait training are promising neurorehabilitation techniques, with advantages over conventional gait training, but the neural substrates underpinning locomotor control remain unknown particularly during different gait training modes and speeds. The present optical imaging study compared cortical activities during conventional stepping walking (SW), treadmill walking (TW), and robot-assisted walking (RW) at different speeds. Fourteen healthy subjects (6 women, mean age 30.06, years ± 4.53) completed three walking training modes (SW, TW, and RW) at various speeds (self-selected, 1.5, 2.0, 2.5, and 3.0  km/h). A functional near-infrared spectroscopy (fNIRS) system determined cerebral hemodynamic changes associated with cortical locomotor network areas in the primary sensorimotor cortex (SMC), premotor cortex (PMC), supplementary motor area (SMA), prefrontal cortex (PFC), and sensory association cortex (SAC). There was increased cortical activation in the SMC, PMC, and SMA during different walking training modes. More global locomotor network activation was observed during RW than TW or SW. As walking speed increased, multiple locomotor network activations were observed, and increased activation power spectrum. This is the first empirical evidence highlighting the neural substrates mediating dynamic locomotion for different gait training modes and speeds. Fast, robot-assisted gait training best facilitated cortical activation associated with locomotor control.

Treadmill Training Enhances Axon Regeneration In Injured Mouse Peripheral Nerves Without Increased Loss of Topographic Specificity

PubMed Central

English, Arthur W.; Cucoranu, Delia; Mulligan, Amanda; Sabatier, Manning

2009-01-01

We investigated the extent of misdirection of regenerating axons when that regeneration was enhanced using treadmill training. Retrograde fluorescent tracers were applied to the cut proximal stumps of the tibial and common fibular nerves two or four weeks after transection and surgical repair of the mouse sciatic nerve. The spatial locations of retrogradely labeled motoneurons were studied in untreated control mice and in mice receiving two weeks of treadmill training, either according to a continuous protocol (10 m/min, one hour/day, five day/week) or an interval protocol (20 m/min for two minutes, followed by a five minute rest, repeated 4 times, five days/week). More retrogradely labeled motoneurons were found in both treadmill trained groups. The magnitude of this increase was as great as or greater than that found after using other enhancement strategies. In both treadmill trained groups, the proportions of motoneurons labeled from tracer applied to the common fibular nerve that were found in spinal cord locations reserved for tibial motoneurons in intact mice was no greater than in untreated control mice and significantly less than found after electrical stimulation or chondroitinase treatment. Treadmill training in the first two weeks following peripheral nerve injury produces a marked enhancement of motor axon regeneration without increasing the propensity of those axons to choose pathways leading to functionally inappropriate targets. PMID:19731339

Human-Robot Interaction: Does Robotic Guidance Force Affect Gait-Related Brain Dynamics during Robot-Assisted Treadmill Walking?

PubMed Central

Knaepen, Kristel; Mierau, Andreas; Swinnen, Eva; Fernandez Tellez, Helio; Michielsen, Marc; Kerckhofs, Eric; Lefeber, Dirk; Meeusen, Romain

2015-01-01

In order to determine optimal training parameters for robot-assisted treadmill walking, it is essential to understand how a robotic device interacts with its wearer, and thus, how parameter settings of the device affect locomotor control. The aim of this study was to assess the effect of different levels of guidance force during robot-assisted treadmill walking on cortical activity. Eighteen healthy subjects walked at 2 km.h-1 on a treadmill with and without assistance of the Lokomat robotic gait orthosis. Event-related spectral perturbations and changes in power spectral density were investigated during unassisted treadmill walking as well as during robot-assisted treadmill walking at 30%, 60% and 100% guidance force (with 0% body weight support). Clustering of independent components revealed three clusters of activity in the sensorimotor cortex during treadmill walking and robot-assisted treadmill walking in healthy subjects. These clusters demonstrated gait-related spectral modulations in the mu, beta and low gamma bands over the sensorimotor cortex related to specific phases of the gait cycle. Moreover, mu and beta rhythms were suppressed in the right primary sensory cortex during treadmill walking compared to robot-assisted treadmill walking with 100% guidance force, indicating significantly larger involvement of the sensorimotor area during treadmill walking compared to robot-assisted treadmill walking. Only marginal differences in the spectral power of the mu, beta and low gamma bands could be identified between robot-assisted treadmill walking with different levels of guidance force. From these results it can be concluded that a high level of guidance force (i.e., 100% guidance force) and thus a less active participation during locomotion should be avoided during robot-assisted treadmill walking. This will optimize the involvement of the sensorimotor cortex which is known to be crucial for motor learning. PMID:26485148

Treadmill training with an incline reduces ankle joint stiffness and improves active range of movement during gait in adults with cerebral palsy.

PubMed

Lorentzen, Jakob; Kirk, Henrik; Fernandez-Lago, Helena; Frisk, Rasmus; Scharff Nielsen, Nanna; Jorsal, Martin; Nielsen, Jens Bo

2017-05-01

We investigated if 30 min of daily treadmill training with an incline for 6 weeks would reduce ankle joint stiffness and improve active range of movement in adults with cerebral palsy (CP). The study was designed as a randomized controlled clinical trial including 32 adults with CP (GMFCS 1-3) aged 38.1 SD 12 years. The training group (n = 16) performed uphill treadmill training at home daily for 30 min for 6 weeks in addition to their usual activities. Passive and reflex mediated stiffness and range of motion (ROM) of the ankle joint, kinematic and functional measures of gait were obtained before and after the intervention/control period. Intervention subjects trained 31.4 SD 10.1 days for 29.0 SD 2.3 min (total) 15.2 h. Passive ankle joint stiffness was reduced (F = 5.1; p = 0.031), maximal gait speed increased (F = 42.8, p < 0.001), amplitude of toe lift prior to heel strike increased (F = 5.3, p < 0.03) and ankle angle at heel strike was decreased (F = 12.5; p < 0.001) significant in the training group as compared to controls. Daily treadmill training with an incline for 6 weeks reduces ankle joint stiffness and increases active ROM during gait in adults with CP. Intensive gait training may thus be beneficial in preventing and reducing contractures and help to maintain functional gait ability in adults with CP. Implications for rehabilitation Uphill gait training is an effective way to reduce ankle joint stiffness in adult with contractures. 6 weeks of daily uphill gait training improves functional gait parameters such as gait speed and dorsal flexion during gait in adults with cerebral palsy.

Accelerating locomotor savings in learning: compressing four training days to one.

PubMed

Day, Kevin A; Leech, Kristan A; Roemmich, Ryan T; Bastian, Amy J

2018-06-01

Acquiring new movements requires the capacity of the nervous system to remember previously experienced motor patterns. The phenomenon of faster relearning after initial learning is termed "savings." Here we studied how savings of a novel walking pattern develops over several days of practice and how this process can be accelerated. We introduced participants to a split-belt treadmill adaptation paradigm for 30 min for 5 consecutive days. By training day 5, participants were able to produce near-perfect performance when switching between split and tied-belt environments. We found that this was due to their ability to shift specific elements of their stepping pattern to account for the split treadmill speeds from day to day. We also applied a state-space model to further characterize multiday locomotor savings. We then explored methods of achieving comparable savings with less total training time. We studied people training only on day 1, with either one extended split-belt exposure or alternating four times between split-belt and tied-belt conditions rapidly in succession. Both of these single-day training groups were tested again on day 5. Experiencing four abbreviated exposures on day 1 improved the performance on day 5 compared with one extended exposure on day 1. Moreover, this abbreviated group performed similarly to the group that trained for 4 consecutive days before testing on day 5, despite only having one-quarter of the total training time. These results demonstrate that we can leverage training structure to achieve a high degree of performance while minimizing training sessions. NEW & NOTEWORTHY Learning a new movement requires repetition. Here, we demonstrate how to more efficiently train an adapted walking pattern. By compressing split-belt treadmill training delivered over 4 days to four abbreviated bouts of training delivered on the first day of training, we were able to induce equivalent savings over a 5-day span. These results suggest that we can manipulate the delivery of training to most efficiently drive multiday learning of a novel walking pattern.

Head control: volitional aspects of rehabilitation training in patients with multiple sclerosis compared with healthy subjects.

PubMed

Cattaneo, Davide; Ferrarin, Maurizio; Frasson, William; Casiraghi, Anna

2005-07-01

To investigate the role of voluntary mechanisms and motor learning in head stability and the impact of longitudinal biofeedback training in head control. Crossover trial and single-subject research design. Neurorehabilitation research institute. Head stability during treadmill gait was measured in healthy subjects and patients with multiple sclerosis (MS). The experimental condition in which subjects walked on the treadmill was compared with that in which the head was voluntarily stabilized. In another experimental condition, augmented feedback of head displacement was provided by means of a laser mounted on the head that projected a laser beam on a screen. The motor learning was investigated with biofeedback training sessions. Positional feedback was represented by the laser beam, with subjects having to stabilize the beam while walking on the treadmill. Head angular oscillation in the sagittal and frontal planes. Results showed that on verbal request, healthy subjects and patients further stabilized the head during gait, especially in the sagittal plane. Short-term feedback of head displacement was no better than self-stabilization at improving head control. Conversely, the motor learning was evident in the rehabilitation protocol: after 10 to 15 training sessions, patients with MS showed a clinically relevant decrease of head angular oscillations. Voluntary mechanisms play a role in head stabilization during gait. Augmented biofeedback of head displacement may be effective in reducing head oscillations.

Treadmill Intervention Attenuates the Cafeteria Diet-Induced Impairment of Stress-Coping Strategies in Young Adult Female Rats

PubMed Central

Cigarroa, Igor; Lalanza, Jaume F.; Caimari, Antoni; del Bas, Josep M.; Capdevila, Lluís; Arola, Lluís; Escorihuela, Rosa M.

2016-01-01

The current prevalence of diet-induced overweight and obesity in adolescents and adults is continuously growing. Although the detrimental biochemical and metabolic consequences of obesity are widely studied, its impact on stress-coping behavior and its interaction with specific exercise doses (in terms of intensity, duration and frequency) need further investigation. To this aim, we fed adolescent rats either an obesogenic diet (cafeteria diet, CAF) or standard chow (ST). Each group was subdivided into four subgroups according to the type of treadmill intervention as follows: a sedentary group receiving no manipulation; a control group exposed to a stationary treadmill; a low-intensity treadmill group trained at 12 m/min; and a higher intensity treadmill group trained at 17 m/min. Both the diet and treadmill interventions started at weaning and lasted for 8 weeks. Subjects were tested for anxiety-like behavior in the open field test and for coping strategies in the two-way active avoidance paradigm at week 7 and were sacrificed at week 8 for biometric and metabolic characterization. CAF feeding increased the weight gain, relative retroperitoneal white adipose tissue (RWAT %), and plasma levels of glucose, insulin, triglycerides and leptin and decreased the insulin sensitivity. Treadmill intervention partially reversed the RWAT% and triglyceride alterations; at higher intensity, it decreased the leptin levels of CAF-fed animals. CAF feeding decreased the motor activity and impaired the performance in a two-way active avoidance assessment. Treadmill intervention reduced defecation in the shuttle box, suggesting diminished anxiety. CAF feeding combined with treadmill training at 17 m/min increased the time spent in the center of the open field and more importantly, partially reversed the two-way active avoidance deficit. In conclusion, this study demonstrates that at doses that decreased anxiety-like behavior, treadmill exercise partially improved the coping strategy in terms of active avoidance behavior in the CAF-fed animals. This effect was not observed at lower doses of treadmill training. PMID:27099927

Treadmill Intervention Attenuates the Cafeteria Diet-Induced Impairment of Stress-Coping Strategies in Young Adult Female Rats.

PubMed

Cigarroa, Igor; Lalanza, Jaume F; Caimari, Antoni; del Bas, Josep M; Capdevila, Lluís; Arola, Lluís; Escorihuela, Rosa M

2016-01-01

The current prevalence of diet-induced overweight and obesity in adolescents and adults is continuously growing. Although the detrimental biochemical and metabolic consequences of obesity are widely studied, its impact on stress-coping behavior and its interaction with specific exercise doses (in terms of intensity, duration and frequency) need further investigation. To this aim, we fed adolescent rats either an obesogenic diet (cafeteria diet, CAF) or standard chow (ST). Each group was subdivided into four subgroups according to the type of treadmill intervention as follows: a sedentary group receiving no manipulation; a control group exposed to a stationary treadmill; a low-intensity treadmill group trained at 12 m/min; and a higher intensity treadmill group trained at 17 m/min. Both the diet and treadmill interventions started at weaning and lasted for 8 weeks. Subjects were tested for anxiety-like behavior in the open field test and for coping strategies in the two-way active avoidance paradigm at week 7 and were sacrificed at week 8 for biometric and metabolic characterization. CAF feeding increased the weight gain, relative retroperitoneal white adipose tissue (RWAT %), and plasma levels of glucose, insulin, triglycerides and leptin and decreased the insulin sensitivity. Treadmill intervention partially reversed the RWAT% and triglyceride alterations; at higher intensity, it decreased the leptin levels of CAF-fed animals. CAF feeding decreased the motor activity and impaired the performance in a two-way active avoidance assessment. Treadmill intervention reduced defecation in the shuttle box, suggesting diminished anxiety. CAF feeding combined with treadmill training at 17 m/min increased the time spent in the center of the open field and more importantly, partially reversed the two-way active avoidance deficit. In conclusion, this study demonstrates that at doses that decreased anxiety-like behavior, treadmill exercise partially improved the coping strategy in terms of active avoidance behavior in the CAF-fed animals. This effect was not observed at lower doses of treadmill training.

Effects of treadmill running on rat gastrocnemius function following botulinum toxin A injection.

PubMed

Tsai, Sen-Wei; Chen, Chun-Jung; Chen, Hsiao-Lin; Chen, Chuan-Mu; Chang, Yin-Yi

2012-02-01

Exercise can improve and maintain neural or muscular function, but the effects of exercise in physiological adaptation to paralysis caused by botulinum toxin A has not been well studied. Twenty-four rats were randomly assigned into control and treadmill groups. The rats assigned to the treadmill group were trained on a treadmill three times per week with the running speed set at 15 m/min. The duration of training was 20 min/session. Muscle strength, nerve conduction study and sciatic functional index (SFI) were used for functional analysis. Treadmill training improved the SFI at 2, 3, and 4 weeks (p = 0.01, 0.004, and 0.01, respectively). The maximal contraction force of the gastrocnemius muscle in the treadmill group was greater than in the control group (p < 0.05). The percentage of activated fibers was higher in the treadmill botox group than the percentage for the control botox group, which was demonstrated by differences in amplitude and area of compound muscle action potential (CMAP) under the curve between the groups (p < 0.05). After BoNT-A injection, treadmill improved the physiological properties of muscle contraction strength, CMAP amplitude, and the recovery of SFI. Copyright © 2011 Orthopaedic Research Society.

Caloric expenditure of aerobic, resistance, or combined high-intensity interval training using a hydraulic resistance system in healthy men.

PubMed

Falcone, Paul H; Tai, Chih-Yin; Carson, Laura R; Joy, Jordan M; Mosman, Matt M; McCann, Tyler R; Crona, Kevin P; Kim, Michael P; Moon, Jordan R

2015-03-01

Although exercise regimens vary in content and duration, few studies have compared the caloric expenditure of multiple exercise modalities with the same duration. The purpose of this study was to compare the energy expenditure of single sessions of resistance, aerobic, and combined exercise with the same duration. Nine recreationally active men (age: 25 ± 7 years; height: 181.6 ± 7.6 cm; weight: 86.6 ± 7.5 kg) performed the following 4 exercises for 30 minutes: a resistance training session using 75% of their 1-repetition maximum (1RM), an endurance cycling session at 70% maximum heart rate (HRmax), an endurance treadmill session at 70% HRmax, and a high-intensity interval training (HIIT) session on a hydraulic resistance system (HRS) that included repeating intervals of 20 seconds at maximum effort followed by 40 seconds of rest. Total caloric expenditure, substrate use, heart rate (HR), and rating of perceived exertion (RPE) were recorded. Caloric expenditure was significantly (p ≤ 0.05) greater when exercising with the HRS (12.62 ± 2.36 kcal·min), compared with when exercising with weights (8.83 ± 1.55 kcal·min), treadmill (9.48 ± 1.30 kcal·min), and cycling (9.23 ± 1.25 kcal·min). The average HR was significantly (p ≤ 0.05) greater with the HRS (156 ± 9 b·min), compared with that using weights (138 ± 16 b·min), treadmill (137 ± 5 b·min), and cycle (138 ± 6 b·min). Similarly, the average RPE was significantly (p ≤ 0.05) higher with the HRS (16 ± 2), compared with that using weights (13 ± 2), treadmill (10 ± 2), and cycle (11 ± 1). These data suggest that individuals can burn more calories performing an HIIT session with an HRS than spending the same amount of time performing a steady-state exercise session. This form of exercise intervention may be beneficial to individuals who want to gain the benefits of both resistance and cardiovascular training but have limited time to dedicate to exercise.

Combination of robot-assisted and conventional body-weight-supported treadmill training improves gait in persons with multiple sclerosis: a pilot study.

PubMed

Ruiz, Jennifer; Labas, Michele P; Triche, Elizabeth W; Lo, Albert C

2013-12-01

The majority of persons with multiple sclerosis (MS) experience problems with gait, which they characterize as highly disabling impairments that adversely impact their quality of life. Thus, it is crucial to develop effective therapies to improve mobility for these individuals. The purpose of this study was to determine whether combination gait training, using robot-assisted treadmill training followed by conventional body-weight-supported treadmill training within the same session, improved gait and balance in individuals with MS. This study tested combination gait training in 7 persons with MS. The participants were randomized into the immediate therapy group (IT group) or the delayed therapy group (DT group). In phase I of the trial, the IT group received treatment while the DT group served as a concurrent comparison group. In phase II of the trial, the DT group received treatment identical to the treatment received by the IT group in phase I. Outcome measures included the 6-Minute Walk Test (6MWT), the Timed 25-Foot Walk Test, velocity, cadence, and the Functional Reach Test (FRT). Nonparametric statistical techniques were used for analysis. Combination gait training resulted in significantly greater improvements in the 6MWT for the IT group (median change = +59 m) compared with Phase I DT group (median change = -8 m) (P = 0.08) and FRT (median change = +3.3 cm in IT vs -0.8 cm in the DT group phase I; P = 0.03). Significant overall pre-post improvements following combination gait training were found in 6MWT (+32 m; P = 0.02) and FRT (+3.3 cm; P = 0.06) for IT and Phase II DT groups combined. Combination of robot with body-weight-supported treadmill training gait training is feasible and improved 6MWT and FRT distances in persons with MS.Video Abstract available (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A62) for more insights from the authors.

Biofeedback for robotic gait rehabilitation

PubMed Central

Lünenburger, Lars; Colombo, Gery; Riener, Robert

2007-01-01

Background Development and increasing acceptance of rehabilitation robots as well as advances in technology allow new forms of therapy for patients with neurological disorders. Robot-assisted gait therapy can increase the training duration and the intensity for the patients while reducing the physical strain for the therapist. Optimal training effects during gait therapy generally depend on appropriate feedback about performance. Compared to manual treadmill therapy, there is a loss of physical interaction between therapist and patient with robotic gait retraining. Thus, it is difficult for the therapist to assess the necessary feedback and instructions. The aim of this study was to define a biofeedback system for a gait training robot and test its usability in subjects without neurological disorders. Methods To provide an overview of biofeedback and motivation methods applied in gait rehabilitation, previous publications and results from our own research are reviewed. A biofeedback method is presented showing how a rehabilitation robot can assess the patients' performance and deliver augmented feedback. For validation, three subjects without neurological disorders walked in a rehabilitation robot for treadmill training. Several training parameters, such as body weight support and treadmill speed, were varied to assess the robustness of the biofeedback calculation to confounding factors. Results The biofeedback values correlated well with the different activity levels of the subjects. Changes in body weight support and treadmill velocity had a minor effect on the biofeedback values. The synchronization of the robot and the treadmill affected the biofeedback values describing the stance phase. Conclusion Robot-aided assessment and feedback can extend and improve robot-aided training devices. The presented method estimates the patients' gait performance with the use of the robot's existing sensors, and displays the resulting biofeedback values to the patients and therapists. The therapists can adapt the therapy and give further instructions to the patients. The feedback might help the patients to adapt their movement patterns and to improve their motivation. While it is assumed that these novel methods also improve training efficacy, the proof will only be possible with future in-depth clinical studies. PMID:17244363

Prescribing water-based exercise from treadmill and arm ergometry in cardiac patients.

PubMed

Fernhall, B; Manfredi, T G; Congdon, K

1992-01-01

This study investigated the appropriateness of prescribing upright water-based exercise from treadmill and arm ergometry in uncomplicated, trained patients with cardiovascular disease (CVD) who were accustomed to water-based activities. Ten male patients with established CVD (mean age 59.4 +/- 8.7 yr) underwent maximal treadmill and arm ergometry in randomized counterbalanced order (half of the patients completed the treadmill test first and the other half completed the arm ergometer test first). Electrocardiographic (ECG), rating of perceived exertion (RPE), and oxygen uptake (VO2) measurements were made during both tests. Patients performed upright water-based exercise at 60, 70, and 80% of their maximal treadmill heart rate for 6 min at each intensity in a heated pool with a water temperature of 28-30 degrees C. They also performed an easy tethered swim, defined as performing at a comfortable exercise intensity, eliciting a heart rate of 86% of the treadmill maximum. VO2 and RPE were collected for all water-based exercise. To compare the RPE and VO2 between water-based, treadmill, and arm ergometry exercise, individual regression equations were constructed between heart rate, VO2, and RPE for both treadmill and arm ergometry tests. VO2 and RPE were then compared at the same heart rates between the three exercise modes. At 60% intensity, treadmill exercise exhibited a higher VO2 than water-based and arm ergometry exercise (P less than 0.05) but similar RPE. At 70%, treadmill exercise still yielded higher VO2, but also lower RPE than (P less than 0.05) and arm ergometry exercise (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of Progressive Body Weight Support Treadmill Forward and Backward Walking Training on Stroke Patients' Affected Side Lower Extremity's Walking Ability.

PubMed

Kim, Kyunghoon; Lee, Sukmin; Lee, Kyoungbo

2014-12-01

[Purpose] The purpose of the present study was to examine the effects of progressive body weight supported treadmill forward and backward walking training (PBWSTFBWT), progressive body weight supported treadmill forward walking training (PBWSTFWT), progressive body weight supported treadmill backward walking training (PBWSTBWT), on stroke patients' affected side lower extremity's walking ability. [Subjects and Methods] A total of 36 chronic stroke patients were divided into three groups with 12 subjects in each group. Each of the groups performed one of the progressive body weight supported treadmill training methods for 30 minute, six times per week for three weeks, and then received general physical therapy without any other intervention until the follow-up tests. For the assessment of the affected side lower extremity's walking ability, step length of the affected side, stance phase of the affected side, swing phase of the affected side, single support of the affected side, and step time of the affected side were measured using optogait and the symmetry index. [Results] In the within group comparisons, all the three groups showed significant differences between before and after the intervention and in the comparison of the three groups, the PBWSTFBWT group showed more significant differences in all of the assessed items than the other two groups. [Conclusion] In the present study progressive body weight supported treadmill training was performed in an environment in which the subjects were actually walked, and PBWSTFBWT was more effective at efficiently training stroke patients' affected side lower extremity's walking ability.

Gait Training Improves Performance in Healthy Adults Exposed to Novel Discordant Conditions

NASA Technical Reports Server (NTRS)

Batson, Crystal D.; Brady, Rachel A.; Peters, Brian T.; Mulavara, Ajitkumar P.; Bloomberg, Jacob J.

2010-01-01

After they return to Earth, astronauts experience sensorimotor disturbances that disrupt their ability to walk. We have previously shown that training with a variety of sensorimotor adaptive challenges enhances the capability of adapting to novel sensorimotor conditions. We are currently developing a sensorimotor adaptability (SA) training program designed to facilitate recovery of function after gravitational transitions. The purpose of this study was to determine whether trained subjects could transfer learned skills from one discordant visuo-proprioceptive environment to another. During three sessions, subjects walked at 2.5 km/h on a treadmill mounted on a motion base platform. Ten subjects trained with a combination of lateral treadmill translation and superimposed sinusoidal lateral optic flow that was presented on a large screen positioned in front of them. Ten controls completed the same training schedule while viewing only the forward optic flow with no visual or physical oscillation. Twenty minutes after the final training session, all subjects completed a 2-minute trial with a novel combination of visual and treadmill roll perturbations not previously experienced during the training (Transfer Test). Compared to the untrained group, participants who received SA training showed faster reaction times and, based on a composite score derived from stride frequency, heart rate, and reaction time, an overall enhanced performance. Our results showed that an SA training program can improve overall walking performance when subjects are exposed to novel incongruent sensory environments. This training has application for both enhancing adaptive responses in astronauts and reducing fall and injury risk in the elderly.

How Do World-Class Nordic Combined Athletes Differ From Specialized Cross-Country Skiers and Ski Jumpers in Sport-Specific Capacity and Training Characteristics?

PubMed

Sandbakk, Øyvind; Rasdal, Vegard; Bråten, Steinar; Moen, Frode; Ettema, Gertjan

2016-10-01

To compare sport-specific laboratory capacities and the annual training of world-class Nordic combined (NC) athletes with specialized ski jumpers (SJ) and cross-country (XC) skiers. Five world-class athletes from each sports discipline were compared. Ski jump imitations were performed on a 3-dimensional force plate in NC athletes and SJ, whereas XC skiing characteristics were obtained from submaximal and maximal roller ski skating on a treadmill in NC athletes and XC skiers. In addition, anthropometrics and annual training characteristics were determined. NC athletes demonstrated 9% higher body mass and showed 17% lower vertical speed in the ski jump imitation than SJ (all P < .05). NC athletes had 12% lower body mass and showed 10% lower peak treadmill speed and 12% lower body-mass-normalized peak oxygen uptake than XC skiers (all P < .05). NC athletes performed half the number of ski-jumping-specific sessions and outdoor ski jumps compared with SJ. NC athletes performed 31% less endurance training, mainly caused by lower amounts of low- and moderate-intensity training in the classical technique, whereas high-intensity strength and speed training and endurance training in the skating technique did not differ substantially from XC skiers. To simultaneously optimize endurance, explosive, and technical capacities in 2 different disciplines, world-class NC athletes train approximately two-thirds of the XC skier's endurance training volume and perform one-half of the ski-jump-specific training compared with SJ. Still, the various laboratory capacities differed only 10-17% compared with SJ and XC skiers.

Physiological responses of young thoroughbred horses to intermittent high-intensity treadmill training

PubMed Central

2013-01-01

Background Training of young Thoroughbred horses must balance development of cardiopulmonary function and aerobic capacity with loading of the musculoskeletal system that can potentially cause structural damage and/or lameness. High-speed equine treadmills are sometimes used to supplement exercise on a track in the training of young Thoroughbreds because the horse can run at high speeds but without the added weight of a rider. We tested the hypothesis that intermittent high-intensity exercise on a treadmill of young Thoroughbred horses entering training can enhance development of aerobic capacity (Vo2max) and running performance more than conventional training under saddle, and do so without causing lameness. Results Twelve yearling Thoroughbreds trained for 8 months with conventional riding (C) only, conventional riding plus a short (2 month, S) interval of once-per-week high-intensity treadmill exercise, or a long (8 month, L) interval of once-per-week high-intensity treadmill exercise. Three treadmill exercise tests evaluated Vo2max, oxygen transport and running performance variables in June of the yearling year (only for L), October of the yearling year and April of the 2-year-old year. No horses experienced lameness during the study. Aerobic capacity increased in all groups after training. In both October and April, Vo2max in L was higher than in C, but did not differ between L and S or S and C. Running speeds eliciting Vo2max also increased in all groups after training, with S (809 ± 3 m/s) and L (804 ± 9 m/s) higher than C (764 ± 27 m/s). Maximum heart rate decreased for all groups after training. Hematocrit and hemoglobin concentration increased for L throughout training. Conclusions Young Thoroughbred horses can increase aerobic capacity and running performance more than by strictly using track training under saddle with the addition of intermittent high-intensity treadmill exercise, and they can do so without experiencing lameness. This finding suggests that young racehorses might be able to achieve higher aerobic fitness during training without subjecting their musculoskeletal systems to increased loading and risk of developing lameness. The findings of this preliminary study do not indicate a specific protocol to best achieve this goal. PMID:23957961

[Temporal pattern of walking on various training facilities under the conditions of the earth's and simulated lunar gravity].

PubMed

Panfilov, V E; Gurfinkel', V S

2009-01-01

Eight test-subjects participated in 120 treadmill tests (drive power of 10 and 85 kW) aimed to compare the walking patterns at 1 and reduced gravity. The temporal pattern of steps was noted to change significantly on the low-power treadmill. On the strength of convergence of calculated and experimental data the suggestion has been made that the leg transfer movement follows the pattern of spontaneous oscillations.

Cardiorespiratory responses to Yo-yo Intermittent Endurance Test in nonelite youth soccer players.

PubMed

Castagna, Carlo; Impellizzeri, Franco M; Belardinelli, Romualdo; Abt, Grant; Coutts, Aaron; Chamari, Karim; D'Ottavio, Stefano

2006-05-01

This study examined the validity of the Yo-yo Intermittent Endurance Test (Level 1; YYIET) as indicator of aerobic power in youth soccer players. Cardiorespiratory responses were determined in 18 moderately trained nonelite youth soccer players (age, 16.6 +/- 0.8 years; height, 178.7 +/- 6.2 cm; body mass, 69.8 +/- 6.0 kg; VO2peak, 52.8 +/- 7.4 ml x kg(-1) x min(-1)) while performing the YYIET and an incremental treadmill test. Maximal heart rate (HRmax), respiratory exchange ratio (RER), O2 pulse, VO2peak, and maximal ventilation (VEmax) were measured. Group YYIET VO2peak, HRmax, RER, and O2 pulse were not significantly different from treadmill responses (p > 0.05). VEmax was significantly lower (p < 0.05) during the YYIET compared to the treadmill condition. No significant correlation was found between treadmill VO2peak and YYIET performance (p > 0.05). This study showed that the YYIET elicits peak VO2 and HR responses. However, YYIET performance results were not related to VO2peak measured in laboratory. Furthermore, the individual VO2peak reached during the TM did not reflect the VO2peak obtained during the YYIET, as shown by the large limits of agreement. As a consequence, compared to other shuttle run field tests, YYIET seems to be a weak indicator of aerobic power in youth moderately trained youth soccer player.

Lower extremity kinematics during walking and elliptical training in individuals with and without traumatic brain injury.

PubMed

Buster, Thad; Burnfield, Judith; Taylor, Adam P; Stergiou, Nicholas

2013-12-01

Elliptical training may be an option for practicing walking-like activity for individuals with traumatic brain injuries (TBI). Understanding similarities and differences between participants with TBI and neurologically healthy individuals during elliptical trainer use and walking may help guide clinical applications incorporating elliptical trainers. Ten participants with TBI and a comparison group of 10 neurologically healthy participants underwent 2 familiarization sessions and 1 data collection session. Kinematic data were collected as participants walked on a treadmill or on an elliptical trainer. Gait-related measures, including coefficient of multiple correlations (a measure of similarity between ensemble joint movement profiles; coefficient of multiple correlations [CMCs]), critical event joint angles, variability of peak critical event joint angles (standard deviations [SDs]) of peak critical event joint angles, and maximum Lyapunov exponents (a measure of the organization of the variability [LyEs]) were compared between groups and conditions. Coefficient of multiple correlations values comparing the similarity in ensemble motion profiles between the TBI and comparison participants exceeded 0.85 for the hip, knee, and ankle joints. The only critical event joint angle that differed significantly between participants with TBI and comparison participants was the ankle during terminal stance. Variability was higher for the TBI group (6 of 11 comparisons significant) compared with comparison participants. Hip and knee joint movement patterns of both participants with TBI and comparison participants on the elliptical trainer were similar to walking (CMCs ≥ 0.87). Variability was higher during elliptical trainer usage compared with walking (5 of 11 comparisons significant). Hip LyEs were higher during treadmill walking. Ankle LyEs were greater during elliptical trainer usage. Movement patterns of participants with TBI were similar to, but more variable than, those of comparison participants while using both the treadmill and the elliptical trainer. If incorporation of complex movements similar to walking is a goal of rehabilitation, elliptical training is a reasonable alternative to treadmill-based training.Video Abstract available (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A65) for more insights from the authors.

VO2 Max in Variable Type Exercise Among Well-Trained Upper Body Athletes.

ERIC Educational Resources Information Center

Seals, Douglas R.; Mullin, John P.

1982-01-01

The maximal oxygen consumption (VO2 max) of well-trained upper body athletes was compared to that of untrained individuals in four types of exercise: arm cranking, legs only cycling, graded treadmill running, and combined arm cranking and leg cycling. Results of the study showed that well-trained upper body athletes attained a significantly higher…

Imbalance in SOD/CAT activities in rat skeletal muscles submitted to treadmill training exercise.

PubMed

Pinho, Ricardo A; Andrades, Michael E; Oliveira, Marcos R; Pirola, Aline C; Zago, Morgana S; Silveira, Paulo C L; Dal-Pizzol, Felipe; Moreira, José Cláudio F

2006-10-01

The association between physical exercise and oxidative damage in the skeletal musculature has been the focus of many studies in literature, but the balance between superoxide dismutase and catalase activities and its relation to oxidative damage is not well established. Thus, the aim of the present study was to investigate the association between regular treadmill physical exercise, oxidative damage and antioxidant defenses in skeletal muscle of rats. Fifteen male Wistar rats (8-12 months) were randomly separated into two groups (trained n=9 and untrained n=6). Trained rats were treadmill-trained for 12 weeks in progressive exercise (velocity, time, and inclination). Training program consisted in a progressive exercise (10 m/min without inclination for 10 min/day). After 1 week the speed, time and inclination were gradually increased until 17 m/min at 10% for 50 min/day. After the training period animals were killed, and gastrocnemius and quadriceps were surgically removed to the determination of biochemical parameters. Lipid peroxidation, protein oxidative damage, catalase, superoxide dismutase and citrate synthase activities, and muscular glycogen content were measured in the isolated muscles. We demonstrated that there is a different modulation of CAT and SOD in skeletal muscle in trained rats when compared to untrained rats (increased SOD/CAT ratio). TBARS levels were significantly decreased and, in contrast, a significant increase in protein carbonylation was observed. These results suggest a non-described adaptation of skeletal muscle against exercise-induced oxidative stress.

Influence of visual and auditory biofeedback on partial body weight support treadmill training of individuals with chronic hemiparesis: a randomized controlled clinical trial.

PubMed

Brasileiro, A; Gama, G; Trigueiro, L; Ribeiro, T; Silva, E; Galvão, É; Lindquist, A

2015-02-01

Stroke is an important causal factor of deficiency and functional dependence worldwide. To determine the immediate effects of visual and auditory biofeedback, combined with partial body weight supported (PBWS) treadmill training on the gait of individuals with chronic hemiparesis. Randomized controlled trial. Outpatient rehabilitation hospital. Thirty subjects with chronic hemiparesis and ability to walk with some help. Participants were randomized to a control group that underwent only PBWS treadmill training; or experimental I group with visual biofeedback from the display monitor, in the form of symbolic feet as the subject took a step; or experimental group II with auditory biofeedback associated display, using a metronome at 115% of the individual's preferred cadence. They trained for 20 minutes and were evaluated before and after training. Spatio-temporal and angular gait variables were obtained by kinematics from the Qualisys Motion Analysis system. Increases in speed and stride length were observed for all groups over time (speed: F=25.63; P<0.001; stride length: F=27.18; P<0.001), as well as changes in hip and ankle range of motion - ROM (hip ROM: F=14.43; P=0.001; ankle ROM: F=4.76; P=0.038), with no time*groups interaction. Other spatio-temporal and angular parameters remain unchanged. Visual biofeedback and auditory biofeedback had no influence on PBWS treadmill training of individuals with chronic hemiparesis, in short term. Additional studies are needed to determine whether, in long term, the biofeedback will promote additional benefit to the PBWS treadmill training. The findings of this study indicate that visual and auditory biofeedback does not bring immediate benefits on PBWS treadmill training of individuals with chronic hemiparesis. This suggest that, for additional benefits are achieved with biofeedback, effects should be investigated after long-term training, which may determine if some kind of biofeedback is superior to another to improve the hemiparetic gait.

A novel walking speed estimation scheme and its application to treadmill control for gait rehabilitation.

PubMed

Yoon, Jungwon; Park, Hyung-Soon; Damiano, Diane Louise

2012-08-28

Virtual reality (VR) technology along with treadmill training (TT) can effectively provide goal-oriented practice and promote improved motor learning in patients with neurological disorders. Moreover, the VR + TT scheme may enhance cognitive engagement for more effective gait rehabilitation and greater transfer to over ground walking. For this purpose, we developed an individualized treadmill controller with a novel speed estimation scheme using swing foot velocity, which can enable user-driven treadmill walking (UDW) to more closely simulate over ground walking (OGW) during treadmill training. OGW involves a cyclic acceleration-deceleration profile of pelvic velocity that contrasts with typical treadmill-driven walking (TDW), which constrains a person to walk at a preset constant speed. In this study, we investigated the effects of the proposed speed adaptation controller by analyzing the gait kinematics of UDW and TDW, which were compared to those of OGW at three pre-determined velocities. Ten healthy subjects were asked to walk in each mode (TDW, UDW, and OGW) at three pre-determined speeds (0.5 m/s, 1.0 m/s, and 1.5 m/s) with real time feedback provided through visual displays. Temporal-spatial gait data and 3D pelvic kinematics were analyzed and comparisons were made between UDW on a treadmill, TDW, and OGW. The observed step length, cadence, and walk ratio defined as the ratio of stride length to cadence were not significantly different between UDW and TDW. Additionally, the average magnitude of pelvic acceleration peak values along the anterior-posterior direction for each step and the associated standard deviations (variability) were not significantly different between the two modalities. The differences between OGW and UDW and TDW were mainly in swing time and cadence, as have been reported previously. Also, step lengths between OGW and TDW were different for 0.5 m/s and 1.5 m/s gait velocities, and walk ratio between OGS and UDW was different for 1.0 m/s gait velocities. Our treadmill control scheme implements similar gait biomechanics of TDW, which has been used for repetitive gait training in a small and constrained space as well as controlled and safe environments. These results reveal that users can walk as stably during UDW as TDW and employ similar strategies to maintain walking speed in both UDW and TDW. Furthermore, since UDW can allow a user to actively participate in the virtual reality (VR) applications with variable walking velocity, it can induce more cognitive activities during the training with VR, which may enhance motor learning effects.

V-TIME: a treadmill training program augmented by virtual reality to decrease fall risk in older adults: study design of a randomized controlled trial.

PubMed

Mirelman, Anat; Rochester, Lynn; Reelick, Miriam; Nieuwhof, Freek; Pelosin, Elisa; Abbruzzese, Giovanni; Dockx, Kim; Nieuwboer, Alice; Hausdorff, Jeffrey M

2013-02-06

Recent work has demonstrated that fall risk can be attributed to cognitive as well as motor deficits. Indeed, everyday walking in complex environments utilizes executive function, dual tasking, planning and scanning, all while walking forward. Pilot studies suggest that a multi-modal intervention that combines treadmill training to target motor function and a virtual reality obstacle course to address the cognitive components of fall risk may be used to successfully address the motor-cognitive interactions that are fundamental for fall risk reduction. The proposed randomized controlled trial will evaluate the effects of treadmill training augmented with virtual reality on fall risk. Three hundred older adults with a history of falls will be recruited to participate in this study. This will include older adults (n=100), patients with mild cognitive impairment (n=100), and patients with Parkinson's disease (n=100). These three sub-groups will be recruited in order to evaluate the effects of the intervention in people with a range of motor and cognitive deficits. Subjects will be randomly assigned to the intervention group (treadmill training with virtual reality) or to the active-control group (treadmill training without virtual reality). Each person will participate in a training program set in an outpatient setting 3 times per week for 6 weeks. Assessments will take place before, after, and 1 month and 6 months after the completion of the training. A falls calendar will be kept by each participant for 6 months after completing the training to assess fall incidence (i.e., the number of falls, multiple falls and falls rate). In addition, we will measure gait under usual and dual task conditions, balance, community mobility, health related quality of life, user satisfaction and cognitive function. This randomized controlled trial will demonstrate the extent to which an intervention that combines treadmill training augmented by virtual reality reduces fall risk, improves mobility and enhances cognitive function in a diverse group of older adults. In addition, the comparison to an active control group that undergoes treadmill training without virtual reality will provide evidence as to the added value of addressing motor cognitive interactions as an integrated unit. (NIH)-NCT01732653.

V-TIME: a treadmill training program augmented by virtual reality to decrease fall risk in older adults: study design of a randomized controlled trial

PubMed Central

2013-01-01

Background Recent work has demonstrated that fall risk can be attributed to cognitive as well as motor deficits. Indeed, everyday walking in complex environments utilizes executive function, dual tasking, planning and scanning, all while walking forward. Pilot studies suggest that a multi-modal intervention that combines treadmill training to target motor function and a virtual reality obstacle course to address the cognitive components of fall risk may be used to successfully address the motor-cognitive interactions that are fundamental for fall risk reduction. The proposed randomized controlled trial will evaluate the effects of treadmill training augmented with virtual reality on fall risk. Methods/Design Three hundred older adults with a history of falls will be recruited to participate in this study. This will include older adults (n=100), patients with mild cognitive impairment (n=100), and patients with Parkinson’s disease (n=100). These three sub-groups will be recruited in order to evaluate the effects of the intervention in people with a range of motor and cognitive deficits. Subjects will be randomly assigned to the intervention group (treadmill training with virtual reality) or to the active-control group (treadmill training without virtual reality). Each person will participate in a training program set in an outpatient setting 3 times per week for 6 weeks. Assessments will take place before, after, and 1 month and 6 months after the completion of the training. A falls calendar will be kept by each participant for 6 months after completing the training to assess fall incidence (i.e., the number of falls, multiple falls and falls rate). In addition, we will measure gait under usual and dual task conditions, balance, community mobility, health related quality of life, user satisfaction and cognitive function. Discussion This randomized controlled trial will demonstrate the extent to which an intervention that combines treadmill training augmented by virtual reality reduces fall risk, improves mobility and enhances cognitive function in a diverse group of older adults. In addition, the comparison to an active control group that undergoes treadmill training without virtual reality will provide evidence as to the added value of addressing motor cognitive interactions as an integrated unit. Trial Registration (NIH)–NCT01732653 PMID:23388087

V̇O2 and Muscle Deoxygenation Kinetics During Skating: Comparison Between Slide Board and Treadmill Skating.

PubMed

Piucco, Tatiane; Soares, Rogério; Diefenthaeler, Fernando; Millet, Guillaume; Murias, Juan

2017-11-15

this study aimed to compare the oxygen uptake (V̇O 2 ) kinetics during skating on a treadmill and skating on a slide board and discuss potential mechanisms that might control the V̇O 2 kinetics responses during skating. breath-by-breath pulmonary V̇O 2 and near-infrared spectroscopy-derived muscle deoxygenation ([HHbMb]) were monitored continuously in 12 well-trained young long track speed skaters. On-transient V̇O 2 and [HHbMb] responses to skating on a treadmill and skating on a slide board at 80% of the estimated gas exchange threshold were fitted as mono-exponential function. The signals were time aligned, and the individual [HHbMb]-to-V̇O 2 ratio was calculated as the average value from 20-120 s after exercise starts. the time constants for the adjustment of phase II V̇O 2 (τ V̇O 2 ) and [HHbMb] (τ[HHbMb]) were low and similar between slide board vs. treadmill skating (18.1 ± 3.4 vs. 18.9 ± 3.6 for τ V̇O 2 and 12.6 ± 4.0 vs. 12.4 ± 4.0 s for τ[HHbMb]). The [HHbMb]/V̇O 2 ratio was not different from 1.0 (p > 0.05) in both conditions. the fast V̇O 2 kinetics during skating suggest that chronical adaptation to skating might overcome any possible restriction in leg blood flow during low intensity exercise. The [HHbMb]/V̇O 2 ratio values also suggest a good matching of O 2 delivery to O 2 utilization in trained speed skaters. The similar τ V̇O 2 and τ [HHbMb] values between slide board and treadmill further reinforce the validity of using a slide board for skating testing and training purposes.

Influence of simulated microgravity on the maximal oxygen consumption of nontrained and trained rats

NASA Technical Reports Server (NTRS)

Woodman, Christopher R.; Monnin, Kimberly A.; Sebastian, Lisa A.; Tipton, Charles M.

1993-01-01

The effects of microgravity and endurance training (TR) on maximal O2 consumption was investigated in trained and nontrained (NT) rats subjected to head-down suspension (HDS) by comparing maximal O2 consumption, treadmill run time (RT), and mechanical efficiency (ME) of treadmill running in HDS rats, both NT and TR, and in respective cage controls. It was found that HDS for 28 days was associated with significant reduction in absolute maximal O2 consumption in both TR and NT rats. Relative maximal O2 consumption, however, was significantly reduced in TR but not NT rats. Reductions in RT and ME occurring in both TR and NT rats after 28 days of HDS were similar. The TR rats exhibited greater diuretic, natriuretic, and kaliuretic responses to HDS than the NT rats.

Effects of 12-week supervised treadmill training on spatio-temporal gait parameters in patients with claudication.

PubMed

Konik, Anita; Kuklewicz, Stanisław; Rosłoniec, Ewelina; Zając, Marcin; Spannbauer, Anna; Nowobilski, Roman; Mika, Piotr

2016-01-01

The purpose of the study was to evaluate selected temporal and spatial gait parameters in patients with intermittent claudication after completion of 12-week supervised treadmill walking training. The study included 36 patients (26 males and 10 females) aged: mean 64 (SD 7.7) with intermittent claudication. All patients were tested on treadmill (Gait Trainer, Biodex). Before the programme and after its completion, the following gait biomechanical parameters were tested: step length (cm), step cycle (cycle/s), leg support time (%), coefficient of step variation (%) as well as pain-free walking time (PFWT) and maximal walking time (MWT) were measured. Training was conducted in accordance with the current TASC II guidelines. After 12 weeks of training, patients showed significant change in gait biomechanics consisting in decreased frequency of step cycle (p < 0.05) and extended step length (p < 0.05). PFWT increased by 96% (p < 0.05). MWT increased by 100% (p < 0.05). After completing the training, patients' gait was more regular, which was expressed via statistically significant decrease of coefficient of variation (p < 0.05) for both legs. No statistically significant relation between the post-training improvement of PFWT and MWT and step length increase and decreased frequency of step cycle was observed (p > 0.05). Twelve-week treadmill walking training programme may lead to significant improvement of temporal and spatial gait parameters in patients with intermittent claudication. Twelve-week treadmill walking training programme may lead to significant improvement of pain-free walking time and maximum walking time in patients with intermittent claudication.

An innovative training program based on virtual reality and treadmill: effects on gait of persons with multiple sclerosis.

PubMed

Peruzzi, Agnese; Zarbo, Ignazio Roberto; Cereatti, Andrea; Della Croce, Ugo; Mirelman, Anat

2017-07-01

In this single blind randomized controlled trial, we examined the effect of a virtual reality-based training on gait of people with multiple sclerosis. Twenty-five individuals with multiple sclerosis with mild to moderate disability were randomly assigned to either the control group (n = 11) or the experimental group (n = 14). The subjects in the control group received treadmill training. Subjects in the experimental group received virtual reality based treadmill training. Clinical measures and gait parameters were evaluated. Subjects in both the groups significantly improved the walking endurance and speed, cadence and stride length, lower limb joint ranges of motion and powers, during single and dual task gait. Moreover, subjects in the experimental group also improved balance, as indicated by the results of the clinical motor tests (p < 0.05). Between-group comparisons revealed that the experimental group improved significantly more than control group in hip range of motion and hip generated power at terminal stance at post-training. Our results support the perceived benefits of training programs that incorporate virtual reality to improve gait measures in individuals with multiple sclerosis. Implication of rehabilitation Gait deficits are common in multiple sclerosis (85%) and worsen during dual task activities. Intensive and progressive treadmill training, with and without virtual reality, is effective on dual task gait in persons with multiple sclerosis. Virtual reality-based treadmill training requiring obstacle negotiation increases the range of motion and the power generated at the hip, consequently allowing longer stride length and, consequently, higher gait speed.

Acute effects of high-intensity interval training and moderate-intensity continuous training sessions on cardiorespiratory parameters in healthy young men.

PubMed

Schaun, Gustavo Zaccaria; Alberton, Cristine Lima; Ribeiro, Diego Oliveira; Pinto, Stephanie Santana

2017-07-01

The aim of the present study was to compare the energy expenditure (EE) during and after two treadmill protocols, high-intensity interval training (HIIT) and moderate continuous training (CONT), in young adult men. The sample was comprised by 26 physically active men aged between 18 and 35 years engaged in aerobic training programs. They were divided into two groups: HIIT (n = 14) which performed eight 20 s bouts at 130% of the velocity associated with the maximal oxygen consumption on a treadmill with 10 s of passive rest, or CONT (n = 12) which performed 30 min running on a treadmill at a submaximal velocity equivalent to 90-95% of the heart rate associated with the anaerobic threshold. Data related to oxygen consumption ([Formula: see text]) and EE were measured during the protocols and the excess post-exercise oxygen consumption (EPOC) was calculated for both sessions. No difference was found between groups for mean [Formula: see text] (HIIT: 2.84 ± 0.46 L min -1 ; CONT: 2.72 ± 0.43 L min -1 ) and EE per minute (HIIT: 14.36 ± 2.34 kcal min -1 ; CONT: 13.21 ± 2.08 kcal min -1 ) during protocols. Regarding total EE during session, CONT resulted in higher values compared to HIIT (390.45 ± 65.15; 55.20 ± 9.33 kcal, respectively). However, post-exercise EE and EPOC values were higher after HIIT (69.31 ± 10.88; 26.27 ± 2.28 kcal, respectively) compared to CONT (55.99 ± 10.20; 13.43 ± 10.45 kcal, respectively). These data suggest that supramaximal HIIT has a higher impact on EE and EPOC in the early phase of recovery when compared to CONT.

Effects of training and weight support on muscle activation in Parkinson's disease.

PubMed

Rose, Martin H; Løkkegaard, Annemette; Sonne-Holm, Stig; Jensen, Bente R

2013-12-01

The aim of this study was to investigate the effect of high-intensity locomotor training on knee extensor and flexor muscle activation and adaptability to increased body-weight (BW) support during walking in patients with Parkinson's disease (PD). Thirteen male patients with idiopathic PD and eight healthy participants were included. The PD patients completed an 8-week training program on a lower-body, positive-pressure treadmill. Knee extensor and flexor muscles activation during steady treadmill walking (3 km/h) were measured before, at the mid-point, and after training. Increasing BW support decreased knee extensor muscle activation (normalization) and increased knee flexor muscle activation (abnormal) in PD patients when compared to healthy participants. Training improved flexor peak muscle activation adaptability to increased (BW) support during walking in PD patients. During walking without BW support shorter knee extensor muscle off-activation time and increased relative peak muscle activation was observed in PD patients and did not improve with 8 weeks of training. In conclusion, patients with PD walked with excessive activation of the knee extensor and flexor muscles when compared to healthy participants. Specialized locomotor training may facilitate adaptive processes related to motor control of walking in PD patients. Copyright © 2013 Elsevier Ltd. All rights reserved.

Aerobic treadmill plus Bobath walking training improves walking in subacute stroke: a randomized controlled trial.

PubMed

Eich, H-J; Mach, H; Werner, C; Hesse, S

2004-09-01

To evaluate the immediate and long-term effects of aerobic treadmill plus Bobath walking training in subacute stroke survivors compared with Bobath walking training alone. Randomized controlled trial. Rehabilitation unit. Fifty patients, first-time supratentorial stroke, stroke interval less than six weeks, Barthel Index (0-100) from 50 to 80, able to walk a minimum distance of 12 m with either intermittent help or stand-by while walking, cardiovascular stable, minimum 50 W in the bicycle ergometry, randomly allocated to two groups, A and B. Group A 30 min of treadmill training, harness secured and minimally supported according to patients' needs, and 30 min of physiotherapy, every workday for six weeks, speed and inclination of the treadmill were adjusted to achieve a heart rate of HR: (Hrmax-HRrest)*0.6+HRrest; in group B 60 min of daily physiotherapy for six weeks. Primary outcome variables were the absolute improvement of walking velocity (m/s) and capacity (m), secondary were gross motor function including walking ability (score out of 13) and walking quality (score out of 41), blindly assessed before and after the intervention, and at follow-up three months later. Patients tolerated the aerobic training well with no side-effects, significantly greater improvement of walking velocity and capacity both at study end (p =0.001 versus p =0.002) and at follow-up (p <0.001 versus p <0.001) in the experimental group. Between weeks 0 and 6, the experimental group improved walking speed and capacity by a mean of.31 m/s and 91 m, the control group by a mean of 0.16 m/s and 56 m. Between weeks 0 and 18, the experimental group improved walking speed and capacity by a mean of 0.36 m/s and 111 m, the control group by a mean of 0.15 m/s and 57 m. Gross motor function and walking quality did not differ at any time. Aerobic treadmill plus Bobath walking training in moderately affected stroke patients was better than Bobath walking training alone with respect to the improvement of walking velocity and capacity. The treatment approach is recommended in patients meeting the inclusion criteria. A multicentre trial should follow to strengthen the evidence.

Improved walking ability and reduced therapeutic stress with an electromechanical gait device.

PubMed

Freivogel, Susanna; Schmalohr, Dieter; Mehrholz, Jan

2009-09-01

To evaluate the effectiveness of repetitive locomotor training using a newly developed electromechanical gait device compared with treadmill training/gait training with respect to patient's ambulatory motor outcome, necessary personnel resources, and discomfort experienced by therapists and patients. Randomized, controlled, cross-over trial. Sixteen non-ambulatory patients after stroke, severe brain or spinal cord injury sequentially received 2 kinds of gait training. Study intervention A: 20 treatments of locomotor training with an electromechanical gait device; control intervention B: 20 treatments of locomotor training with treadmill or task-oriented gait training. The primary variable was walking ability (Functional Ambulation Category). Secondary variables included gait velocity, Motricity-Index, Rivermead-Mobility-Index, number of therapists needed, and discomfort and effort of patients and therapists during training. Gait ability and the other motor outcome related parameters improved for all patients, but without significant difference between intervention types. However, during intervention A, significantly fewer therapists were needed, and they reported less discomfort and a lower level of effort during training sessions. Locomotor training with or without an electromechanical gait trainer leads to improved gait ability; however, using the electromechanical gait trainer requires less therapeutic assistance, and therapist discomfort is reduced.

Is body-weight-supported treadmill training or robotic-assisted gait training superior to overground gait training and other forms of physiotherapy in people with spinal cord injury? A systematic review.

PubMed

Mehrholz, J; Harvey, L A; Thomas, S; Elsner, B

2017-08-01

Systematic review about randomised trials comparing different training strategies to improve gait in people with spinal cord injuries (SCI). The aim of this systematic review was to compare the effectiveness of body-weight-supported treadmill training (BWSTT) and robotic-assisted gait training with overground gait training and other forms of physiotherapy in people with traumatic SCI. Systematic review conducted by researchers from Germany and Australia. An extensive search was conducted for randomised controlled trials involving people with traumatic SCI that compared either BWSTT or robotic-assisted gait training with overground gait training and other forms of physiotherapy. The two outcomes of interest were walking speed (m s -1 ) and walking distance (m). BWSTT and robotic-assisted gait training were analysed separately, and data were pooled across trials to derive mean between-group differences using a random-effects model. Thirteen randomised controlled trials involving 586 people were identified. Ten trials involving 462 participants compared BWSTT to overground gait training and other forms of physiotherapy, but only nine trials provided useable data. The pooled mean (95% confidence interval (CI)) between-group differences for walking speed and walking distance were -0.03 m s -1 (-0.10 to 0.04) and -7 m (-45 to 31), respectively, favouring overground gait training. Five trials involving 344 participants compared robotic-assisted gait training to overground gait training and other forms of physiotherapy but only three provided useable data. The pooled mean (95% CI) between-group differences for walking speed and walking distance were -0.04 m s -1 (95% CI -0.21 to 0.13) and -6 m (95% CI -86 to 74), respectively, favouring overground gait training. BWSTT and robotic-assisted gait training do not increase walking speed more than overground gait training and other forms of physiotherapy do, but their effects on walking distance are not clear.

Oxygen consumption of elite distance runners on an anti-gravity treadmill®.

PubMed

McNeill, David K P; Kline, John R; de Heer, Hendrick D; Coast, J Richard

2015-06-01

Lower body positive pressure (LBPP), or 'anti-gravity' treadmills® have become increasingly popular among elite distance runners. However, to date, few studies have assessed the effect of body weight support (BWS) on the metabolic cost of running among elite runners. This study evaluated how BWS influenced the relationship between velocity and metabolic cost among 6 elite male distance runners. Participants ran three- 16 minute tests consisting of 4 stages of 4 minutes at 8, 7, 6 and 5 min·mile(-1) pace (3.35, 3.84, 4.47 and 5.36 m·s(-1)), while maintaining an aerobic effort (Respiratory Exchange Ratio ≤1.00). One test was run on a regular treadmill, one on an anti-gravity treadmill with 40% BWS and one with 20% BWS being provided. Expired gas data were collected and regression equations used to determine and compare slopes. Significant decreases in oxygen uptake (V̇O2) were found with each increase in BWS (p < 0.001). At 20% BWS, the average decrease in net VO2 was greater than proportional (34%), while at 40% BWS, the average net reduction in VO2 was close to proportional (38%). Across velocities, the slope of the relationship between VO2 and velocity (ΔV̇O2/Δv) was steeper with less support. The slopes at both the 20% and 40% BWS conditions were similar, especially when compared to the regular treadmill. Variability in VO2 between athletes was much greater on the LBPP treadmill and was greater with increased levels of BWS. In this study we evaluated the effect of body weight support on V̇O2 among elite distance runners. We have shown that oxygen uptake decreased with support, but not in direct proportion to that support. Further, because of the high variability in oxygen uptake between athletes on the LBPP treadmill, prediction equations may not be reliable and other indicators (heart rate, perceived exertion or directly measured oxygen uptake) should be used to guide training intensity when training on the LBPP treadmill. Key pointsWith increasing amounts of body weight-support (BWS), the slope of the relationship between velocity and oxygen consumption (ΔVO2/Δv) decreases significantly. This means the change in oxygen consumption (VO2) is significantly smaller over a given change in velocity at higher amounts of BWS.There is a non-linear decrease in VO2 with increasing BWS. As such, with each increment in the amount of BWS provided, the reduction in VO2 becomes increasingly smaller.This paper provides first of its kind data on the effects of BWS on the cost of running among highly trained, elite runners. The outcomes of this study are in line with previous findings among non-elite runners.

Complexity, fractal dynamics and determinism in treadmill ambulation: Implications for clinical biomechanists.

PubMed

Hollman, John H; Watkins, Molly K; Imhoff, Angela C; Braun, Carly E; Akervik, Kristen A; Ness, Debra K

2016-08-01

Reduced inter-stride complexity during ambulation may represent a pathologic state. Evidence is emerging that treadmill training for rehabilitative purposes may constrain the locomotor system and alter gait dynamics in a way that mimics pathological states. The purpose of this study was to examine the dynamical system components of gait complexity, fractal dynamics and determinism during treadmill ambulation. Twenty healthy participants aged 23.8 (1.2) years walked at preferred walking speeds for 6min on a motorized treadmill and overground while wearing APDM 6 Opal inertial monitors. Stride times, stride lengths and peak sagittal plane trunk velocities were measured. Mean values and estimates of complexity, fractal dynamics and determinism were calculated for each parameter. Data were compared between overground and treadmill walking conditions. Mean values for each gait parameter were statistically equivalent between overground and treadmill ambulation (P>0.05). Through nonlinear analyses, however, we found that complexity in stride time signals (P<0.001), and long-range correlations in stride time and stride length signals (P=0.005 and P=0.024, respectively), were reduced on the treadmill. Treadmill ambulation induces more predictable inter-stride time dynamics and constrains fluctuations in stride times and stride lengths, which may alter feedback from destabilizing perturbations normally experienced by the locomotor control system during overground ambulation. Treadmill ambulation, therefore, may provide less opportunity for experiencing the adaptability necessary to successfully ambulate overground. Investigators and clinicians should be aware that treadmill ambulation will alter dynamic gait characteristics. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cerebral Blood Flow Responses to Aquatic Treadmill Exercise.

PubMed

Parfitt, Rhodri; Hensman, Marianne Y; Lucas, Samuel J E

2017-07-01

Aquatic treadmills are used as a rehabilitation method for conditions such as spinal cord injury, osteoarthritis, and stroke, and can facilitate an earlier return to exercise training for athletes. However, their effect on cerebral blood flow (CBF) responses has not been examined. We tested the hypothesis that aquatic treadmill exercise would augment CBF and lower HR compared with land-based treadmill exercise. Eleven participants completed incremental exercise (crossover design) starting from walking pace (4 km·h, immersed to iliac crest [aquatic], 6 km·h [land]) and increasing 1 km·h every 2 min up to 10 km·h for aquatic (maximum belt speed) or 12 km·h for land. After this, participants completed two 2-min bouts of exercise immersed to midthigh and midchest at constant submaximal speed (aquatic), or were ramped to exhaustion (land; increased gradient 2° every min). Middle cerebral artery blood flow velocity (MCAv) and HR were measured throughout, and the initial 10 min of each protocol and responses at each immersion level were compared. Compared with land-based treadmill, MCAvmean increased more from baseline for aquatic exercise (21% vs 12%, P < 0.001), while being associated with lower overall HR (pooled difference, 11 bpm; P < 0.001). MCAvmean increased similarly during aquatic walking compared with land-based moderate intensity running (~10 cm·s, P = 0.56). Greater water immersion lowered HR (139 vs 178 bpm for midchest vs midthigh), whereas MCAvmean remained constant (P = 0.37). Findings illustrate the potential for aquatic treadmill exercise to enhance exercise-induced elevations in CBF and thus optimize shear stress-mediated adaptation of the cerebrovasculature.

Functional Mobility Performance and Balance Confidence in Older Adults after Sensorimotor Adaptation Training

NASA Technical Reports Server (NTRS)

Buccello-Stout, Regina R.; Cromwell, Ronita L.; Bloomberg, Jacob J.; Weaver, G. D.

2010-01-01

Research indicates a main contributor of injury in older adults is from falling. The decline in sensory systems limits information needed to successfully maneuver through the environment. The objective of this study was to determine if prolonged exposure to the realignment of perceptual-motor systems increases adaptability of balance, and if balance confidence improves after training. A total of 16 older adults between ages 65-85 were randomized to a control group (walking on a treadmill while viewing a static visual scene) and an experimental group (walking on a treadmill while viewing a rotating visual scene). Prior to visual exposure, participants completed six trials of walking through a soft foamed obstacle course. Participants came in twice a week for 4 weeks to complete training of walking on a treadmill and viewing the visual scene for 20 minutes each session. Participants completed the obstacle course after training and four weeks later. Average time, penalty, and Activity Balance Confidence Scale scores were computed for both groups across testing times. The older adults who trained, significantly improved their time through the obstacle course F (2, 28) = 9.41, p < 0.05, as well as reduced their penalty scores F (2, 28) = 21.03, p < 0.05, compared to those who did not train. There was no difference in balance confidence scores between groups across testing times F (2, 28) = 0.503, p > 0.05. Although the training group improved mobility through the obstacle course, there were no differences between the groups in balance confidence.

Gait training reduces ankle joint stiffness and facilitates heel strike in children with Cerebral Palsy.

PubMed

Willerslev-Olsen, Maria; Lorentzen, Jakob; Nielsen, Jens Bo

2014-01-01

Foot drop and toe walking are frequent concerns in children with cerebral palsy (CP). Increased stiffness of the ankle joint muscles may contribute to these problems. Does four weeks of daily home based treadmill training with incline reduce ankle joint stiffness and facilitate heel strike in children with CP? Seventeen children with CP (4-14 years) were recruited. Muscle stiffness and gait ability were measured twice before and twice after training with an interval of one month. Passive and reflex-mediated stiffness were measured by a dynamometer which applied stretches below and above reflex threshold. Gait kinematics were recorded by 3-D video-analysis during treadmill walking. Foot pressure was measured by force-sensitive foot soles during treadmill and over-ground walking. Children with increased passive stiffness showed a significant reduction in stiffness following training (P = 0.01). Toe lift in the swing phase (P = 0.014) and heel impact (P = 0.003) increased significantly following the training during both treadmill and over-ground walking. Daily intensive gait training may influence the elastic properties of ankle joint muscles and facilitate toe lift and heel strike in children with CP. Intensive gait training may be beneficial in preventing contractures and maintain gait ability in children with CP.

Locomotor Treadmill Training Promotes Soleus Trophism by Mammalian Target of Rapamycin Pathway in Paraplegic Rats.

PubMed

do Espírito Santo, Caroline Cunha; Secco, Daniela Dal; Meireles, Anamaria; de Freitas, Gabriel Ribeiro; Bobinski, Franciane; Cunha, Mauricio Peña; Rodrigues, Ana Lúcia Severo; Swarowsky, Alessandra; Santos, Adair Roberto Soares; Ilha, Jocemar

2018-06-01

Assisted-treadmill training, may be helpful in promoting muscle mass preservation after incomplete spinal cord injury (SCI). However, biological mechanism involved in this process is still not fully understood. This study investigated the effects of locomotor treadmill training on muscle trophism mediated by protein kinase B (Akt)/mammalian target of rapamycin (mTOR)/p70 ribosomal protein S6 kinase (p70S6K) in paraplegic rats. Adult female Wistar rats underwent an incomplete thoracic SCI induced by compression using an aneurysm clip. After 7 days, injured animals started a 3-week locomotor treadmill training with body weight-support and manual step help. Soleus trophism was measured by muscle weight and transverse myofiber cross-sectional area (CSA). An enzyme-linked immunosorbent assay (ELISA) and western blot analysis were used to detect brain-derived neurotrophic factor (BDNF), tropomyosin-related kinase B (TrkB), Akt, mTOR and p70S6K in paretic soleus. Trained animals did not show locomotor improved, but present an increase in muscle weight and myofiber CSA. Furthermore, the levels of Akt, p70S6K phosphorylation, mTOR and TrkB receptor were increased by training in soleus. In contrast, muscle BDNF levels were significantly reduced after training. The results suggest locomotor treadmill training partially reverts/prevents soleus muscle hypotrophy in rats with SCI. Furthermore, this study provided the first evidence that morphological muscle changes were caused by Akt/mTOR/p70S6K signaling pathway and TrkB up-regulation, which may increase the sensitivity of muscle, reducing autocrine signaling pathway demand of BDNF for cell growth.

Effects of Gait Training With Body Weight Support on a Treadmill Versus Overground in Individuals With Stroke.

PubMed

Gama, Gabriela L; Celestino, Melissa L; Barela, José A; Forrester, Larry; Whitall, Jill; Barela, Ana M

2017-04-01

To investigate the effects of gait training with body weight support (BWS) on a treadmill versus overground in individuals with chronic stroke. Randomized controlled trial. University research laboratory. Individuals (N=28) with chronic stroke (>6mo from the stroke event). Participants were randomly assigned to receive gait training with BWS on a treadmill (n=14) or overground (n=14) 3 times a week for 6 weeks. Gait speed measured using the 10-meter walk test, endurance measured using the 6-minute walk test, functional independence measured using the motor domain of the FIM, lower limb recovery measured using the lower extremity domain of the Fugl-Meyer assessment, step length, step length symmetry ratio, and single-limb support duration. Measurements were obtained at baseline, immediately after the training session, and 6 weeks after the training session. At 1 week after the last training session, both groups improved in all outcome measures except paretic step length and step length symmetry ratio, which were improved only in the overground group (P=.01 and P=.01, respectively). At 6 weeks after the last training session, all improvements remained and the treadmill group also improved paretic step length (P<.001) but not step length symmetry ratio (P>.05). Individuals with chronic stroke equally improve gait speed and other gait parameters after 18 sessions of BWS gait training on either a treadmill or overground. Only the overground group improved step length symmetry ratio, suggesting a role of integrating overground walking into BWS interventions poststroke. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Task-specific ankle robotics gait training after stroke: a randomized pilot study.

PubMed

Forrester, Larry W; Roy, Anindo; Hafer-Macko, Charlene; Krebs, Hermano I; Macko, Richard F

2016-06-02

An unsettled question in the use of robotics for post-stroke gait rehabilitation is whether task-specific locomotor training is more effective than targeting individual joint impairments to improve walking function. The paretic ankle is implicated in gait instability and fall risk, but is difficult to therapeutically isolate and refractory to recovery. We hypothesize that in chronic stroke, treadmill-integrated ankle robotics training is more effective to improve gait function than robotics focused on paretic ankle impairments. Participants with chronic hemiparetic gait were randomized to either six weeks of treadmill-integrated ankle robotics (n = 14) or dose-matched seated ankle robotics (n = 12) videogame training. Selected gait measures were collected at baseline, post-training, and six-week retention. Friedman, and Wilcoxon Sign Rank and Fisher's exact tests evaluated within and between group differences across time, respectively. Six weeks post-training, treadmill robotics proved more effective than seated robotics to increase walking velocity, paretic single support, paretic push-off impulse, and active dorsiflexion range of motion. Treadmill robotics durably improved gait dorsiflexion swing angle leading 6/7 initially requiring ankle braces to self-discarded them, while their unassisted paretic heel-first contacts increased from 44 % to 99.6 %, versus no change in assistive device usage (0/9) following seated robotics. Treadmill-integrated, but not seated ankle robotics training, durably improves gait biomechanics, reversing foot drop, restoring walking propulsion, and establishing safer foot landing in chronic stroke that may reduce reliance on assistive devices. These findings support a task-specific approach integrating adaptive ankle robotics with locomotor training to optimize mobility recovery. NCT01337960. https://clinicaltrials.gov/ct2/show/NCT01337960?term=NCT01337960&rank=1.

Molecular Mechanisms of Treadmill Therapy on Neuromuscular Atrophy Induced via Botulinum Toxin A

PubMed Central

Tsai, Sen-Wei; Chen, Hsiao-Ling

2013-01-01

Botulinum toxin A (BoNT-A) is a bacterial zinc-dependent endopeptidase that acts specifically on neuromuscular junctions. BoNT-A blocks the release of acetylcholine, thereby decreasing the ability of a spastic muscle to generate forceful contraction, which results in a temporal local weakness and the atrophy of targeted muscles. BoNT-A-induced temporal muscle weakness has been used to manage skeletal muscle spasticity, such as poststroke spasticity, cerebral palsy, and cervical dystonia. However, the combined effect of treadmill exercise and BoNT-A treatment is not well understood. We previously demonstrated that for rats, following BoNT-A injection in the gastrocnemius muscle, treadmill running improved the recovery of the sciatic functional index (SFI), muscle contraction strength, and compound muscle action potential (CMAP) amplitude and area. Treadmill training had no influence on gastrocnemius mass that received BoNT-A injection, but it improved the maximal contraction force of the gastrocnemius, and upregulation of GAP-43, IGF-1, Myo-D, Myf-5, myogenin, and acetylcholine receptor (AChR) subunits α and β was found following treadmill training. Taken together, these results suggest that the upregulation of genes associated with neurite and AChR regeneration following treadmill training may contribute to enhanced gastrocnemius strength recovery following BoNT-A injection. PMID:24327926

The Integrated Virtual Environment Rehabilitation Treadmill System

PubMed Central

Feasel, Jeff; Whitton, Mary C.; Kassler, Laura; Brooks, Frederick P.; Lewek, Michael D.

2015-01-01

Slow gait speed and interlimb asymmetry are prevalent in a variety of disorders. Current approaches to locomotor retraining emphasize the need for appropriate feedback during intensive, task-specific practice. This paper describes the design and feasibility testing of the integrated virtual environment rehabilitation treadmill (IVERT) system intended to provide real-time, intuitive feedback regarding gait speed and asymmetry during training. The IVERT system integrates an instrumented, split-belt treadmill with a front-projection, immersive virtual environment. The novel adaptive control system uses only ground reaction force data from the treadmill to continuously update the speeds of the two treadmill belts independently, as well as to control the speed and heading in the virtual environment in real time. Feedback regarding gait asymmetry is presented 1) visually as walking a curved trajectory through the virtual environment and 2) proprioceptively in the form of different belt speeds on the split-belt treadmill. A feasibility study involving five individuals with asymmetric gait found that these individuals could effectively control the speed of locomotion and perceive gait asymmetry during the training session. Although minimal changes in overground gait symmetry were observed immediately following a single training session, further studies should be done to determine the IVERT’s potential as a tool for rehabilitation of asymmetric gait by providing patients with congruent visual and proprioceptive feedback. PMID:21652279

Physiological and perceptual responses to incremental exercise testing in healthy men: effect of exercise test modality.

PubMed

Muscat, Kristina M; Kotrach, Houssam G; Wilkinson-Maitland, Courtney A; Schaeffer, Michele R; Mendonca, Cassandra T; Jensen, Dennis

2015-11-01

In a randomized cross-over study of 15 healthy men aged 20-30 years, we compared physiological and perceptual responses during treadmill and cycle exercise test protocols matched for increments in work rate - the source of increased locomotor muscle metabolic and contractile demands. The rates of O2 consumption and CO2 production were higher at the peak of treadmill versus cycle testing (p ≤ 0.05). Nevertheless, work rate, minute ventilation, tidal volume (VT), breathing frequency (fR), inspiratory capacity (IC), inspiratory reserve volume (IRV), tidal esophageal (Pes,tidal) and transdiaphragmatic pressure swings (Pdi,tidal), peak expiratory gastric pressures (Pga,peak), the root mean square of the diaphragm electromyogram (EMGdi,rms) expressed as a percentage of maximum EMGdi,rms (EMGdi,rms%max), and dyspnea ratings were similar at the peak of treadmill versus cycle testing (p > 0.05). Ratings of leg discomfort were higher at the peak of cycle versus treadmill exercise (p ≤ 0.05), even though peak O2 consumption was lower during cycling. Oxygen consumption, CO2 production, minute ventilation, fR, Pes,tidal, Pdi,tidal and Pga,peak were higher (p ≤ 0.05), while VT, IC, IRV, EMGdi,rms%max, and ratings of dyspnea and leg discomfort were similar (p > 0.05) at all or most submaximal work rates during treadmill versus cycle exercise. Our findings highlight important differences (and similarities) in physiological and perceptual responses at maximal and submaximal work rates during incremental treadmill and cycle exercise testing protocols. The lack of effect of exercise test modality on peak work rate advocates for the use of this readily available parameter to optimize training intensity determination, regardless of exercise training mode.

Bone loss during partial weight bearing (1/6th gravity) is mitigated by resistance and aerobic exercise in mice

NASA Astrophysics Data System (ADS)

Boudreaux, R. D.; Metzger, C. E.; Macias, B. R.; Shirazi-Fard, Y.; Hogan, H. A.; Bloomfield, S. A.

2014-06-01

Astronauts on long duration missions continue to experience bone loss, as much as 1-2% each month, for up to 4.5 years after a mission. Mechanical loading of bone with exercise has been shown to increase bone formation, mass, and geometry. The aim of this study was to compare the efficacy of two exercise protocols during a period of reduced gravitational loading (1/6th body weight) in mice. Since muscle contractions via resistance exercise impart the largest physiological loads on the skeleton, we hypothesized that resistance training (via vertical tower climbing) would better protect against the deleterious musculoskeletal effects of reduced gravitational weight bearing when compared to endurance exercise (treadmill running). Young adult female BALB/cBYJ mice were randomly assigned to three groups: 1/6 g (G/6; n=6), 1/6 g with treadmill running (G/6+RUN; n=8), or 1/6 g with vertical tower climbing (G/6+CLB; n=9). Exercise was performed five times per week. Reduced weight bearing for 21 days was achieved through a novel harness suspension system. Treadmill velocity (12-20 m/min) and daily run time duration (32-51 min) increased incrementally throughout the study. Bone geometry and volumetric bone mineral density (vBMD) at proximal metaphysis and mid-diaphysis tibia were assessed by in vivo peripheral quantitative computed tomography (pQCT) on days 0 and 21 and standard dynamic histomorphometry was performed on undemineralized sections of the mid-diaphysis after tissue harvest. G/6 caused a significant decrease (P<0.001) in proximal tibia metaphysis total vBMD (-9.6%). These reductions of tibia metaphyseal vBMD in G/6 mice were mitigated in both G/6+RUN and G/6+CLB groups (P<0.05). After 21 days of G/6, we saw an absolute increase in tibia mid-diaphysis vBMD and in distal metaphysis femur vBMD in both G/6+RUN and G/6+CLB mice (P<0.05). Substantial increases in endocortical and periosteal mineralizing surface (MS/BS) at mid-diaphysis tibia in G/6+CLB demonstrate that bone formation can be increased even in the presence of reduced weight bearing. These data suggest that moderately vigorous endurance exercise and resistance training, through treadmill running or climb training mitigates decrements in vBMD during 21 days of reduced weight bearing. Consistent with our hypothesis, tower climb training, most pronounced in the tibia mid-diaphysis, provides a more potent osteogenic response compared to treadmill running.

Training Enhances Both Locomotor and Cognitive Adaptability to a Novel Sensory Environment

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Peters, B. T.; Mulavara, A. P.; Brady, R. A.; Batson, C. D.; Ploutz-Snyder, R. J.; Cohen, H. S.

2010-01-01

During adaptation to novel gravitational environments, sensorimotor disturbances have the potential to disrupt the ability of astronauts to perform required mission tasks. The goal of this project is to develop a sensorimotor adaptability (SA) training program to facilitate rapid adaptation. We have developed a unique training system comprised of a treadmill placed on a motion-base facing a virtual visual scene that provides an unstable walking surface combined with incongruent visual flow designed to enhance sensorimotor adaptability. The goal of our present study was to determine if SA training improved both the locomotor and cognitive responses to a novel sensory environment and to quantify the extent to which training would be retained. Methods: Twenty subjects (10 training, 10 control) completed three, 30-minute training sessions during which they walked on the treadmill while receiving discordant support surface and visual input. Control subjects walked on the treadmill but did not receive any support surface or visual alterations. To determine the efficacy of training all subjects performed the Transfer Test upon completion of training. For this test, subjects were exposed to novel visual flow and support surface movement, not previously experienced during training. The Transfer Test was performed 20 minutes, 1 week, 1, 3 and 6 months after the final training session. Stride frequency, auditory reaction time, and heart rate data were collected as measures of postural stability, cognitive effort and anxiety, respectively. Results: Using mixed effects regression methods we determined that subjects who received SA training showed less alterations in stride frequency, auditory reaction time and heart rate compared to controls. Conclusion: Subjects who received SA training improved performance across a number of modalities including enhanced locomotor function, increased multi-tasking capability and reduced anxiety during adaptation to novel discordant sensory information. Trained subjects maintained their level of performance over six months.

A novel walking speed estimation scheme and its application to treadmill control for gait rehabilitation

PubMed Central

2012-01-01

Background Virtual reality (VR) technology along with treadmill training (TT) can effectively provide goal-oriented practice and promote improved motor learning in patients with neurological disorders. Moreover, the VR + TT scheme may enhance cognitive engagement for more effective gait rehabilitation and greater transfer to over ground walking. For this purpose, we developed an individualized treadmill controller with a novel speed estimation scheme using swing foot velocity, which can enable user-driven treadmill walking (UDW) to more closely simulate over ground walking (OGW) during treadmill training. OGW involves a cyclic acceleration-deceleration profile of pelvic velocity that contrasts with typical treadmill-driven walking (TDW), which constrains a person to walk at a preset constant speed. In this study, we investigated the effects of the proposed speed adaptation controller by analyzing the gait kinematics of UDW and TDW, which were compared to those of OGW at three pre-determined velocities. Methods Ten healthy subjects were asked to walk in each mode (TDW, UDW, and OGW) at three pre-determined speeds (0.5 m/s, 1.0 m/s, and 1.5 m/s) with real time feedback provided through visual displays. Temporal-spatial gait data and 3D pelvic kinematics were analyzed and comparisons were made between UDW on a treadmill, TDW, and OGW. Results The observed step length, cadence, and walk ratio defined as the ratio of stride length to cadence were not significantly different between UDW and TDW. Additionally, the average magnitude of pelvic acceleration peak values along the anterior-posterior direction for each step and the associated standard deviations (variability) were not significantly different between the two modalities. The differences between OGW and UDW and TDW were mainly in swing time and cadence, as have been reported previously. Also, step lengths between OGW and TDW were different for 0.5 m/s and 1.5 m/s gait velocities, and walk ratio between OGS and UDW was different for 1.0 m/s gait velocities. Conclusions Our treadmill control scheme implements similar gait biomechanics of TDW, which has been used for repetitive gait training in a small and constrained space as well as controlled and safe environments. These results reveal that users can walk as stably during UDW as TDW and employ similar strategies to maintain walking speed in both UDW and TDW. Furthermore, since UDW can allow a user to actively participate in the virtual reality (VR) applications with variable walking velocity, it can induce more cognitive activities during the training with VR, which may enhance motor learning effects. PMID:22929169

Five clinical tests to assess balance following ball exercises and treadmill training in adult persons with intellectual disability.

PubMed

Carmeli, Eli; Bar-Chad, Shmuel; Lotan, Meir; Merrick, Joav; Coleman, Raymond

2003-08-01

Incidence rates of falling increase progressively with aging. Preventing or delaying the onset of functional decline is a crucial important goal, because more individuals with intellectual disability (ID) are living well into their sixth and seventh decades. The question of whether walking and ball exercises can effect balance performance has never been reported. This pilot study was conducted to determine the effects of therapeutic training on improving balance capabilities in adults with mild ID. The study included 13 women and 4 men, aged 50-67 years (mean age 56.5 years) residing in a residential care center. Five clinical tests were used to determine the "real" picture of the locomotor function and balance before and after the training protocol. Baseline values were determined using 2 control groups of age-matched adults with and without ID. The tests included modified get-up-and-go, full turn, forward reach, sit-to-stand, and one-legged standing. Therapeutic training for 6 months included dynamic ball exercises and treadmill walking with a 2-3% positive inclination. Participants in the program showed little to no improvement in terms of their static and dynamic balance compared to their initial values. Thus, only 2 of the tests showed statistical significance. Lack of improvement was noted in both postural and balance control in adults with mild ID as a result of 6 months of intervention by means of ball exercise and treadmill training.

Changes in Gait Symmetry After Training on a Treadmill with Biofeedback in Chronic Stroke Patients: A 6-Month Follow-Up from a Randomized Controlled Trial

PubMed Central

Drużbicki, Mariusz; Guzik, Agnieszka; Przysada, Grzegorz; Kwolek, Andrzej; Brzozowska-Magoń, Agnieszka; Sobolewski, Marek

2016-01-01

Background One of the most significant challenges for patients who survive a stroke is relearning basic motor tasks such as walking. The goal of this study was to evaluate whether training on a treadmill with visual biofeedback improves gait symmetry, as well as spatiotemporal and kinematic gait parameters, in stroke patients. Material/Methods Thirty patients in the chronic phase after a stroke were randomly allocated into groups with a rehabilitation program of treadmill training with or without visual biofeedback. The training program lasted 10 days. Spatiotemporal and kinematic gait parameters were evaluated. For all parameters analyzed, a symmetrical index was calculated. Follow-up studies were performed 6 months after completion of the program. Results The symmetrical index had significantly normalized in terms of the step length (p=0.006), stance phase time, and inter-limb ratio in the intervention group. After 6 months, the improvement in the symmetry of the step length had been maintained. In the control group, no statistically significant change was observed in any of the parameters tested. There was no significant difference between the intervention group and the control group on completion of the program or at 6 months following the completion of the program. Conclusions Training on a treadmill has a significant effect on the improvement of spatiotemporal parameters and symmetry of gait in patients with chronic stroke. In the group with the treadmill training using visual biofeedback, no significantly greater improvement was observed. PMID:27941712

Locomotor training with body weight support in SCI: EMG improvement is more optimally expressed at a low testing speed.

PubMed

Meyns, P; Van de Crommert, H W A A; Rijken, H; van Kuppevelt, D H J M; Duysens, J

2014-12-01

Case series. To determine the optimal testing speed at which the recovery of the EMG (electromyographic) activity should be assessed during and after body weight supported (BWS) locomotor training. Tertiary hospital, Sint Maartenskliniek, Nijmegen, The Netherlands. Four participants with incomplete chronic SCI were included for BWS locomotor training; one AIS-C and three AIS-D (according to the ASIA (American Spinal Injury Association) Impairment Scale or AIS). All were at least 5 years after injury. The SCI participants were trained three times a week for a period of 6 weeks. They improved their locomotor function in terms of higher walking speed, less BWS and less assistance needed. To investigate which treadmill speed for EMG assessment reflects the functional improvement most adequately, all participants were assessed weekly using the same two speeds (0.5 and 1.5 km h(-1), referred to as low and high speed, respectively) for 6 weeks. The change in root mean square EMG (RMS EMG) was assessed in four leg muscles; biceps femoris, rectus femoris, gastrocnemius medialis and tibialis anterior. The changes in RMS EMG occurred at similar phases of the step cycle for both walking conditions, but these changes were larger when the treadmill was set at a low speed (0.5 km h(-1)). Improvement in gait is feasible with BWS treadmill training even long after injury. The EMG changes after treadmill training are more optimally expressed using a low rather than a high testing treadmill speed.

Functional and physiological effects of treadmill training induced by buspirone, carbidopa, and L-DOPA in clenbuterol-treated paraplegic mice.

PubMed

Ung, Roth-Visal; Rouleau, Pascal; Guertin, Pierre A

2012-05-01

Chronic spinal cord injury may be complicated by weight loss, muscle atrophy, and bone loss. The authors identified a combination pharmacotherapy using buspirone, carbidopa, and L-DOPA (BCD) that elicits bouts of locomotor-like movements in spinal cord-transected (Tx) mice. They then evaluated the effects of 8 weeks of treadmill training in Tx mice that received BCD or BCD + clenbuterol, a monoaminergic agent with anabolic properties, on locomotor function, muscle atrophy, adipose tissue loss, and bone density measures. Induced locomotor movement, adipose tissue, skeletal muscle, and femoral bone properties were compared in unoperated control mice, operated controls (untreated, untrained Tx mice), and 2 groups of treated, trained Tx mice (Tx + BCD, Tx + BCD + clenbuterol) that also received training. BCD- and BCD + clenbuterol-treated mice showed comparable levels of locomotor movements that significantly improved over time. Soleus muscle mass and soleus and extensor digitorum longus cross-sectional area significantly increased in both groups of BCD-treated mice, with greater effects in BCD + clenbuterol-treated animals. Fiber type conversion, adipose tissues, bone mineral density, and content were reduced in all Tx groups compared with unoperated control mice. These findings suggest that locomotor movement and muscle properties can be restored to near-normal levels after several weeks of BCD treatment, regular training, and clenbuterol in completely paraplegic animals.

Acute and chronic effects of aquatic treadmill training on land treadmill running kinematics: A cross-over and single-subject design approach.

PubMed

Bressel, Eadric; Louder, Talin J; Hoover, James P; Roberts, Luke C; Dolny, Dennis G

2017-11-01

The aim of this study was to determine if selected kinematic measures (foot strike index [SI], knee contact angle and overstride angle) were different between aquatic treadmill (ATM) and land treadmill (LTM) running, and to determine if these measures were altered during LTM running as a result of 6 weeks of ATM training. Acute effects were tested using 15 competitive distance runners who completed 1 session of running on each treadmill type at 5 different running speeds. Subsequently, three recreational runners completed 6 weeks of ATM training following a single-subject baseline, intervention and withdrawal experiment. Kinematic measures were quantified from digitisation of video. Regardless of speed, SI values during ATM running (61.3 ± 17%) were significantly greater (P = 0.002) than LTM running (42.7 ± 23%). Training on the ATM did not change (pre/post) the SI (26 ± 3.2/27 ± 3.1), knee contact angle (165 ± 0.3/164 ± 0.8) or overstride angle (89 ± 0.4/89 ± 0.1) during LTM running. Although SI values were different between acute ATM and LTM running, 6 weeks of ATM training did not appear to alter LTM running kinematics as evidenced by no change in kinematic values from baseline to post intervention assessments.

The Combined Effects of Body Weight Support and Gait Speed on Gait Related Muscle Activity: A Comparison between Walking in the Lokomat Exoskeleton and Regular Treadmill Walking

PubMed Central

Van Kammen, Klaske; Boonstra, Annemarijke; Reinders-Messelink, Heleen; den Otter, Rob

2014-01-01

Background For the development of specialized training protocols for robot assisted gait training, it is important to understand how the use of exoskeletons alters locomotor task demands, and how the nature and magnitude of these changes depend on training parameters. Therefore, the present study assessed the combined effects of gait speed and body weight support (BWS) on muscle activity, and compared these between treadmill walking and walking in the Lokomat exoskeleton. Methods Ten healthy participants walked on a treadmill and in the Lokomat, with varying levels of BWS (0% and 50% of the participants’ body weight) and gait speed (0.8, 1.8, and 2.8 km/h), while temporal step characteristics and muscle activity from Erector Spinae, Gluteus Medius, Vastus Lateralis, Biceps Femoris, Gastrocnemius Medialis, and Tibialis Anterior muscles were recorded. Results The temporal structure of the stepping pattern was altered when participants walked in the Lokomat or when BWS was provided (i.e. the relative duration of the double support phase was reduced, and the single support phase prolonged), but these differences normalized as gait speed increased. Alternations in muscle activity were characterized by complex interactions between walking conditions and training parameters: Differences between treadmill walking and walking in the exoskeleton were most prominent at low gait speeds, and speed effects were attenuated when BWS was provided. Conclusion Walking in the Lokomat exoskeleton without movement guidance alters the temporal step regulation and the neuromuscular control of walking, although the nature and magnitude of these effects depend on complex interactions with gait speed and BWS. If normative neuromuscular control of gait is targeted during training, it is recommended that very low speeds and high levels of BWS should be avoided when possible. PMID:25226302

High Intensity Interval Training Improves Physical Performance and Frailty in Aged Mice.

PubMed

Seldeen, Kenneth Ladd; Lasky, Ginger; Leiker, Merced Marie; Pang, Manhui; Personius, Kirkwood Ely; Troen, Bruce Robert

2018-03-14

Sarcopenia and frailty are highly prevalent in older individuals, increasing the risk of disability and loss of independence. High intensity interval training (HIIT) may provide a robust intervention for both sarcopenia and frailty by achieving both strength and endurance benefits with lower time commitments than other exercise regimens. To better understand the impacts of HIIT during aging, we compared 24-month-old C57BL/6J sedentary mice with those that were administered 10-minute uphill treadmill HIIT sessions three times per week over 16 weeks. Baseline and end point assessments included body composition, physical performance, and frailty based on criteria from the Fried physical frailty scale. HIIT-trained mice demonstrated dramatic improvement in grip strength (HIIT 10.9% vs -3.9% in sedentary mice), treadmill endurance (32.6% vs -2.0%), and gait speed (107.0% vs 39.0%). Muscles from HIIT mice also exhibited greater mass, larger fiber size, and an increase in mitochondrial biomass. Furthermore, HIIT exercise led to a dramatic reduction in frailty scores in five of six mice that were frail or prefrail at baseline, with four ultimately becoming nonfrail. The uphill treadmill HIIT exercise sessions were well tolerated by aged mice and led to performance gains, improvement in underlying muscle physiology, and reduction in frailty.

Comparison of body's center of mass motion relative to center of pressure between treadmill and over-ground walking.

PubMed

Lu, Hsuan-Lun; Lu, Tung-Wu; Lin, Hsiu-Chen; Chan, Wing P

2017-03-01

Treadmills have been used in rehabilitation settings to provide convenient protocols and continuous monitoring of movement over multiple cycles at well-controlled speeds for gait and balance training. However, the potential differences in the movement control may affect the translation of the training outcomes to real life over-ground walking (OW). The similarities and differences in the balance control between treadmill walking (TW) and OW have largely been unexplored. The current study bridged the gap by comparing the motions of the body's center of mass (COM) relative to the center of pressure (COP) between TW and OW, in terms of the COM-COP inclination angle (IA) and its rate of change (RCIA). The movement of the COM and COP separately were quite different between OW and TW, but when describing the COM motion relative to the COP, the COM motions became similar qualitatively with similar butterfly patterns. However, significantly increased peak values in themediolateral RCIA and greater ranges of mediolateral IA were found during TW (p<0.004). In the sagittal plane, the posterior velocity of the belt led to an anterior RCIA (posterior RCIA in OW) with increasing anterior IA during early double-limb support phase, and reduced posterior RCIA (p<0.009) with an increased anterior IA (p<0.001) during the remainder of the phase. These differences between TW and OW may have to be taken into account in future designs of strategies to optimize the translation of treadmill gait training outcomes into real life over-ground walking. Copyright © 2017. Published by Elsevier B.V.

Effect of exercise training program in post-CRET post-CABG patients with normal and subnormal ejection fraction (EF > 50% or < 50%) after coronary artery bypass grafting surgery.

PubMed

Ansari, Basit; Qureshi, Masood A; Zohra, Raheela Rahmat

2014-11-01

The aim of the present study is to compare the effect of exercise training program in post-Cardiac Rehabilitation Exercise Training (CRET), post-CABG patients with normal & subnormal ejection fraction (EF >50% or <50%) who have undergoing coronary artery bypass grafting (CABG) surgery. The study was conducted on 100 cardiac patients of both sexes (age: 57-65 years) who after CABG surgery, were referred to the department of Physiotherapy and Rehabilitation between 2008 and 2010 at Liaquat National Hospital & Medical College, Karachi. The patients undertook exercise training program (using treadmill, Recumbent Bike), keeping in view the Borg's scale of perceived exertion, for 6 weeks. Heart Rate (HR) and Blood Pressure (BP) were measured & compared in post CABG Patients with EF (>50% or <50%) at the start and end of the exercise training program. Statistical formulae were applied to analyze the improvement in cardiac functional indicators. Exercise significantly restores the values of HR and BP (systolic) in post CABGT Patients with EF (>50% or <50%) from the baseline to the last session of the training program. There appeared significant improvement in cardiac function four to six weeks of treadmill exercise training program. After CABG all patients showed similar improvement in cardiac function with exercise training program. The exercise training program is beneficial for improving exercise capacity linked with recovery cardiac function in Pakistani CABG patients.

Acute physiological responses to different circuit training protocols.

PubMed

Monteiro, A G; Alveno, D A; Prado, M; Monteiro, G A; Ugrinowitsch, C; Aoki, M S; Piçarro, I C

2008-12-01

The purpose of present study was to compare the acute physiological responses to a circuit weight training with the responses to a combined circuit training (weight training and treadmill run). The sample consisted of 25 individuals at an average state of training, 10 men and 15 female, between 18 and 35 year old. There were selected 60 second sets of resistance exercises to the circuit weight training (CWT). Whereas in the combined circuit training (CCT), the subjects spent 30 seconds on the same resistance exercises and 30 seconds running on the treadmill. The rest intervals between the sets lasted 15 seconds. The analysis of variance (ANOVA) with 5% significance level was utilized to the statistical analysis of the results. Comparing circuit training protocols, it was noted that CCT elicits a higher relative and absolute VO2 and energy expenditure values than CWT for both genders (P<0.05). Regarding inter-gender comparison, males showed higher absolute and relative VO2 and absolute energy expenditure values for both CWT and CCT than females (P<0.05). Females showed a significant greater %VO2max value for both CWT and CCT. Due to the experimental conditions used to state both circuit training bouts (CWT and CCT), the VO2 rate found was higher than the values reported by previous studies which used heavier weight lift. CCT seems adequate to produce cardiovascular improvements and greater energy expenditure for both men and women, while CWT group classes are sufficient only for unfit women.

A Reactive Balance Rating Method that Correlates with Kinematics after Trip-Like Perturbations on a Treadmill and Fall Risk Among Residents of Older Adult Congregate Housing.

PubMed

Madigan, Michael L; Aviles, Jessica; Allin, Leigh J; Nussbaum, Maury A; Alexander, Neil B

2018-04-16

A growing number of studies are using modified treadmills to train reactive balance after trip-like perturbations that require multiple steps to recover balance. The goal of this study was thus to develop and validate a low-tech reactive balance rating method in the context of trip-like treadmill perturbations to facilitate the implementation of this training outside the research setting. Thirty-five residents of five senior congregate housing facilities participated in the study. Subjects completed a series of reactive balance tests on a modified treadmill from which the reactive balance rating was determined, along with a battery of standard clinical balance and mobility tests that predict fall risk. We investigated the strength of correlation between the reactive balance rating and reactive balance kinematics. We compared the strength of correlation between the reactive balance rating and clinical tests predictive of fall risk, with the strength of correlation between reactive balance kinematics and the same clinical tests. We also compared the reactive balance rating between subjects predicted to be at a high or low risk of falling. The reactive balance rating was correlated with reactive balance kinematics (Spearman's rho squared = .04 - .30), exhibited stronger correlations with clinical tests than most kinematic measures (Spearman's rho squared = .00 - .23), and was 42-60% lower among subjects predicted to be at a high risk for falling. The reactive balance rating method may provide a low-tech, valid measure of reactive balance kinematics, and an indicator of fall risk, after trip-like postural perturbations.

Varied overground walking training versus body-weight-supported treadmill training in adults within 1 year of stroke: a randomized controlled trial.

PubMed

DePaul, Vincent G; Wishart, Laurie R; Richardson, Julie; Thabane, Lehana; Ma, Jinhui; Lee, Timothy D

2015-05-01

Although task-related walking training has been recommended after stroke, the theoretical basis, content, and impact of interventions vary across the literature. There is a need for a comparison of different approaches to task-related walking training after stroke. To compare the impact of a motor-learning-science-based overground walking training program with body-weight-supported treadmill training (BWSTT) in ambulatory, community-dwelling adults within 1 year of stroke onset. In this rater-blinded, 1:1 parallel, randomized controlled trial, participants were stratified by baseline gait speed. Participants assigned to the Motor Learning Walking Program (MLWP) practiced various overground walking tasks under the supervision of 1 physiotherapist. Cognitive effort was encouraged through random practice and limited provision of feedback and guidance. The BWSTT program emphasized repetition of the normal gait cycle while supported on a treadmill and assisted by 1 to 3 therapy staff. The primary outcome was comfortable gait speed at postintervention assessment (T2). In total, 71 individuals (mean age = 67.3; standard deviation = 11.6 years) with stroke (mean onset = 20.9 [14.1] weeks) were randomized (MLWP, n = 35; BWSTT, n = 36). There was no significant between-group difference in gait speed at T2 (0.002 m/s; 95% confidence interval [CI] = -0.11, 0.12; P > .05). The MLWP group improved by 0.14 m/s (95% CI = 0.09, 0.19), and the BWSTT group improved by 0.14 m/s (95% CI = 0.08, 0.20). In this sample of community-dwelling adults within 1 year of stroke, a 15-session program of varied overground walking-focused training was not superior to a BWSTT program of equal frequency, duration, and in-session step activity. © The Author(s) 2014.

Differential expression of stress proteins in rat myocardium after free wheel or treadmill run training.

PubMed

Noble, E G; Moraska, A; Mazzeo, R S; Roth, D A; Olsson, M C; Moore, R L; Fleshner, M

1999-05-01

High-intensity treadmill exercise increases the expression of a cardioprotective, inducible 72-kDa stress protein (SP72) in cardiac muscle. This investigation examined whether voluntary free wheel exercise training would be sufficient to confer a similar response. Male Sprague-Dawley rats were randomly assigned to either treadmill (TM-Tr) or free wheel (FW-Tr) training groups. By the end of the 8-wk training period, TM-Tr animals ran 1 h/day, 5 days/wk up a 10% grade, covering a distance of 8,282 m/wk. FW-Tr rats ran, on average, 5,300 m/wk, with one-third of the animals covering distances similar to those for the TM-Tr group. At the time of death, hearts of trained and caged sedentary control (Sed) animals were divided into left (LV) and right (RV) ventricles. Citrate synthase activity and the relative immunoblot contents of SP72, SP73 (the constitutive isoform of the SP70 family), and a 75-kDa mitochondrial chaperone (SP75) were subsequently determined. LV and RV did not differ on any measure, and SP73, SP75, and citrate synthase were not affected by training. Cardiac SP72 levels were elevated over fourfold in both ventricles of TM-Tr compared with RV of FW-Sed rats. Despite the animals having run a similar total distance, cardiac SP72 content in FW-Tr rats was not different from that in Sed animals. These data indicate that voluntary exercise training is insufficient to elicit an elevation of SP72 in rat heart and suggest that exercise intensity may be a critical factor in evoking the cardioprotective SP72 response.

ABCG5 gene responses to treadmill running with or without administration of Pistachio atlantica in female rats

PubMed Central

Ghanbari-Niaki, Abbass; Zare-Kookandeh, Navabeh; Zare-Kookandeh, Asghar

2014-01-01

Objective(s): ABC transporters comprise a large family of transmembrane proteins that use the energy provided by ATP hydrolysis to translocate a variety of substrates across biological membranes. All members of the human ABCG subfamily, except for ABCG2, are cholesterol-transporter. The aim of this study was to determine the liver, the small intestine and kidney ABCG5 relative gene expression in response to treadmill-running training in female rats. Materials and Methods: Twenty Wistar rats (6-8 weeks old and 125-135 g weight) were used. Animals were randomly assigned to saline-control (SC), saline-training (ST), and Baneh-control (BC), and Baneh-training (BT) groups. Training groups did the exercise on a motor-driven treadmill at 25 m/min (0% grade) for 60 min/day for eight weeks (5 days/week). Rats were fed orally, with Baneh extraction and saline for six weeks. The two-way ANOVA was employed for statistical analysis. ABCG5 relative gene expression was detected by Real-time PCR method. Results: The current findings indicate that the Baneh-treated tissues had significantly lower levels of ABCG5 gene expression in the liver, small intestine, and kidneys (P< 0.001, P< 0.003, P< 0.001, respectively), when compared with saline-treated tissues. However, a higher level of gene expression was observed in exercise groups. A lower level of HDL-c but not triglyceride (TG) and total cholesterol (TC) levels were found in Baneh-treated animals at rest. Conclusion: Exercise training increases ABCG5 relative gene expression in the liver, small intestine and kidney tissues; therefore exercise training may adjust the reduction of ABCG5 relative gene expression in Baneh-training group. PMID:24847418

Effects of Sprint Interval Training With Active Recovery vs. Endurance Training on Aerobic and Anaerobic Power, Muscular Strength, and Sprint Ability.

PubMed

Sökmen, Bülent; Witchey, Ronald L; Adams, Gene M; Beam, William C

2018-03-01

Sökmen, B, Witchey, RL, Adams, GM, and Beam, WC. Effects of sprint interval training with active recovery vs. endurance training on aerobic and anaerobic power, muscular strength, and sprint ability. J Strength Cond Res 32(3): 624-631, 2018-This study compared sprint interval training with active recovery (SITAR) to moderate-intensity endurance training (ET) in aerobic and anaerobic power, muscular strength, and sprint time results. Forty-two recreationally active adults were randomly assigned to a SITAR or ET group. Both groups trained 3× per week for 10 weeks at 75% of V[Combining Dot Above]O2max for 30 minutes weeks 1-4, with duration increasing to 35 minutes weeks 5-7 and 40 minutes weeks 8-10. While ET ran on a 400-m track without rest for the full training session, SITAR sprinted until the 200-m mark and recovered with fast walking or light jogging the second 200 m to the finish line in 3× original sprint time. Maximal oxygen consumption (V[Combining Dot Above]O2max), anaerobic treadmill run to exhaustion at 12.5 km·h at 20% incline, isokinetic leg extension and flexion strength at 60 and 300°·s, and 50 m sprint time were determined before and after training. Results showed a significant improvement (p ≤ 0.05) in absolute and relative V[Combining Dot Above]O2max, anaerobic treadmill run, and sprint time in both groups. Only SITAR showed significant improvements in isokinetic leg extension and flexion at 300°·s and decreases in body mass (p ≤ 0.05). SITAR also showed significantly greater improvement (p ≤ 0.05) over ET in anaerobic treadmill run and 50 m sprint time. These data suggest that SITAR is a time-efficient strategy to induce rapid adaptations in V[Combining Dot Above]O2max comparable to ET with added improvements in anaerobic power, isokinetic strength, and sprint time not observed with ET.

Overground vs. treadmill-based robotic gait training to improve seated balance in people with motor-complete spinal cord injury: a case report.

PubMed

Chisholm, Amanda E; Alamro, Raed A; Williams, Alison M M; Lam, Tania

2017-04-11

Robotic overground gait training devices, such as the Ekso, require users to actively participate in triggering steps through weight-shifting movements. It remains unknown how much the trunk muscles are activated during these movements, and if it is possible to transfer training effects to seated balance control. This study was conducted to compare the activity of postural control muscles of the trunk during overground (Ekso) vs. treadmill-based (Lokomat) robotic gait training, and evaluate changes in seated balance control in people with high-thoracic motor-complete spinal cord injury (SCI). Three individuals with motor-complete SCI from C7-T4, assumed to have no voluntary motor function below the chest, underwent robotic gait training. The participants were randomly assigned to Ekso-Lokomat-Ekso or Lokomat-Ekso-Lokomat for 10 sessions within each intervention phase for a total of 30 sessions. We evaluated static and dynamic balance control through analysis of center of pressure (COP) movements after each intervention phase. Surface electromyography was used to compare activity of the abdominal and erector spinae muscles during Ekso and Lokomat walking. We observed improved postural stability after training with Ekso compared to Lokomat during static balance tasks, indicated by reduced COP root mean square distance and ellipse area. In addition, Ekso training increased total distance of COP movements during a dynamic balance task. The trunk muscles showed increased activation during Ekso overground walking compared to Lokomat walking. Our findings suggest that the Ekso actively recruits trunk muscles through postural control mechanisms, which may lead to improved balance during sitting. Developing effective training strategies to reactivate the trunk muscles is important to facilitate independence during seated balance activity in people with SCI.

A longitudinal study of skeletal muscle following spinal cord injury and locomotor training.

PubMed

Liu, M; Bose, P; Walter, G A; Thompson, F J; Vandenborne, K

2008-07-01

Experimental rat model of spinal cord contusion injury (contusion SCI). The objectives of this study were (1) to characterize the longitudinal changes in rat lower hindlimb muscle morphology following contusion SCI by using magnetic resonance imaging and (2) to determine the therapeutic potential of two types of locomotor training, treadmill and cycling. University research setting. After moderate midthoracic contusion SCI, Sprague-Dawley rats were assigned to either treadmill training, cycle training or an untrained group. Lower hindlimb muscle size was examined prior to SCI and at 1-, 2-, 4-, 8-, and 12-week post injury. Following contusion SCI, we observed significant atrophy in all rat hindlimb muscles with the posterior muscles (triceps surae and flexor digitorum) showing greater atrophy than the anterior muscles (tibialis anterior and extensor digitorum). The greatest amount of atrophy was measured at 2-week post injury (range from 11 to 26%), and spontaneous recovery in muscle size was observed by 4 weeks post-SCI. Both cycling and treadmill training halted the atrophic process and accelerated the rate of recovery. The therapeutic influence of both training interventions was observed within 1 week of training and no significant difference was noted between the two interventions, except in the tibialis anterior muscle. Finally, a positive correlation was found between locomotor functional scores and hindlimb muscle size following SCI. Both treadmill and cycle training diminish the extent of atrophy and facilitate muscle plasticity after contusion SCI.

Oxygen Consumption of Elite Distance Runners on an Anti-Gravity Treadmill®

PubMed Central

McNeill, David K.P.; Kline, John R.; de Heer, Hendrick D.; Coast, J. Richard

2015-01-01

Lower body positive pressure (LBPP), or ‘anti-gravity’ treadmills® have become increasingly popular among elite distance runners. However, to date, few studies have assessed the effect of body weight support (BWS) on the metabolic cost of running among elite runners. This study evaluated how BWS influenced the relationship between velocity and metabolic cost among 6 elite male distance runners. Participants ran three- 16 minute tests consisting of 4 stages of 4 minutes at 8, 7, 6 and 5 min·mile−1 pace (3.35, 3.84, 4.47 and 5.36 m·s−1), while maintaining an aerobic effort (Respiratory Exchange Ratio ≤1.00). One test was run on a regular treadmill, one on an anti-gravity treadmill with 40% BWS and one with 20% BWS being provided. Expired gas data were collected and regression equations used to determine and compare slopes. Significant decreases in oxygen uptake (V̇O2) were found with each increase in BWS (p < 0.001). At 20% BWS, the average decrease in net VO2 was greater than proportional (34%), while at 40% BWS, the average net reduction in VO2 was close to proportional (38%). Across velocities, the slope of the relationship between VO2 and velocity (ΔV̇O2/Δv) was steeper with less support. The slopes at both the 20% and 40% BWS conditions were similar, especially when compared to the regular treadmill. Variability in VO2 between athletes was much greater on the LBPP treadmill and was greater with increased levels of BWS. In this study we evaluated the effect of body weight support on V̇O2 among elite distance runners. We have shown that oxygen uptake decreased with support, but not in direct proportion to that support. Further, because of the high variability in oxygen uptake between athletes on the LBPP treadmill, prediction equations may not be reliable and other indicators (heart rate, perceived exertion or directly measured oxygen uptake) should be used to guide training intensity when training on the LBPP treadmill. Key points With increasing amounts of body weight-support (BWS), the slope of the relationship between velocity and oxygen consumption (ΔVO2/Δv) decreases significantly. This means the change in oxygen consumption (VO2) is significantly smaller over a given change in velocity at higher amounts of BWS. There is a non-linear decrease in VO2 with increasing BWS. As such, with each increment in the amount of BWS provided, the reduction in VO2 becomes increasingly smaller. This paper provides first of its kind data on the effects of BWS on the cost of running among highly trained, elite runners. The outcomes of this study are in line with previous findings among non-elite runners. PMID:25983582

Bilateral coordination and gait symmetry after body-weight supported treadmill training for persons with chronic stroke.

PubMed

Combs, Stephanie A; Dugan, Eric L; Ozimek, Elicia N; Curtis, Amy B

2013-04-01

Locomotor interventions are commonly assessed using functional outcomes, but these outcomes provide limited information about changes toward recovery or compensatory mechanisms. The study purposes were to examine changes in gait symmetry and bilateral coordination following body-weight supported treadmill training in individuals with chronic hemiparesis due to stroke and to compare findings to participants without disability. Nineteen participants with stroke (>6 months) who ambulated between 0.4 and 0.8 m/s and 22 participants without disability were enrolled in this repeated-measures study. The stroke group completed 24 intervention sessions over 8 weeks with 20 minutes of walking/session. The non-disabled group served as a comparison for describing changes in symmetry and coordination. Bilateral 3-dimensional motion analysis and gait speed were assessed across 3 time points (pre-test, immediate post-test, and 6-month retention). Continuous relative phase was used to evaluate bilateral coordination (thigh-thigh, shank-shank, foot-foot) and gait symmetry was assessed with spatiotemporal ratios (step length, swing time, stance time). Significant improvements in continuous relative phase (shank-shank and foot-foot couplings) were found at post-test and retention for the stroke group. Significant differences in spatiotemporal symmetry ratios were not found over time. Compared to the non-disabled group, changes in bilateral coordination moved in the direction of normal recovery. Most measures of continuous relative phase were more responsive to change after training than the spatiotemporal ratios. After body-weight supported treadmill training, the stroke group made improvements toward recovery of normal bilateral coordination. Bilateral coordination and gait symmetry measures may assess different aspects of gait. Copyright © 2013 Elsevier Ltd. All rights reserved.

Treadmill Kinematics Baseline Data Collection

NASA Image and Video Library

2011-05-12

PHOTO DATE: 5-12-11 LOCATION: Building 261 - Room 138 SUBJECT: Expedition 29 Preflight Training with Dan Burbank during Treadmill Kinematics Baseline Data Collection. WORK ORDER: 2011-1214 PHOTOGRAPHER: Lauren Harnett

Body weight-supported gait training for restoration of walking in people with an incomplete spinal cord injury: a systematic review.

PubMed

Wessels, Monique; Lucas, Cees; Eriks, Inge; de Groot, Sonja

2010-06-01

To evaluate the effect of body weight-supported gait training on restoration of walking, activities of daily living, and quality of life in persons with an incomplete spinal cord injury by a systematic review of the literature. Cochrane, MEDLINE, EMBASE, CINAHL, PEDro, DocOnline were searched and identified studies were assessed for eligibility and methodological quality and described regarding population, training protocol, and effects on walking ability, activities of daily living and quality of life. A descriptive and quantitative synthesis was conducted. Eighteen articles (17 studies) were included. Two randomized controlled trials showed that subjects with injuries of less than one year duration reached higher scores on the locomotor item of the Functional Independence Measure (range 1-7) in the over-ground training group compared with the body weight-supported treadmill training group. Only for persons with an American Spinal Injury Association Impairment Scale C or D was the mean difference significant, with 0.80 (95% confidence interval 0.04-1.56). No differences were found regarding walking velocity, activities of daily living or quality of life. Subjects with subacute motor incomplete spinal cord injury reached a higher level of independent walking after over-ground training, compared with body weight-supported treadmill training. More randomized controlled trials are needed to clarify the effectiveness of body weight-supported gait training on walking, activities of daily living, and quality of life for subgroups of persons with an incomplete spinal cord injury.

Treadmill Training with HAL Exoskeleton-A Novel Approach for Symptomatic Therapy in Patients with Limb-Girdle Muscular Dystrophy-Preliminary Study.

PubMed

Sczesny-Kaiser, Matthias; Kowalewski, Rebecca; Schildhauer, Thomas A; Aach, Mirko; Jansen, Oliver; Grasmücke, Dennis; Güttsches, Anne-Katrin; Vorgerd, Matthias; Tegenthoff, Martin

2017-01-01

Purpose: Exoskeletons have been developed for rehabilitation of patients with walking impairment due to neurological disorders. Recent studies have shown that the voluntary-driven exoskeleton HAL® (hybrid assistive limb) can improve walking functions in spinal cord injury and stroke. The aim of this study was to assess safety and effects on walking function of HAL® supported treadmill therapy in patients with limb-girdle muscular dystrophy (LGMD). Materials and Methods: Three LGMD patients received 8 weeks of treadmill training with HAL® 3 times a week. Outcome parameters were 10-meter walk test (10 MWT), 6-minute walk test, and timed-up-and-go test (TUG). Parameters were assessed pre and post training and 6 weeks later (follow-up). Results: All patients completed the therapy without adverse reactions and reported about improvement in endurance. Improvements in outcome parameters after 8 weeks could be demonstrated. Persisting effects were observed after 6 weeks for the 10 MWT and TUG test (follow-up). Conclusions: HAL® treadmill training in LGMD patients can be performed safely and enables an intensive highly repetitive locomotor training. All patients benefitted from this innovative method. Upcoming controlled studies with larger cohorts should prove its effects in different types of LGMD and other myopathies.

Treadmill Training with HAL Exoskeleton—A Novel Approach for Symptomatic Therapy in Patients with Limb-Girdle Muscular Dystrophy—Preliminary Study

PubMed Central

Sczesny-Kaiser, Matthias; Kowalewski, Rebecca; Schildhauer, Thomas A.; Aach, Mirko; Jansen, Oliver; Grasmücke, Dennis; Güttsches, Anne-Katrin; Vorgerd, Matthias; Tegenthoff, Martin

2017-01-01

Purpose: Exoskeletons have been developed for rehabilitation of patients with walking impairment due to neurological disorders. Recent studies have shown that the voluntary-driven exoskeleton HAL® (hybrid assistive limb) can improve walking functions in spinal cord injury and stroke. The aim of this study was to assess safety and effects on walking function of HAL® supported treadmill therapy in patients with limb-girdle muscular dystrophy (LGMD). Materials and Methods: Three LGMD patients received 8 weeks of treadmill training with HAL® 3 times a week. Outcome parameters were 10-meter walk test (10 MWT), 6-minute walk test, and timed-up-and-go test (TUG). Parameters were assessed pre and post training and 6 weeks later (follow-up). Results: All patients completed the therapy without adverse reactions and reported about improvement in endurance. Improvements in outcome parameters after 8 weeks could be demonstrated. Persisting effects were observed after 6 weeks for the 10 MWT and TUG test (follow-up). Conclusions: HAL® treadmill training in LGMD patients can be performed safely and enables an intensive highly repetitive locomotor training. All patients benefitted from this innovative method. Upcoming controlled studies with larger cohorts should prove its effects in different types of LGMD and other myopathies. PMID:28848377

Mirror therapy and treadmill training for a patient with chronic stroke: A case report.

PubMed

Broderick, Patrick; Horgan, Frances; Blake, Catherine; Hickey, Paula; O'Reilly, Joanne; Ehrensberger, Monika; Simpson, Daniel; Roberts, David; Monaghan, Kenneth

2018-03-28

A large proportion of patients with chronic stroke have permanent lower limb functional disability leading to reduced levels of independent mobility. Individually, both mirror therapy and treadmill training have been shown to improve aspects of lower limb functioning in patients with stroke. This case report examined whether a new combination of both interventions would lead to improvements in lower limb functional disability for a patient with chronic stroke. The participant was a 50-year-old female who had a left middle cerebral artery infarction (47 months' post stroke). Due to hemiparesis, she had lower limb motor impairment and gait deficits. The participant engaged in a combination of mirror therapy and treadmill training for 30 minutes per day, 3 days per week, for 4 weeks. Modified Ashworth Scale, Fugl-Meyer Assessment-Lower Extremity and the 10 m Walk Test demonstrated clinically meaningful change. The 6 Minute Walk Test did not demonstrate meaningful change. The positive outcomes from this new combination therapy for this participant are encouraging given the relatively small dose of training and indicate the potential benefit of mirror therapy as an adjunct to treadmill training for enhancing lower limb muscle tone, motor function and walking velocity in patients with chronic stroke.

Compliance of Children with Moderate to Severe Intellectual Disability to Treadmill Walking: A Pilot Study

ERIC Educational Resources Information Center

Vashdi, E.; Hutzler, Y.; Roth, D.

2008-01-01

Background: Individuals with Intellectual Disability (ID) exhibit reduced levels of compliance to exercise, including treadmill walking. The purpose of this study was to measure the effects of several training conditions on compliance to participation in treadmill walking of children with moderate to severe ID. Method: Criteria for compliance were…

Comparison of energy expenditure between aquatic and overground treadmill walking in people post-stroke.

PubMed

Jung, Taeyou; Ozaki, Yoshi; Lai, Byron; Vrongistinos, Konstantinos

2014-03-01

This study aimed to compare the cardiorespiratory responses between aquatic treadmill walking (ATW) and overground treadmill walking (OTW) in people with hemiparesis post-stroke. Eight participants post-stroke aged 58.5 ± 11.4 years and eight healthy adult controls aged 56.1 ± 8.6 years participated in a cross-sectional comparative study. Participants completed three 8-minute walking sessions separated by at least 72-hour rest. On the first visit, participants identified their comfortable walking speed on an aquatic and overground treadmill. The second and third visit consisted of either ATW or OTW at a matched speed. Oxygen consumption (VO2), carbon dioxide production (VCO2 ), minute ventilation (VE) and energy expenditure (EE) were measured at rest and during walking in both exercise modes. Mean steady-state cardiorespiratory responses during ATW showed a significant decrease compared with OTW at a matched speed. During ATW, mean VO2 values decreased by 39% in the stroke group and 21% in the control group, mean VCO2 values decreased by 42% in the stroke group and 30% in the control group, and mean EE decreased by 40% in the stroke group and 25% in the control group. Mean steady-state VE values and resting cardiorespiratory response values showed no significant change between the two conditions. This study demonstrated a decreased metabolic cost when ATW at matched speeds to that of OTW. Reduced metabolic cost during ATW may allow for longer durations of treadmill-induced gait training compared with OTW for improved outcomes. This knowledge may aid clinicians when prescribing aquatic treadmill exercise for people post-stroke with goals of improving gait and functional mobility. However, decreased metabolic cost during ATW suggests that to improve cardiovascular fitness, ATW may not be a time-efficient method of cardiovascular exercise for healthy adults and people post-stroke. Copyright © 2013 John Wiley & Sons, Ltd.

Clinical experience using a 5-week treadmill training program with virtual reality to enhance gait in an ambulatory physical therapy service.

PubMed

Shema, Shirley Roth; Brozgol, Marina; Dorfman, Moran; Maidan, Inbal; Sharaby-Yeshayahu, Lior; Malik-Kozuch, Hila; Wachsler Yannai, Orly; Giladi, Nir; Hausdorff, Jeffrey M; Mirelman, Anat

2014-09-01

Current literature views safe gait as a complex task, relying on motor and cognitive resources. The use of virtual reality (VR) in gait training offers a multifactorial approach, showing positive effects on mobility, balance, and fall risk in elderly people and individuals with neurological disorders. This form of training has been described as a viable research tool; however, it has not been applied routinely in clinical practice. Recently, VR was used to develop an adjunct training method for use by physical therapists in an ambulatory clinical setting. The aim of this article is to describe the initial clinical experience of applying a 5-week VR clinical service to improve gait and mobility in people with a history of falls, poor mobility, or postural instability. A retrospective data analysis was conducted. The clinical records of the first 60 patients who completed the VR gait training program were examined. Training was provided 3 times per week for 5 weeks, with each session lasting approximately 1 hour and consisting of walking on a treadmill while negotiating virtual obstacles. Main outcome measures were compared across time and included the Timed "Up & Go" Test (TUG), the Two-Minute Walk Test (2MWT), and the Four Square Step Test (FSST). After 5 weeks of training, time to complete the TUG decreased by 10.3%, the distance walked during the 2MWT increased by 9.5%, and performance on the FSST improved by 13%. Limitations of the study include the use of a retrospective analysis with no control group and the lack of objective cognitive assessment. Treadmill training with VR appears to be an effective and practical tool that can be applied in an outpatient physical therapy clinic. This training apparently leads to improvements in gait, mobility, and postural control. It, perhaps, also may augment cognitive and functional aspects. © 2014 American Physical Therapy Association.

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

PubMed Central

Kim, Janis; Arora, Pooja; Zhang, Yunhui

2016-01-01

Treadmill training has been used for improving locomotor function in children with cerebral palsy (CP), but the functional gains are relatively small, suggesting a need to improve current paradigms. The understanding of the kinematic and EMG responses to forces applied to the body of subjects during treadmill walking is crucial for improving current paradigms. The objective of this study was to determine the kinematics and EMG responses to the pelvis and/or leg assistance force. Ten children with spastic CP were recruited to participate in this study. A controlled assistance force was applied to the pelvis and/or legs during stance and swing phase of gait through a custom designed robotic system during walking. Muscle activities and spatial-temporal gait parameters were measured at different loading conditions during walking. In addition, the spatial-temporal gait parameters during overground walking before and after treadmill training were also collected. Applying pelvis assistance improved step height and applying leg assistance improved step length during walking, but applying leg assistance also reduced muscle activation of ankle flexor during the swing phase of gait. In addition, step length and self-selected walking speed significantly improved after one session of treadmill training with combined pelvis and leg assistance. PMID:27651955

The Reliability of a 5km Run Test on a Motorized Treadmill

ERIC Educational Resources Information Center

Driller, Matthew; Brophy-Williams, Ned; Walker, Anthony

2017-01-01

The purpose of the present study was to determine the reliability of a 5km run test on a motorized treadmill. Over three consecutive weeks, 12 well-trained runners completed three 5km time trials on a treadmill following a standardized warm-up. Runners were partially-blinded to their running speed and distance covered. Total time to complete the…

Locomotion Strategy and Magnitude of Ground Reaction Forces During Treadmill Training on ISS.

PubMed

Fomina, Elena; Savinkina, Alexandra

2017-09-01

Creation of the cosmonaut in-flight physical training process is currently based on the leading role of support afferents in the development of hypogravity changes in the motor system. We assume that the strength of support afferents is related to the magnitude of the ground reaction forces (GRF). For this purpose it was necessary to compare the GRF magnitude on the Russian BD-2 treadmill for different locomotion types (walking and running), modes (active and passive), and subjects. Relative GRF values were analyzed while subjects performed walking and running during active and passive modes of treadmill belt movement under 1 G (N = 6) and 0 G (N = 4) conditions. For different BD-2 modes and both types of locomotion, maximum GRF values varied in both 0 G and 1 G. Considerable individual variations were also found in the locomotion strategies, as well as in maximum GRF values. In 0 G, the smallest GRF values were observed for walking in active mode, and the largest during running in passive mode. In 1 G, GRF values were higher during running than while walking, but the difference between active and passive modes was not observed; we assume this was due to the uniqueness of the GRF profile. The maximum GRF recorded during walking and running in active and passive modes depended on the individual pattern of locomotion. The maximum GRF values that we recorded on BD-2 were close to values found by other researchers. The observations from this study could guide individualized countermeasures prescriptions for microgravity.Fomina E, Savinkina A. Locomotion strategy and magnitude of ground reaction forces during treadmill training on ISS. Aerosp Med Hum Perform. 2017; 88(9):841-849.

Treadmill Training with Partial Body-Weight Support in Children with Cerebral Palsy: A Systematic Review

ERIC Educational Resources Information Center

Mutlu, Akmer; Krosschell, Kristin; Spira, Deborah Gaebler

2009-01-01

OKAim: The aim of this systematic review was to examine the literature on the effects of partial body-weight support treadmill training (PBWSTT) in children with cerebral palsy (CP) on functional outcomes and attainment of ambulation. Method: We searched the relevant literature from 1950 to July 2007. We found eight studies on the use of PWSBTT on…

Long-term integrated telerehabilitation of COPD Patients: a multicentre randomised controlled trial (iTrain).

PubMed

Zanaboni, Paolo; Dinesen, Birthe; Hjalmarsen, Audhild; Hoaas, Hanne; Holland, Anne E; Oliveira, Cristino Carneiro; Wootton, Richard

2016-08-22

Pulmonary rehabilitation (PR) is an effective intervention for the management of people with chronic obstructive pulmonary disease (COPD). However, available resources are often limited, and many patients bear with poor availability of programmes. Sustaining PR benefits and regular exercise over the long term is difficult without any exercise maintenance strategy. In contrast to traditional centre-based PR programmes, telerehabilitation may promote more effective integration of exercise routines into daily life over the longer term and broaden its applicability and availability. A few studies showed promising results for telerehabilitation, but mostly with short-term interventions. The aim of this study is to compare long-term telerehabilitation with unsupervised exercise training at home and with standard care. An international multicentre randomised controlled trial conducted across sites in three countries will recruit 120 patients with COPD. Participants will be randomly assigned to telerehabilitation, treadmill and control, and followed up for 2 years. The telerehabilitation intervention consists of individualised exercise training at home on a treadmill, telemonitoring by a physiotherapist via videoconferencing using a tablet computer, and self-management via a customised website. Patients in the treadmill arm are provided with a treadmill only to perform unsupervised exercise training at home. Patients in the control arm are offered standard care. The primary outcome is the combined number of hospitalisations and emergency department presentations. Secondary outcomes include changes in health status, quality of life, anxiety and depression, self-efficacy, subjective impression of change, physical performance, level of physical activity, and personal experiences in telerehabilitation. This trial will provide evidence on whether long-term telerehabilitation represents a cost-effective strategy for the follow-up of patients with COPD. The delivery of telerehabilitation services will also broaden the availability of PR and maintenance strategies, especially to those living in remote areas and with no access to centre-based exercise programmes. ClinicalTrials.gov: NCT02258646 .

Varied overground walking-task practice versus body-weight-supported treadmill training in ambulatory adults within one year of stroke: a randomized controlled trial protocol.

PubMed

DePaul, Vincent G; Wishart, Laurie R; Richardson, Julie; Lee, Timothy D; Thabane, Lehana

2011-10-21

Although task-oriented training has been shown to improve walking outcomes after stroke, it is not yet clear whether one task-oriented approach is superior to another. The purpose of this study is to compare the effectiveness of the Motor Learning Walking Program (MLWP), a varied overground walking task program consistent with key motor learning principles, to body-weight-supported treadmill training (BWSTT) in community-dwelling, ambulatory, adults within 1 year of stroke. A parallel, randomized controlled trial with stratification by baseline gait speed will be conducted. Allocation will be controlled by a central randomization service and participants will be allocated to the two active intervention groups (1:1) using a permuted block randomization process. Seventy participants will be assigned to one of two 15-session training programs. In MLWP, one physiotherapist will supervise practice of various overground walking tasks. Instructions, feedback, and guidance will be provided in a manner that facilitates self-evaluation and problem solving. In BWSTT, training will emphasize repetition of the normal gait cycle while supported over a treadmill, assisted by up to three physiotherapists. Outcomes will be assessed by a blinded assessor at baseline, post-intervention and at 2-month follow-up. The primary outcome will be post-intervention comfortable gait speed. Secondary outcomes include fast gait speed, walking endurance, balance self-efficacy, participation in community mobility, health-related quality of life, and goal attainment. Groups will be compared using analysis of covariance with baseline gait speed strata as the single covariate. Intention-to-treat analysis will be used. In order to direct clinicians, patients, and other health decision-makers, there is a need for a head-to-head comparison of different approaches to active, task-related walking training after stroke. We hypothesize that outcomes will be optimized through the application of a task-related training program that is consistent with key motor learning principles related to practice, guidance and feedback. ClinicalTrials.gov # NCT00561405.

Varied overground walking-task practice versus body-weight-supported treadmill training in ambulatory adults within one year of stroke: a randomized controlled trial protocol

PubMed Central

2011-01-01

Background Although task-oriented training has been shown to improve walking outcomes after stroke, it is not yet clear whether one task-oriented approach is superior to another. The purpose of this study is to compare the effectiveness of the Motor Learning Walking Program (MLWP), a varied overground walking task program consistent with key motor learning principles, to body-weight-supported treadmill training (BWSTT) in community-dwelling, ambulatory, adults within 1 year of stroke. Methods/Design A parallel, randomized controlled trial with stratification by baseline gait speed will be conducted. Allocation will be controlled by a central randomization service and participants will be allocated to the two active intervention groups (1:1) using a permuted block randomization process. Seventy participants will be assigned to one of two 15-session training programs. In MLWP, one physiotherapist will supervise practice of various overground walking tasks. Instructions, feedback, and guidance will be provided in a manner that facilitates self-evaluation and problem solving. In BWSTT, training will emphasize repetition of the normal gait cycle while supported over a treadmill, assisted by up to three physiotherapists. Outcomes will be assessed by a blinded assessor at baseline, post-intervention and at 2-month follow-up. The primary outcome will be post-intervention comfortable gait speed. Secondary outcomes include fast gait speed, walking endurance, balance self-efficacy, participation in community mobility, health-related quality of life, and goal attainment. Groups will be compared using analysis of covariance with baseline gait speed strata as the single covariate. Intention-to-treat analysis will be used. Discussion In order to direct clinicians, patients, and other health decision-makers, there is a need for a head-to-head comparison of different approaches to active, task-related walking training after stroke. We hypothesize that outcomes will be optimized through the application of a task-related training program that is consistent with key motor learning principles related to practice, guidance and feedback. Trial Registration ClinicalTrials.gov # NCT00561405 PMID:22018267

Accuracy of unloading with the anti-gravity treadmill.

PubMed

McNeill, David K P; de Heer, Hendrik D; Bounds, Roger G; Coast, J Richard

2015-03-01

Body weight (BW)-supported treadmill training has become increasingly popular in professional sports and rehabilitation. To date, little is known about the accuracy of the lower-body positive pressure treadmill. This study evaluated the accuracy of the BW support reported on the AlterG "Anti-Gravity" Treadmill across the spectrum of unloading, from full BW (100%) to 20% BW. Thirty-one adults (15 men and 16 women) with a mean age of 29.3 years (SD = 10.9), and a mean weight of 66.55 kg (SD = 12.68) were recruited. Participants were weighed outside the machine and then inside at 100-20% BW in 10% increments. Predicted BW, as presented by the AlterG equipment, was compared with measured BW. Significant differences between predicted and measured BW were found at all but 90% through 70% of BW. Differences were small (<5%), except at the extreme ends of the unloading spectrum. At 100% BW, the measured weight was lower than predicted (mean = 93.15%, SD = 1.21, p < 0.001 vs. predicted). At 30 and 20% BW, the measured weight was higher than predicted at 35.75% (SD = 2.89, p < 0.001), and 27.67% (SD = 3.76, p < 0.001), respectively. These findings suggest that there are significant differences between reported and measured BW support on the AlterG Anti-Gravity Treadmill®, with the largest differences (>5%) found at 100% BW and the greatest BW support (30 and 20% BW). These differences may be associated with changes in metabolic demand and maximum speed during walking or running and should be taken into consideration when using these devices for training and research purposes.

Efficacy of Aquatic Treadmill Training on Gait Symmetry and Balance in Subacute Stroke Patients

PubMed Central

2017-01-01

Objective To determine the efficacy of aquatic treadmill training (ATT) as a new modality for stroke rehabilitation, by assessing changes in gait symmetry, balance function, and subjective balance confidence for the paretic and non-paretic leg in stroke patients. Methods Twenty-one subacute stroke patients participated in 15 intervention sessions of aquatic treadmill training. The Comfortable 10-Meter Walk Test (CWT), spatiotemporal gait parameters, Berg Balance Scale (BBS), and Activities-specific Balance Confidence scale (ABC) were assessed pre- and post-interventions. Results From pre- to post-intervention, statistically significant improvements were observed in the CWT (0.471±0.21 to 0.558±0.23, p<0.001), BBS (39.66±8.63 to 43.80±5.21, p<0.001), and ABC (38.39±13.46 to 46.93±12.32, p<0.001). The step-length symmetry (1.017±0.25 to 0.990±0.19, p=0.720) and overall temporal symmetry (1.404±0.36 to 1.314±0.34, p=0.218) showed improvement without statistical significance. Conclusion ATT improves the functional aspects of gait, including CWT, BBS and ABC, and spatiotemporal gait symmetry, though without statistical significance. Further studies are required to examine and compare the potential benefits of ATT as a new modality for stroke therapy, with other modalities. PMID:28758074

Efficacy of Aquatic Treadmill Training on Gait Symmetry and Balance in Subacute Stroke Patients.

PubMed

Lee, Mi Eun; Jo, Geun Yeol; Do, Hwan Kwon; Choi, Hee Eun; Kim, Woo Jin

2017-06-01

To determine the efficacy of aquatic treadmill training (ATT) as a new modality for stroke rehabilitation, by assessing changes in gait symmetry, balance function, and subjective balance confidence for the paretic and non-paretic leg in stroke patients. Twenty-one subacute stroke patients participated in 15 intervention sessions of aquatic treadmill training. The Comfortable 10-Meter Walk Test (CWT), spatiotemporal gait parameters, Berg Balance Scale (BBS), and Activities-specific Balance Confidence scale (ABC) were assessed pre- and post-interventions. From pre- to post-intervention, statistically significant improvements were observed in the CWT (0.471±0.21 to 0.558±0.23, p<0.001), BBS (39.66±8.63 to 43.80±5.21, p<0.001), and ABC (38.39±13.46 to 46.93±12.32, p<0.001). The step-length symmetry (1.017±0.25 to 0.990±0.19, p=0.720) and overall temporal symmetry (1.404±0.36 to 1.314±0.34, p=0.218) showed improvement without statistical significance. ATT improves the functional aspects of gait, including CWT, BBS and ABC, and spatiotemporal gait symmetry, though without statistical significance. Further studies are required to examine and compare the potential benefits of ATT as a new modality for stroke therapy, with other modalities.

Burrowing as a novel voluntary strength training method for mice: A comparison of various voluntary strength or resistance exercise methods.

PubMed

Roemers, P; Mazzola, P N; De Deyn, P P; Bossers, W J; van Heuvelen, M J G; van der Zee, E A

2018-04-15

Voluntary strength training methods for rodents are necessary to investigate the effects of strength training on cognition and the brain. However, few voluntary methods are available. The current study tested functional and muscular effects of two novel voluntary strength training methods, burrowing (digging a substrate out of a tube) and unloaded tower climbing, in male C57Bl6 mice. To compare these two novel methods with existing exercise methods, resistance running and (non-resistance) running were included. Motor coordination, grip strength and muscle fatigue were measured at baseline, halfway through and near the end of a fourteen week exercise intervention. Endurance was measured by an incremental treadmill test after twelve weeks. Both burrowing and resistance running improved forelimb grip strength as compared to controls. Running and resistance running increased endurance in the treadmill test and improved motor skills as measured by the balance beam test. Post-mortem tissue analyses revealed that running and resistance running induced Soleus muscle hypertrophy and reduced epididymal fat mass. Tower climbing elicited no functional or muscular changes. As a voluntary strength exercise method, burrowing avoids the confounding effects of stress and positive reinforcers elicited in forced strength exercise methods. Compared to voluntary resistance running, burrowing likely reduces the contribution of aerobic exercise components. Burrowing qualifies as a suitable voluntary strength training method in mice. Furthermore, resistance running shares features of strength training and endurance (aerobic) exercise and should be considered a multi-modal aerobic-strength exercise method in mice. Copyright © 2017 Elsevier B.V. All rights reserved.

Novel swing-assist un-motorized exoskeletons for gait training.

PubMed

Mankala, Kalyan K; Banala, Sai K; Agrawal, Sunil K

2009-07-03

Robotics is emerging as a promising tool for functional training of human movement. Much of the research in this area over the last decade has focused on upper extremity orthotic devices. Some recent commercial designs proposed for the lower extremity are powered and expensive - hence, these could have limited affordability by most clinics. In this paper, we present a novel un-motorized bilateral exoskeleton that can be used to assist in treadmill training of motor-impaired patients, such as with motor-incomplete spinal cord injury. The exoskeleton is designed such that the human leg will have a desirable swing motion, once it is strapped to the exoskeleton. Since this exoskeleton is un-motorized, it can potentially be produced cheaply and could reduce the physical demand on therapists during treadmill training. A swing-assist bilateral exoskeleton was designed and fabricated at the University of Delaware having the following salient features: (i) The design uses torsional springs at the hip and the knee joints to assist the swing motion. The springs get charged by the treadmill during stance phase of the leg and provide propulsion forces to the leg during swing. (ii) The design of the exoskeleton uses simple dynamic models of sagittal plane walking, which are used to optimize the parameters of the springs so that the foot can clear the ground and have a desirable forward motion during walking. The bilateral exoskeleton was tested on a healthy subject during treadmill walking for a range of walking speeds between 1.0 mph and 4.0 mph. Joint encoders and interface force-torque sensors mounted on the exoskeleton were used to evaluate the effectiveness of the exoskeleton in terms of the hip and knee joint torques applied by the human during treadmill walking. We compared two different cases. In case 1, we estimated the torque applied by the human joints when walking with the device using the joint kinematic data and interface force-torque sensors. In case 2, we calculated the required torque to perform a similar gait only using the kinematic data collected from joint motion sensors. On analysis, we found that at 2.0 mph, the device was effective in reducing the maximum hip torque requirement and the knee joint torque during the beginning of the swing. These behaviors were retained as the treadmill speed was changed between 1-4 mph. These results were remarkable considering the simplicity of the dynamic model, model uncertainty, non-ideal spring behavior, and friction in the joints. We believe that the results can be further improved in the future. Nevertheless, this promises to provide a useful and effective methodology for design of un-motorized exoskeletons to assist and train swing of motor-impaired patients.

Physical exercise increases adult hippocampal neurogenesis in male rats provided it is aerobic and sustained

PubMed Central

Lensu, Sanna; Ahtiainen, Juha P.; Johansson, Petra P.; Koch, Lauren G.; Britton, Steven L.; Kainulainen, Heikki

2016-01-01

Key points Aerobic exercise, such as running, enhances adult hippocampal neurogenesis (AHN) in rodents.Little is known about the effects of high‐intensity interval training (HIT) or of purely anaerobic resistance training on AHN.Here, compared with a sedentary lifestyle, we report a very modest effect of HIT and no effect of resistance training on AHN in adult male rats.We found the most AHN in rats that were selectively bred for an innately high response to aerobic exercise that also run voluntarily and increase maximal running capacity.Our results confirm that sustained aerobic exercise is key in improving AHN. Abstract Aerobic exercise, such as running, has positive effects on brain structure and function, such as adult hippocampal neurogenesis (AHN) and learning. Whether high‐intensity interval training (HIT), referring to alternating short bouts of very intense anaerobic exercise with recovery periods, or anaerobic resistance training (RT) has similar effects on AHN is unclear. In addition, individual genetic variation in the overall response to physical exercise is likely to play a part in the effects of exercise on AHN but is less well studied. Recently, we developed polygenic rat models that gain differentially for running capacity in response to aerobic treadmill training. Here, we subjected these low‐response trainer (LRT) and high‐response trainer (HRT) adult male rats to various forms of physical exercise for 6–8 weeks and examined the effects on AHN. Compared with sedentary animals, the highest number of doublecortin‐positive hippocampal cells was observed in HRT rats that ran voluntarily on a running wheel, whereas HIT on the treadmill had a smaller, statistically non‐significant effect on AHN. Adult hippocampal neurogenesis was elevated in both LRT and HRT rats that underwent endurance training on a treadmill compared with those that performed RT by climbing a vertical ladder with weights, despite their significant gain in strength. Furthermore, RT had no effect on proliferation (Ki67), maturation (doublecortin) or survival (bromodeoxyuridine) of new adult‐born hippocampal neurons in adult male Sprague–Dawley rats. Our results suggest that physical exercise promotes AHN most effectively if the exercise is aerobic and sustained, especially when accompanied by a heightened genetic predisposition for response to physical exercise. PMID:26844666

The role of resistance and aerobic exercise training on insulin sensitivity measures in STZ-induced Type 1 diabetic rodents.

PubMed

Hall, Katharine E; McDonald, Matthew W; Grisé, Kenneth N; Campos, Oscar A; Noble, Earl G; Melling, C W James

2013-10-01

Individuals with Type 1 Diabetes Mellitus (T1DM) can develop insulin resistance. Regular exercise may improve insulin resistance partially through increased expression of skeletal muscle GLUT4 content. To examine if different exercise training modalities can alter glucose tolerance through changes in skeletal muscle GLUT4 content in T1DM rats. Fifty rats were divided into 5 groups; control, diabetic control, diabetic resistance exercised, and diabetic high and low intensity treadmill exercised. Diabetes was induced using multiple low dose Streptozotocin (20 mg/kg/day) injections and blood glucose concentrations were maintained moderately hyperglycemic through subcutaneous insulin pellets. Resistance trained rats climbed a ladder with incremental loads, while treadmill trained rats ran on a treadmill at 27 or 15 m/min, respectively, all for 6 weeks. At weeks 3 and 6, area under the curve measurements following an intravenous glucose tolerance test (AUC-IVGTT) in all diabetic groups were higher than control rats (p<0.05). At 6 weeks, all exercise groups had significantly lower AUC-IVGTT values than diabetic control animals (p<0.05). Treadmill trained rats had the lowest insulin dose requirement of the T1DM rats and the greatest reduction in insulin dosage was evident in high intensity treadmill exercise. Concomitant with improvements in glucose handling improvements, tissue-specific elevations in GLUT4 content were demonstrated in both red and white portions of vastus lateralis and gastrocnemius muscles, suggesting that glucose handling capacity was altered in the skeletal muscle of exercised T1DM rats. These results suggest that, while all exercise modalities can improve glucose tolerance, each mode leads to differential improvements in insulin requirements and protein content alterations. Copyright © 2013 Elsevier Inc. All rights reserved.

A pilot clinical trial on a Variable Automated Speed and Sensing Treadmill (VASST) for hemiparetic gait rehabilitation in stroke patients.

PubMed

Chua, Karen S G; Chee, Johnny; Wong, Chin J; Lim, Pang H; Lim, Wei S; Hoo, Chuan M; Ong, Wai S; Shen, Mira L; Yu, Wei S

2015-01-01

Impairments in walking speed and capacity are common problems after stroke which may benefit from treadmill training. However, standard treadmills, are unable to adapt to the slower walking speeds of stroke survivors and are unable to automate training progression. This study tests a Variable Automated Speed and Sensing Treadmill (VASST) using a standard clinical protocol. VASST is a semi-automated treadmill with multiple sensors and micro controllers, including wireless control to reposition a fall-prevention harness, variable pre-programmed exercise parameters and laser beam foot sensors positioned on the belt to detect subject's foot positions. An open-label study with assessor blinding was conducted in 10 community-dwelling chronic hemiplegic patients who could ambulate at least 0.1 m/s. Interventions included physiotherapist-supervised training on VASST for 60 min three times per week for 4 weeks (total 12 h). Outcome measures of gait speed, quantity, balance, and adverse events were assessed at baseline, 2, 4, and 8 weeks. Ten subjects (8 males, mean age 55.5 years, 2.1 years post stroke) completed VASST training. Mean 10-m walk test speed was 0.69 m/s (SD = 0.29) and mean 6-min walk test distance was 178.3 m (84.0). After 4 weeks of training, 70% had significant positive gains in gait speed (0.06 m/s, SD = 0.08 m/s, P = 0.037); and 90% improved in walking distance. (54.3 m, SD = 30.9 m, P = 0.005). There were no adverse events. This preliminary study demonstrates the initial feasibility and short-term efficacy of VASST for walking speed and distance for people with chronic post-stroke hemiplegia.

Effect of transcranial direct current stimulation combined with gait and mobility training on functionality in children with cerebral palsy: study protocol for a double-blind randomized controlled clinical trial

PubMed Central

2013-01-01

Background The project proposes three innovative intervention techniques (treadmill training, mobility training with virtual reality and transcranial direct current stimulation that can be safely administered to children with cerebral palsy. The combination of transcranial stimulation and physical therapy resources will provide the training of a specific task with multiple rhythmic repetitions of the phases of the gait cycle, providing rich sensory stimuli with a modified excitability threshold of the primary motor cortex to enhance local synaptic efficacy and potentiate motor learning. Methods/design A prospective, double-blind, randomized, controlled, analytical, clinical trial will be carried out.Eligible participants will be children with cerebral palsy classified on levels I, II and III of the Gross Motor Function Classification System between four and ten years of age. The participants will be randomly allocated to four groups: 1) gait training on a treadmill with placebo transcranial stimulation; 2) gait training on a treadmill with active transcranial stimulation; 3) mobility training with virtual reality and placebo transcranial stimulation; 4) mobility training with virtual reality and active transcranial stimulation. Transcranial direct current stimulation will be applied with the anodal electrode positioned in the region of the dominant hemisphere over C3, corresponding to the primary motor cortex, and the cathode positioned in the supraorbital region contralateral to the anode. A 1 mA current will be applied for 20 minutes. Treadmill training and mobility training with virtual reality will be performed in 30-minute sessions five times a week for two weeks (total of 10 sessions). Evaluations will be performed on four occasions: one week prior to the intervention; one week following the intervention; one month after the end of the intervention;and 3 months after the end of the intervention. The evaluations will involve three-dimensional gait analysis, analysis of cortex excitability (motor threshold and motor evoked potential), Six-Minute Walk Test, Timed Up-and-Go Test, Pediatric Evaluation Disability Inventory, Gross Motor Function Measure, Berg Balance Scale, stabilometry, maximum respiratory pressure and an effort test. Discussion This paper offers a detailed description of a prospective, double-blind, randomized, controlled, analytical, clinical trial aimed at demonstrating the effect combining transcranial stimulation with treadmill and mobility training on functionality and primary cortex excitability in children with Cerebral Palsy classified on Gross Motor Function Classification System levels I, II and III. The results will be published and will contribute to evidence regarding the use of treadmill training on this population. Trial registration ReBEC RBR-9B5DH7 PMID:24112817

Effects of treadmill training on functional recovery following peripheral nerve injury in rats

PubMed Central

Boeltz, Tiffany; Ireland, Meredith; Mathis, Kristin; Nicolini, Jennifer; Poplavski, Karen; Rose, Samuel J.; Wilson, Erin

2013-01-01

Exercise, in the form of moderate daily treadmill training following nerve transection and repair leads to enhanced axon regeneration, but its effect on functional recovery is less well known. Female rats were exercised by walking continuously, at a slow speed (10 m/min), for 1 h/day on a level treadmill, beginning 3 days after unilateral transection and surgical repair of the sciatic nerve, and conducted 5 days/wk for 2 wk. In Trained rats, both direct muscle responses to tibial nerve stimulation and H reflexes in soleus reappeared earlier and increased in amplitude more rapidly over time than in Untrained rats. The efficacy of the restored H reflex was greater in Trained rats than in Untrained controls. The reinnervated tibialis anterior and soleus were coactivated during treadmill locomotion in Untrained rats. In Trained animals, the pattern of activation of soleus, but not tibialis anterior, was not significantly different from that found in Intact rats. The overall length of the hindlimb during level and up- and downslope locomotion was conserved after nerve injury in both groups. This conservation was achieved by changes in limb orientation. Limb length was conserved effectively in all rats during downslope walking but only in Trained rats during level and upslope walking. Moderate daily exercise applied immediately after sciatic nerve transection is sufficient to promote axon regeneration, to restore muscle reflexes, and to improve the ability of rats to cope with different biomechanical demands of slope walking. PMID:23468390

Improvement of metabolic and cardiorespiratory responses through treadmill gait training with neuromuscular electrical stimulation in quadriplegic subjects.

PubMed

de Carvalho, Daniela Cristina Leite; Martins, Cristiane Luzia; Cardoso, Simone David; Cliquet, Alberto

2006-01-01

This work assessed the influence of treadmill gait training with neuromuscular electrical stimulation (NMES) on the metabolic and cardiorespiratory responses in quadriplegic subjects. The gait group (GG) (n=11) performed 6 months of treadmill training with 30-50% body weight support and with the help of physiotherapists, twice a week, allotting 20 min for each session. The control group (CG) (n=10), during the 6 months of training, did not perform any activity using NMES, performing instead conventional physiotherapy. Metabolic and cardiorespiratory responses (O(2) uptake [VO(2)], CO(2) production [VCO(2)], pulmonary ventilation (V(E)), heart rate [HR], and blood pressure [BP]) were measured on inclusion and after 6 months. For the GG, differences were found in all parameters after training (P<0.05), except for HR and diastolic BP. During gait, VO(2) (L/min) increased by 36%, VCO(2) (L/min) increased by 42.97%, V(E) (L/min) increased by 30.48%, and systolic BP (mm Hg) increased by 4.8%. For the CG, only VO(2) and VCO(2) (L/min) significantly increased at rest (30.82 and 16.39%, respectively) and during knee-extension exercise (26.29 and 17.37%, respectively). Treadmill gait with NMES was, therefore, more efficient toward increasing the aerobic capacity due to yielding higher metabolic and cardiovascular stresses.

Body-weight-supported treadmill rehabilitation after stroke.

PubMed

Duncan, Pamela W; Sullivan, Katherine J; Behrman, Andrea L; Azen, Stanley P; Wu, Samuel S; Nadeau, Stephen E; Dobkin, Bruce H; Rose, Dorian K; Tilson, Julie K; Cen, Steven; Hayden, Sarah K

2011-05-26

Locomotor training, including the use of body-weight support in treadmill stepping, is a physical therapy intervention used to improve recovery of the ability to walk after stroke. The effectiveness and appropriate timing of this intervention have not been established. We stratified 408 participants who had had a stroke 2 months earlier according to the extent of walking impairment--moderate (able to walk 0.4 to <0.8 m per second) or severe (able to walk <0.4 m per second)--and randomly assigned them to one of three training groups. One group received training on a treadmill with the use of body-weight support 2 months after the stroke had occurred (early locomotor training), the second group received this training 6 months after the stroke had occurred (late locomotor training), and the third group participated in an exercise program at home managed by a physical therapist 2 months after the stroke (home-exercise program). Each intervention included 36 sessions of 90 minutes each for 12 to 16 weeks. The primary outcome was the proportion of participants in each group who had an improvement in functional walking ability 1 year after the stroke. At 1 year, 52.0% of all participants had increased functional walking ability. No significant differences in improvement were found between early locomotor training and home exercise (adjusted odds ratio for the primary outcome, 0.83; 95% confidence interval [CI], 0.50 to 1.39) or between late locomotor training and home exercise (adjusted odds ratio, 1.19; 95% CI, 0.72 to 1.99). All groups had similar improvements in walking speed, motor recovery, balance, functional status, and quality of life. Neither the delay in initiating the late locomotor training nor the severity of the initial impairment affected the outcome at 1 year. Ten related serious adverse events were reported (occurring in 2.2% of participants undergoing early locomotor training, 3.5% of those undergoing late locomotor training, and 1.6% of those engaging in home exercise). As compared with the home-exercise group, each of the groups receiving locomotor training had a higher frequency of dizziness or faintness during treatment (P=0.008). Among patients with severe walking impairment, multiple falls were more common in the group receiving early locomotor training than in the other two groups (P=0.02). Locomotor training, including the use of body-weight support in stepping on a treadmill, was not shown to be superior to progressive exercise at home managed by a physical therapist. (Funded by the National Institute of Neurological Disorders and Stroke and the National Center for Medical Rehabilitation Research; LEAPS ClinicalTrials.gov number, NCT00243919.).

A Novel Treadmill with a Function of Simulating Walkway-Walking

NASA Astrophysics Data System (ADS)

Funabiki, Shigeyuki; Nishiyama, Shinji; Tanaka, Toshihiko; Fujihara, Jun-Ichi; Maniwa, Sokichi; Sakai, Yasuo

There are differences between walkway walking and walking on a treadmill. It is considered that these differences are based on the fact that the walking on the treadmill is a passive motion, while the walkway walking is an active motion. The differences in walking between on a floor and on a treadmill are investigated using the electromyograph and on the oral questionnaires from subjects. The obtained knowledge is as follows. (1) The muscular activity of the legs in walking on the treadmill without the tractive force is smaller than that in walking on the floor. (2) The walking on the treadmill with 60% of the tractive force being equivalent to the walkway walking from the rear downward of 30 degrees becomes similar to the usual walking on the floor. This paper proposes a novel treadmill with a function of simulating walkway-walking. The developed treadmill has a walking-load device towing the subject from the rear downward and controlling the walking speed according to the position of subject on the treadmill. The verification experiment of walking on the developed treadmill shows the availability to gait training and rehabilitation.

Development of Training Programs to Optimize Planetary Ambulation

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Mulavara, A. P.; Peters, B. T.; Cohen, H. S.; Miller, C. A.; Brady, R.; Warren, L. E.; Rutley, T. M.; Kozlovskaya, I. B.

2007-01-01

Astronauts experience disturbances in functional mobility following their return to Earth due to adaptive responses that occur during exposure to the microgravity conditions of space flight. Despite significant time spent performing in-flight exercise routines, these training programs have not been able to mitigate postflight alterations in postural and locomotor function. Therefore, the goal of our two inter-related projects (NSBRI-ground based and ISS flight study, "Mobility") is to develop and test gait training programs that will serve to optimize functional mobility during the adaptation period immediately following space flight, thereby improving the safety and efficiency of planetary ambulation. The gait training program entails manipulating the sensory conditions of treadmill exercise to systematically challenge the balance and gait control system. This enhances the overall adaptability of locomotor function enabling rapid reorganization of gait control to respond to ambulation in different gravitational environments. To develop the training program, we are conducting a series of ground-based studies evaluating the training efficacy associated with variation in visual flow, body loading, and support surface stability during treadmill walking. We will also determine the optimal method to present training stimuli within and across training sessions to maximize both the efficacy and efficiency of the training procedure. Results indicate that variations in both visual flow and body unloading during treadmill walking leads to modification in locomotor control and can be used as effective training modalities. Additionally, the composition and timing of sensory challenges experienced during each training session has significant impact on the ability to rapidly reorganize locomotor function when exposed to a novel sensory environment. We have developed the capability of producing support surface variation during gait training by mounting a treadmill on a six-degree-of-freedom motion device. This hardware development will allow us to evaluate the efficacy of this type of training in conjunction with variation in visual flow and body unloading.

Treadmill training as an augmentation treatment for Alzheimer's disease: a pilot randomized controlled study.

PubMed

Arcoverde, Cynthia; Deslandes, Andrea; Moraes, Helena; Almeida, Cloyra; Araujo, Narahyana Bom de; Vasques, Paulo Eduardo; Silveira, Heitor; Laks, Jerson

2014-03-01

To assess the effect of aerobic exercise on the cognition and functional capacity in Alzheimer's disease (AD) patients. Elderly (n=20) with mild dementia (NINCDS-ADRDA/CDR1) were randomly assigned to an exercise group (EG) on a treadmill (30 minutes, twice a week and moderate intensity of 60% VO₂max) and control group (GC) 10 patients. The primary outcome measure was the cognitive function using Cambridge Cognitive Examination (CAMCOG). Specifics instruments were also applied to evaluate executive function, memory, attention and concentration, cognitive flexibility, inhibitory control and functional capacity. After 16 weeks, the EG showed improvement in cognition CAMCOG whereas the CG declined. Compared to the CG, the EG presented significant improvement on the functional capacity. The analysis of the effect size has shown a favorable response to the physical exercise in all dependent variables. Walking on treadmill may be recommended as an augmentation treatment for patients with AD.

Upslope treadmill exercise enhances motor axon regeneration but not functional recovery following peripheral nerve injury

PubMed Central

Cannoy, Jill; Crowley, Sam; Jarratt, Allen; Werts, Kelly LeFevere; Osborne, Krista; Park, Sohee

2016-01-01

Following peripheral nerve injury, moderate daily exercise conducted on a level treadmill results in enhanced axon regeneration and modest improvements in functional recovery. If the exercise is conducted on an upwardly inclined treadmill, even more motor axons regenerate successfully and reinnervate muscle targets. Whether this increased motor axon regeneration also results in greater improvement in functional recovery from sciatic nerve injury was studied. Axon regeneration and muscle reinnervation were studied in Lewis rats over an 11 wk postinjury period using stimulus evoked electromyographic (EMG) responses in the soleus muscle of awake animals. Motor axon regeneration and muscle reinnervation were enhanced in slope-trained rats. Direct muscle (M) responses reappeared faster in slope-trained animals than in other groups and ultimately were larger than untreated animals. The amplitude of monosynaptic H reflexes recorded from slope-trained rats remained significantly smaller than all other groups of animals for the duration of the study. The restoration of the amplitude and pattern of locomotor EMG activity in soleus and tibialis anterior and of hindblimb kinematics was studied during treadmill walking on different slopes. Slope-trained rats did not recover the ability to modulate the intensity of locomotor EMG activity with slope. Patterned EMG activity in flexor and extensor muscles was not noted in slope-trained rats. Neither hindblimb length nor limb orientation during level, upslope, or downslope walking was restored in slope-trained rats. Slope training enhanced motor axon regeneration but did not improve functional recovery following sciatic nerve transection and repair. PMID:27466130

Virtual Reality as a Medium for Sensorimotor Adaptation Training and Spaceflight Countermeasures

NASA Technical Reports Server (NTRS)

Madansingh, S.; Bloomberg, J. J.

2015-01-01

With the upcoming shift to extra-long duration missions (1 year) aboard the ISS, sensorimotor adaptations during transitory periods in-and-out of microgravity are more important to understand and prepare for. Advances in virtual reality technology enables everyday adoption of these tools for entertainment and use in training. Experiencing virtual environments (VE) allows for the manipulation of visual flow to elicit automatic motor behavior and produce sensorimotor adaptation (SA). Recently, the ability to train individuals using repeatable and varied exposures to SA challenges has shown success by improving performance during exposure to a novel environment (Batson 2011). This capacity to 'learn to learn' is referred to as sensorimotor adaptive generalizability and, through the use of treadmill training, represents an untapped potential for individualized countermeasures. The goal of this study is to determine the feasibility of present head mounted displays (HMDs) to produce compelling visual flow information and the expected adaptations for use in future SA treadmill-based countermeasures. Participants experience infinite hallways providing congruent (baseline) or incongruent visual information (half or double speed) via HMD while walking on an instrumented treadmill at 1.1m/s. As gait performance approaches baseline levels, an adaptation time constant is derived to establish individual time-to-adapt (TTA). It is hypothesized that decreasing the TTA through SA treadmill training will facilitate sensorimotor adaptation during gravitational transitions. In this way, HMD technology represents a novel platform for SA training using off-the-shelf consumer products for greater training flexibility in astronaut and terrestrial applications alike.

Countermeasures to Enhance Sensorimotor Adaptability

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Peters, B. T.; Mulavara, A. P.; Brady, R. A.; Batson, C. C.; Miller, C. A.; Cohen, H. S.

2011-01-01

During exploration-class missions, sensorimotor disturbances may lead to disruption in the ability to ambulate and perform functional tasks during the initial introduction to a novel gravitational environment following a landing on a planetary surface. The goal of our current project is to develop a sensorimotor adaptability (SA) training program to facilitate rapid adaptation to novel gravitational environments. We have developed a unique training system comprised of a treadmill placed on a motion-base facing a virtual visual scene that provides an unstable walking surface combined with incongruent visual flow designed to enhance sensorimotor adaptability. We have conducted a series of studies that have shown: Training using a combination of modified visual flow and support surface motion during treadmill walking enhances locomotor adaptability to a novel sensorimotor environment. Trained individuals become more proficient at performing multiple competing tasks while walking during adaptation to novel discordant sensorimotor conditions. Trained subjects can retain their increased level of adaptability over a six months period. SA training is effective in producing increased adaptability in a more complex over-ground ambulatory task on an obstacle course. This confirms that for a complex task like walking, treadmill training contains enough of the critical features of overground walking to be an effective training modality. The structure of individual training sessions can be optimized to promote fast/strategic motor learning. Training sessions that each contain short-duration exposures to multiple perturbation stimuli allows subjects to acquire a greater ability to rapidly reorganize appropriate response strategies when encountering a novel sensory environment. Individual sensory biases (i.e. increased visual dependency) can predict adaptive responses to novel sensory environments suggesting that customized training prescriptions can be developed to enhance adaptability. These results indicate that SA training techniques can be added to existing treadmill exercise equipment and procedures to produce a single integrated countermeasure system to improve performance of astro/cosmonauts during prolonged exploratory space missions.

Outcome of patients after lower limb fracture with partial weight bearing postoperatively treated with or without anti-gravity treadmill (alter G®) during six weeks of rehabilitation - a protocol of a prospective randomized trial.

PubMed

Henkelmann, Ralf; Schneider, Sebastian; Müller, Daniel; Gahr, Ralf; Josten, Christoph; Böhme, Jörg

2017-03-14

Partial or complete immobilization leads to different adjustment processes like higher risk of muscle atrophy or a decrease of general performance. The present study is designed to prove efficacy of the anti-gravity treadmill (alter G®) compared to a standard rehabilitation protocol in patients with tibial plateau (group 1)or ankle fractures (group 2) with six weeks of partial weight bearing of 20 kg. This prospective randomized study will include a total of 60 patients for each group according to predefined inclusion and exclusion criteria. 1:1 randomization will be performed centrally via fax supported by the Clinical Trial Centre Leipzig (ZKS Leipzig). Patients in the treatment arm will be treated with an anti-gravity treadmill (alter G®) instead of physiotherapy. The protocol is designed parallel to standard physiotherapy with a frequency of two to three times of training with the treadmill per week with duration of 20 min for six weeks. Up to date no published randomized controlled trial with an anti-gravity treadmill is available. The findings of this study can help to modify rehabilitation of patients with partial weight bearing due to their injury or postoperative protocol. It will deliver interesting results if an anti-gravity treadmill is useful in rehabilitation in those patients. Further ongoing studies will identify different indications for an anti-gravity treadmill. Thus, in connection with those studies, a more valid statement regarding safety and efficacy is possible. NCT02790229 registered on May 29, 2016.

Recovery of forward stepping in spinal cord injured patients does not transfer to untrained backward stepping.

PubMed

Grasso, Renato; Ivanenko, Yuri P; Zago, Myrka; Molinari, Marco; Scivoletto, Giorgio; Lacquaniti, Francesco

2004-08-01

Six spinal cord injured (SCI) patients were trained to step on a treadmill with body-weight support for 1.5-3 months. At the end of training, foot motion recovered the shape and the step-by-step reproducibility that characterize normal gait. They were then asked to step backward on the treadmill belt that moved in the opposite direction relative to standard forward training. In contrast to healthy subjects, who can immediately reverse the direction of walking by time-reversing the kinematic waveforms, patients were unable to step backward. Similarly patients were unable to perform another untrained locomotor task, namely stepping in place on the idle treadmill. Two patients who were trained to step backward for 2-3 weeks were able to develop control of foot motion appropriate for this task. The results show that locomotor improvement does not transfer to untrained tasks, thus supporting the idea of task-dependent plasticity in human locomotor networks.

Changes of pelvis control with subacute stroke: A comparison of body-weight- support treadmill training coupled virtual reality system and over-ground training.

PubMed

Mao, Yurong; Chen, Peiming; Li, Lifang; Li, Le; Huang, Dongfeng

2015-01-01

Gait recovery is very important to stroke survivors to regain their independence in activity of daily life. This study aimed to investigate the effects of virtual reality (VR) coupled body weight support treadmill training (BWSTT) on pelvic control at the early stage of stroke. Kinematic and kinetic changes of pelvic motion were evaluated by a 3D gait analysis system and were compared to the results from over-ground walking training. Twenty-four patients having unilateral hemiplegia with subacute stroke were recruited to a VR coupled BWSTT group (n= 12) and a conventional therapy (CT) group (n= 12). Both of the groups received training of 20-40 min/day, 5 days/week, for 3 weeks. The results showed the tilt of pelvis in sagittal plane improved significantly (P= 0.038) after treatment in the BWSTT+VR group, in terms of decreased amplitude of anterior peak (mean, from 10.99° to 6.25°), while there were no significant differences in the control group. The findings suggested that VR coupled BWSTT gait training could decrease anterior tilt of pelvis in early hemiparetic persons following a modest intervention dose, and the training may have advantages over conventional over-ground gait training and can assist the therapists in correcting abnormal gait pattern of stroke survivors.

Active Video Games as a Training Tool for Individuals With Chronic Respiratory Diseases: A SYSTEMATIC REVIEW.

PubMed

Butler, Stacey J; Lee, Annemarie L; Goldstein, Roger S; Brooks, Dina

2018-02-26

Exercise is an effective treatment for reducing symptom severity and improving quality of life for patients with chronic respiratory diseases. Active video games offer a new and enjoyable way to exercise and have gained popularity in a rehabilitation setting. However, it is unclear whether they achieve comparable physiological and clinical effects as traditional exercise training. A systematic literature search was performed to identify studies that included an active video game component as a form of exercise training and a comparator group in chronic respiratory disease. Two assessors independently reviewed study quality using the Cochrane risk of bias tool and extracted data for exercise capacity, quality of life, and preference of exercise model. Six studies were included in this review. Because of the heterogeneity of the populations, study designs, length of intervention, and outcome measures, meta-analysis could not be performed. Active video game training resulted in comparable training maximal heart rate and dyspnea levels to those achieved when exercising using a treadmill or cycle (n = 5). There was insufficient evidence (n = 3) to determine whether active video game training improved exercise capacity as measured by 6-min walk test or treadmill endurance walking. Although the quality of evidence was low, in a small number of studies active video games induced peak heart rates and dyspnea levels comparable with traditional exercise training. Larger and longer-term randomized controlled trials are needed to establish the impact of video game training for individuals with chronic respiratory diseases.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

The Effect of Body Weight Support Treadmill Training on Gait Recovery, Proximal Lower Limb Motor Pattern, and Balance in Patients with Subacute Stroke

PubMed Central

Lo, Wai Leung; Lin, Qiang; Xiao, Xiang; Raghavan, Preeti; Huang, Dong-Feng

2015-01-01

Objective. Gait performance is an indicator of mobility impairment after stroke. This study evaluated changes in balance, lower extremity motor function, and spatiotemporal gait parameters after receiving body weight supported treadmill training (BWSTT) and conventional overground walking training (CT) in patients with subacute stroke using 3D motion analysis. Setting. Inpatient department of rehabilitation medicine at a university-affiliated hospital. Participants. 24 subjects with unilateral hemiplegia in the subacute stage were randomized to the BWSTT (n = 12) and CT (n = 12) groups. Parameters were compared between the two groups. Data from twelve age matched healthy subjects were recorded as reference. Interventions. Patients received gait training with BWSTT or CT for an average of 30 minutes/day, 5 days/week, for 3 weeks. Main Outcome Measures. Balance was measured by the Brunel balance assessment. Lower extremity motor function was evaluated by the Fugl-Meyer assessment scale. Kinematic data were collected and analyzed using a gait capture system before and after the interventions. Results. Both groups improved on balance and lower extremity motor function measures (P < 0.05), with no significant difference between the two groups after intervention. However, kinematic data were significantly improved (P < 0.05) after BWSTT but not after CT. Maximum hip extension and flexion angles were significantly improved (P < 0.05) for the BWSTT group during the stance and swing phases compared to baseline. Conclusion. In subacute patients with stroke, BWSTT can lead to improved gait quality when compared with conventional gait training. Both methods can improve balance and motor function. PMID:26649295

The Effect of Body Weight Support Treadmill Training on Gait Recovery, Proximal Lower Limb Motor Pattern, and Balance in Patients with Subacute Stroke.

PubMed

Mao, Yu-Rong; Lo, Wai Leung; Lin, Qiang; Li, Le; Xiao, Xiang; Raghavan, Preeti; Huang, Dong-Feng

2015-01-01

Gait performance is an indicator of mobility impairment after stroke. This study evaluated changes in balance, lower extremity motor function, and spatiotemporal gait parameters after receiving body weight supported treadmill training (BWSTT) and conventional overground walking training (CT) in patients with subacute stroke using 3D motion analysis. Inpatient department of rehabilitation medicine at a university-affiliated hospital. 24 subjects with unilateral hemiplegia in the subacute stage were randomized to the BWSTT (n = 12) and CT (n = 12) groups. Parameters were compared between the two groups. Data from twelve age matched healthy subjects were recorded as reference. Patients received gait training with BWSTT or CT for an average of 30 minutes/day, 5 days/week, for 3 weeks. Balance was measured by the Brunel balance assessment. Lower extremity motor function was evaluated by the Fugl-Meyer assessment scale. Kinematic data were collected and analyzed using a gait capture system before and after the interventions. Both groups improved on balance and lower extremity motor function measures (P < 0.05), with no significant difference between the two groups after intervention. However, kinematic data were significantly improved (P < 0.05) after BWSTT but not after CT. Maximum hip extension and flexion angles were significantly improved (P < 0.05) for the BWSTT group during the stance and swing phases compared to baseline. In subacute patients with stroke, BWSTT can lead to improved gait quality when compared with conventional gait training. Both methods can improve balance and motor function.

Partial Body Weight-Supported Treadmill Training in Spinocerebellar Ataxia.

PubMed

de Oliveira, Laura Alice Santos; Martins, Camilla Polonini; Horsczaruk, Carlos Henrique Ramos; da Silva, Débora Cristina Lima; Vasconcellos, Luiz Felipe; Lopes, Agnaldo José; Meira Mainenti, Míriam Raquel; Rodrigues, Erika de Carvalho

2018-01-01

The motor impairments related to gait and balance have a huge impact on the life of individuals with spinocerebellar ataxia (SCA). Here, the aim was to assess the possibility of retraining gait, improving cardiopulmonary capacity, and challenging balance during gait in SCA using a partial body weight support (BWS) and a treadmill. Also, the effects of this training over functionality and quality of life were investigated. Eight SCA patients were engaged in the first stage of the study that focused on gait training and cardiovascular conditioning. From those, five took part in a second stage of the study centered on dynamic balance training during gait. The first and second stages lasted 8 and 10 weeks, respectively, both comprising sessions of 50 min (2 times per week). The results showed that gait training using partial BWS significantly increased gait performance, treadmill inclination, duration of exercise, and cardiopulmonary capacity in individuals with SCA. After the second stage, balance improvements were also found. Combining gait training and challenging tasks to the postural control system in SCA individuals is viable, well tolerated by patients with SCA, and resulted in changes in capacity for walking and balance.

Partial Body Weight-Supported Treadmill Training in Spinocerebellar Ataxia

PubMed Central

Martins, Camilla Polonini; Horsczaruk, Carlos Henrique Ramos; da Silva, Débora Cristina Lima; Meira Mainenti, Míriam Raquel; Rodrigues, Erika de Carvalho

2018-01-01

Background and Purpose The motor impairments related to gait and balance have a huge impact on the life of individuals with spinocerebellar ataxia (SCA). Here, the aim was to assess the possibility of retraining gait, improving cardiopulmonary capacity, and challenging balance during gait in SCA using a partial body weight support (BWS) and a treadmill. Also, the effects of this training over functionality and quality of life were investigated. Methods Eight SCA patients were engaged in the first stage of the study that focused on gait training and cardiovascular conditioning. From those, five took part in a second stage of the study centered on dynamic balance training during gait. The first and second stages lasted 8 and 10 weeks, respectively, both comprising sessions of 50 min (2 times per week). Results The results showed that gait training using partial BWS significantly increased gait performance, treadmill inclination, duration of exercise, and cardiopulmonary capacity in individuals with SCA. After the second stage, balance improvements were also found. Conclusion Combining gait training and challenging tasks to the postural control system in SCA individuals is viable, well tolerated by patients with SCA, and resulted in changes in capacity for walking and balance. PMID:29535874

Energetic cost of locomotion on different equine treadmills.

PubMed

Jones, J H; Ohmura, H; Stanley, S D; Hiraga, A

2006-08-01

Human athletes run faster and experience fewer injuries when running on surfaces with a stiffness 'tuned' to their bodies. We questioned if the same might be true for horses, and if so, would running on surfaces of different stiffness cause a measurable change in the amount of energy required to move at a given speed? Different brands of commercial treadmills have pans of unequal stiffness, and this difference would result in different metabolic power requirements to locomote at a given speed. We tested for differences in stiffness between a Mustang 2200 and a Säto I commercial treadmill by incrementally loading each treadmill near the centre of the pan with fixed weights and measuring the displacement of the pan as weights were added or removed from the pan. We trained six 3-year-old Thoroughbreds to run on the 2 treadmills. After 4 months the horses ran with reproducible specific maximum rates of O2 consumption (VO2max/kg bwt, 2.62 +/- 0.23 (s.d.) mlO2 STPD/sec/kg) at 14.2 +/- 0.7 (s.d.) m/sec. They were alternately run on the 2 treadmills at identical grade (0.40 +/- 0.02%) and speeds (1.83 (walk), 4.0 (trot) and 8.0 (canter) m/sec, all +/- 0.03 m/sec) while wearing an open-flow mask for measurement of VO2. The Mustang treadmill was over 6 times stiffer than the Säto. The VO2/kg bwt increased by approximately 4-fold over the range of speeds studied on both treadmills. Oxygen consumption was significantly lower at all speeds for the Mustang treadmill compared to the Säto. The fractional difference in energy cost decreased by a factor of 6 with increasing speed, although absolute difference in cost was relatively constant. We suggest it costs less energy for horses to walk, trot or canter on a stiffer treadmill than on a more compliant treadmill, at least within the ranges of stiffness evaluated. It may be possible to define a substrate stiffness 'tuned' to a horse's body enabling maximal energetic economy when running. The differences between treadmills allows more accurate comparisons between physiological studies conducted on treadmills of different stiffness, and might help to identify an ideal track stiffness to reduce locomotor injuries in equine athletes.

A forced running wheel system with a microcontroller that provides high-intensity exercise training in an animal ischemic stroke model.

PubMed

Chen, C C; Chang, M W; Chang, C P; Chan, S C; Chang, W Y; Yang, C L; Lin, M T

2014-10-01

We developed a forced non-electric-shock running wheel (FNESRW) system that provides rats with high-intensity exercise training using automatic exercise training patterns that are controlled by a microcontroller. The proposed system successfully makes a breakthrough in the traditional motorized running wheel to allow rats to perform high-intensity training and to enable comparisons with the treadmill at the same exercise intensity without any electric shock. A polyvinyl chloride runway with a rough rubber surface was coated on the periphery of the wheel so as to permit automatic acceleration training, and which allowed the rats to run consistently at high speeds (30 m/min for 1 h). An animal ischemic stroke model was used to validate the proposed system. FNESRW, treadmill, control, and sham groups were studied. The FNESRW and treadmill groups underwent 3 weeks of endurance running training. After 3 weeks, the experiments of middle cerebral artery occlusion, the modified neurological severity score (mNSS), an inclined plane test, and triphenyltetrazolium chloride were performed to evaluate the effectiveness of the proposed platform. The proposed platform showed that enhancement of motor function, mNSS, and infarct volumes was significantly stronger in the FNESRW group than the control group (P<0.05) and similar to the treadmill group. The experimental data demonstrated that the proposed platform can be applied to test the benefit of exercise-preconditioning-induced neuroprotection using the animal stroke model. Additional advantages of the FNESRW system include stand-alone capability, independence of subjective human adjustment, and ease of use.

A forced running wheel system with a microcontroller that provides high-intensity exercise training in an animal ischemic stroke model

PubMed Central

Chen, C.C.; Chang, M.W.; Chang, C.P.; Chan, S.C.; Chang, W.Y.; Yang, C.L.; Lin, M.T.

2014-01-01

We developed a forced non-electric-shock running wheel (FNESRW) system that provides rats with high-intensity exercise training using automatic exercise training patterns that are controlled by a microcontroller. The proposed system successfully makes a breakthrough in the traditional motorized running wheel to allow rats to perform high-intensity training and to enable comparisons with the treadmill at the same exercise intensity without any electric shock. A polyvinyl chloride runway with a rough rubber surface was coated on the periphery of the wheel so as to permit automatic acceleration training, and which allowed the rats to run consistently at high speeds (30 m/min for 1 h). An animal ischemic stroke model was used to validate the proposed system. FNESRW, treadmill, control, and sham groups were studied. The FNESRW and treadmill groups underwent 3 weeks of endurance running training. After 3 weeks, the experiments of middle cerebral artery occlusion, the modified neurological severity score (mNSS), an inclined plane test, and triphenyltetrazolium chloride were performed to evaluate the effectiveness of the proposed platform. The proposed platform showed that enhancement of motor function, mNSS, and infarct volumes was significantly stronger in the FNESRW group than the control group (P<0.05) and similar to the treadmill group. The experimental data demonstrated that the proposed platform can be applied to test the benefit of exercise-preconditioning-induced neuroprotection using the animal stroke model. Additional advantages of the FNESRW system include stand-alone capability, independence of subjective human adjustment, and ease of use. PMID:25140816

Effects of High-Velocity Circuit Resistance and Treadmill Training on Cardiometabolic Risk, Blood Markers, and Quality of Life in Older Adults.

PubMed

Roberson, Kirk B; Potiaumpai, Melanie; Widdowson, Kayla; Jaghab, Annmarie; Chowdhari, Sean; Armitage, Catherine; Seeley, Afton D; Jacobs, Kevin A; Signorile, Joseph F

2018-03-14

The presence of cardiometabolic syndrome (CMS) infers an increased risk for cardiovascular incidence and mortality, and is associated with reduced health-related quality of life (HRQoL). Although the effects of exercise on biomarkers, HRQoL, and future risk have been studied; no study has measured the effects on all three components. The present study compared the effects of steady-state, moderate-intensity treadmill training (TM) and high-velocity circuit resistance training (HVCRT) on biological markers, HRQoL, and overall CVD risk in adults with CMS and CVD risk factors. Thirty participants (22 F; 8 M) were randomly assigned to one of three groups: HVCRT, TM, or control. Participants in exercise groups attended training 3 days/wk for a total of 12 weeks. Of the thirty participants who began the study, twenty-four (19 F; 5 M) were included in the final analysis. Primary outcome measures included CMS criteria, hemodynamic measures, Framingham Risk Score (FRS), and HRQoL. All variables were measured pre- and post-intervention. CMS z score significantly decreased for HVCRT (p=0.03), with no significant changes for TM or control. FRS significantly decreased in HVCRT compared to TM (p= 0.03) and control (p=0.03). Significant decreases in systolic (p<0.01) and diastolic blood pressures (p<0.01) for HVCRT accompanied significant increases from baseline in stroke volume (p=0.03) and end-diastolic volume (p<0.01). Systemic vascular resistance significantly decreased (p=0.05) for HVCRT compared to control. Emotional well-being significantly improved following HVCRT and TM compared to control (p=0.04; p=0.03). HVCRT represents a novel training modality that improved factors in each of the three components assessed.

Blood lactate thresholds and walking/running economy are determinants of backpack-running performance in trained soldiers.

PubMed

Simpson, Richard J; Graham, Scott M; Connaboy, Christopher; Clement, Richard; Pollonini, Luca; Florida-James, Geraint D

2017-01-01

We developed a standardized laboratory treadmill protocol for assessing physiological responses to a simulated backpack load-carriage task in trained soldiers, and assessed the efficacy of blood lactate thresholds (LTs) and economy in predicting future backpack running success over an 8-mile course in field conditions. LTs and corresponding physiological responses were determined in 17 elite British soldiers who completed an incremental treadmill walk/run protocol to exhaustion carrying 20 kg backpack load. Treadmill velocity at the breakpoint (r = -0.85) and Δ 1 mmol l(-1) (r = -0.80) LTs, and relative V˙O2 at 4 mmol l(-1) (r = 0.76) and treadmill walk/run velocities of 6.4 (r = 0.76), 7.4 (r = 0.80), 11.4 (r = 0.66) and 12.4 (r = 0.65) km h(-1) were significantly associated with field test completion time. We report for the first time that LTs and backpack walk/run economy are major determinants of backpack load-carriage performance in trained soldiers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of body-weight supported treadmill training on kinetic symmetry in persons with chronic stroke.

PubMed

Combs, Stephanie A; Dugan, Eric L; Ozimek, Elicia N; Curtis, Amy B

2012-11-01

The purpose was to examine changes in kinetic symmetry in persons with chronic stroke immediately and 6-months after body-weight supported treadmill training. Fifteen participants at least six-months post stroke and able to ambulate between 0.4 and 0.8m/s and 20 participants without neurological conditions completed all phases of the study and were included in the analysis. The non-disabled group served as a comparison for describing changes in kinetic symmetry. The stroke group completed 24 sessions of body-weight supported treadmill training over 8-weeks with 20 minutes of total walking per session. Bilateral 3-dimensional motion analysis and gait speed were assessed 1-week before training (pre-test), 1-week after training (post-test) and 6-months after training (retention) in a repeated measures design. Relative propulsion of the paretic leg and relative positive work of the hip, knee and ankle joints of both legs were calculated to evaluate symmetry of kinetic forces. Statistically significant differences in relative propulsion and positive joint work within the paretic and non-paretic legs were not found over time. The stroke group significantly improved gait speed from pre- to post-test (p=.001) and pre-test to retention (p=.008). In comparison to the non-disabled group, forces produced by the stroke group were asymmetrical demonstrating compensatory adaptation. Although the participants with chronic stroke walked faster after body-weight supported treadmill training, the relative percentages of propulsion and positive work remained unchanged. These findings suggest that the increase in speed was likely due to strengthening existing compensatory strategies rather than through recovery of normal kinetic symmetry. Copyright © 2012 Elsevier Ltd. All rights reserved.

The impact of an anti-gravity treadmill (AlterG) training on walking capacity and corticospinal tract structure in children with cerebral palsy.

PubMed

Azizi, Sh; Marzbani, H; Raminfard, S; Birgani, P M; Rasooli, A H; Mirbagheri, M M

2017-07-01

We studied the effects of an anti-gravity treadmill (AlterG) training on walking capacity and corticospinal tract structure in children with Cerebral Palsy (CP). AlterG can help CP children walk on the treadmill by reducing their weights up to 80% and maintain their balance during locomotion. AlterG training thus has the potential to improve walking capacity permanently as it can provide systematic and intense locomotor training for sufficiently long period of time and produce brain neuroplasticity. AlterG training was given for 45 minutes, three times a week for two months. The neuroplasticity of corticospinal tract was evaluated using Diffusion Tensor Imaging (DTI). The fractional Anisotropy (FA) feature was extracted to quantify structural changes of the corticospinal tract. Walking capacity was evaluated using popular clinical measurements of gait; i.e., walking speed, mobility and balance. The evaluations were done before and after training. Our results revealed that AlterG training resulted in an increase in average FA value of the corticospinal tract following the training. The outcome measures of clinical assessments of gait presented enhanced walking capacity of the CP subjects. Our findings indicated that the improved walking capacity was concurrent with the enhancement of the corticospinal tract structure. The clinical implication is that AlterG training may be considered as a therapeutic tool for permanent gait improvement in CP children.

Body Weight–Supported Treadmill Training Is No Better Than Overground Training for Individuals with Chronic Stroke: A Randomized Controlled Trial

PubMed Central

Middleton, Addie; Merlo-Rains, Angela; Peters, Denise M.; Greene, Jennifaye V.; Blanck, Erika L.; Moran, Robert; Fritz, Stacy L.

2014-01-01

Background Body weight–supported treadmill training (BWSTT) has produced mixed results compared with other therapeutic techniques. Objective The purpose of this study was to determine whether an intensive intervention (intensive mobility training) including BWSTT provides superior gait, balance, and mobility outcomes compared with a similar intervention with overground gait training in place of BWSTT. Methods Forty-three individuals with chronic stroke (mean [SD] age, 61.5 [13.5] years; mean [SD] time since stroke, 3.3 [3.8] years), were randomized to a treatment (BWSTT, n = 23) or control (overground gait training, n = 20) group. Treatment consisted of 1 hour of gait training; 1 hour of balance activities; and 1 hour of strength, range of motion, and coordination for 10 consecutive weekdays (30 hours). Assessments (step length differential, self-selected and fast walking speed, 6-minute walk test, Berg Balance Scale [BBS], Dynamic Gait Index [DGI], Activities-specific Balance Confidence [ABC] scale, single limb stance, Timed Up and Go [TUG], Fugl-Meyer [FM], and perceived recovery [PR]) were conducted before, immediately after, and 3 months after intervention. Results No significant differences (α = 0.05) were found between groups after training or at follow-up; therefore, groups were combined for remaining analyses. Significant differences (α = 0.05) were found pretest to posttest for fast walking speed, BBS, DGI, ABC, TUG, FM, and PR. DGI, ABC, TUG, and PR results remained significant at follow-up. Effect sizes were small to moderate in the direction of improvement. Conclusions Future studies should investigate the effectiveness of intensive interventions of durations greater than 10 days for improving gait, balance, and mobility in individuals with chronic stroke. PMID:25467394

Body weight-supported treadmill training is no better than overground training for individuals with chronic stroke: a randomized controlled trial.

PubMed

Middleton, Addie; Merlo-Rains, Angela; Peters, Denise M; Greene, Jennifaye V; Blanck, Erika L; Moran, Robert; Fritz, Stacy L

2014-01-01

Body weight-supported treadmill training (BWSTT) has produced mixed results compared with other therapeutic techniques. The purpose of this study was to determine whether an intensive intervention (intensive mobility training) including BWSTT provides superior gait, balance, and mobility outcomes compared with a similar intervention with overground gait training in place of BWSTT. Forty-three individuals with chronic stroke (mean [SD] age, 61.5 [13.5] years; mean [SD] time since stroke, 3.3 [3.8] years), were randomized to a treatment (BWSTT, n = 23) or control (overground gait training, n = 20) group. Treatment consisted of 1 hour of gait training; 1 hour of balance activities; and 1 hour of strength, range of motion, and coordination for 10 consecutive weekdays (30 hours). Assessments (step length differential, self-selected and fast walking speed, 6-minute walk test, Berg Balance Scale [BBS], Dynamic Gait Index [DGI], Activities-specific Balance Confidence [ABC] scale, single limb stance, Timed Up and Go [TUG], Fugl-Meyer [FM], and perceived recovery [PR]) were conducted before, immediately after, and 3 months after intervention. No significant differences (α = 0.05) were found between groups after training or at follow-up; therefore, groups were combined for remaining analyses. Significant differences (α = 0.05) were found pretest to posttest for fast walking speed, BBS, DGI, ABC, TUG, FM, and PR. DGI, ABC, TUG, and PR results remained significant at follow-up. Effect sizes were small to moderate in the direction of improvement. Future studies should investigate the effectiveness of intensive interventions of durations greater than 10 days for improving gait, balance, and mobility in individuals with chronic stroke.

Effects of Antigravity Treadmill Training on Gait, Balance, and Fall Risk in Children With Diplegic Cerebral Palsy.

PubMed

El-Shamy, Shamekh Mohamed

2017-11-01

The aim of this study was to investigate the effects of antigravity treadmill training on gait, balance, and fall risk in children with diplegic cerebral palsy. Thirty children with diplegic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received antigravity treadmill training (20 mins/d, 3 d/wk) together with traditional physical therapy for 3 successive mos and (2) a control group that received only traditional physical therapy program for the same period. Outcomes included selected gait parameters, postural stability, and fall risk. Outcomes were measured at baseline and after 3 mos of intervention. Children in both groups showed significant improvements in the mean values of all measured variables (P < 0.05), with significantly greater improvements in the experimental group than the control group. The posttreatment gait parameters (i.e., velocity, stride length, cadence, and percent of time spent in double-limb support) were 0.74 m/sec, 119 steps/min, 0.75 m/sec, 0.65 sec, and 55.9% as well as 0.5 m, 125 steps/min, 0.6 m/sec, 0.49 sec, and 50.4% for the experimental and control group, respectively. Antigravity treadmill training may be a useful tool for improving gait parameters, balance, and fall risk in children with diplegic cerebral palsy.

Powered lower limb orthoses for gait rehabilitation

PubMed Central

Ferris, Daniel P.; Sawicki, Gregory S.; Domingo, Antoinette

2006-01-01

Bodyweight supported treadmill training has become a prominent gait rehabilitation method in leading rehabilitation centers. This type of locomotor training has many functional benefits but the labor costs are considerable. To reduce therapist effort, several groups have developed large robotic devices for assisting treadmill stepping. A complementary approach that has not been adequately explored is to use powered lower limb orthoses for locomotor training. Recent advances in robotic technology have made lightweight powered orthoses feasible and practical. An advantage to using powered orthoses as rehabilitation aids is they allow practice starting, turning, stopping, and avoiding obstacles during overground walking. PMID:16568153

Specific physiological and biomechanical performance in elite, sub-elite and in non-elite male team handball players.

PubMed

Wagner, Herbert; Fuchs, Philip X; von Duvillard, Serge P

2018-01-01

Team handball is a dynamic sport game that is played professionally in numerous countries. However, knowledge about training and competition is based mostly on practical experience due to limited scientific studies. Consequently, the aims of our study were to compare specific physiological and biomechanical performance in elite, sub-elite and in non-elite male team handball players. Thirty-six elite, sub-elite and non-elite male team handball players performed a game based performance test, upper-body and lower-body strength tests, 30-m sprint test, counter movement jump test and an incremental treadmill running test. Significant differences (P<0.05) were found for the peak oxygen uptake, heart rate, offense and defense time, jump height and ball velocity during the jump throw in the game based performance test, maximal oxygen uptake in the incremental treadmill running test as well as in maximal leg strength and leg explosive strength in the isometric strength test. Elite male players have an enhanced specific agility, a better throwing performance, a higher team handball specific oxygen uptake and higher leg strength compared to sub-elite and non-elite players. Based on these results we recommend that training in team handball should focus on game based training methods to improve performance in specific agility, endurance and technique.

Effects of virtual reality training on mobility in individuals with Parkinson's disease.

PubMed

Melo, G; Kleiner, A F R; Lopes, J; Zen, G Z D; Marson, N; Santos, T; Dumont, A; Galli, M; Oliveira, C

2018-06-19

The aim of the present study was to evaluate the effects of gait training with virtual reality (VR) on mobility in patients with Parkinson's disease (PD). Thirty-seven individuals with PD were allocated to three groups (control = 12, VR = 12 and treadmill = 13) submitted to 12 twenty-minute training sessions. Evaluations involved the Timed Up and Go (TUG) test before the intervention, after one session, after all 12 sessions and 30 days after the end of the intervention. The groups submitted to VR and treadmill training took less time to execute the TUG test than the control group. Individuals with PD submitted to VR and treadmill gait training presented mobility improvements in comparison to traditional physiotherapeutic training. Copyright © 2018. Published by Elsevier B.V.

On-Orbit Evaluation of a New Treadmill Harness for Improved Crewmember Comfort and Load Distribution

NASA Technical Reports Server (NTRS)

Perusek, G. P.; Sheehan, C. C.; Savina, M. C.; Owings, T. M.; Davis, B. L.; Ryder, J. W.

2011-01-01

The current design of the International Space Station (ISS) Treadmill Harness has been reported to cause pain and discomfort to crewmembers during exercise. The Harness Station Development Test Objective (SDTO) provided participating crewmembers (n = 6) with a new harness design, the "Glenn Harness," to evaluate for comfort and loading as compared to the current Treadmill Harness. A novel suite of load-sensing instrumentation was developed to noninvasively measure load distribution and provided a first-ever quantification of actual dynamic loads during treadmill exercise. In addition, crew debriefs provided feedback on harness preference and overall impressions. Conclusions: Post-flight analysis in returned Glenn Harnesses (n = 3) showed minimal wear and tear. Four of the six subjects found the Glenn Harness to be more comfortable in this on-orbit, side-by-side comparison as measured by the crew comfort questionnaire and crew debriefs. Specific areas for improvement have been identified, and forward recommendations will be provided to the Human Research Program. The protocol developed for the SDTO provided valuable insight into crew comfort issues, design improvements, and loading preferences for exercise harnessing, which lays the groundwork for better harnessing systems and training protocols.

Treadmill Exercise with Increased Body Loading Enhances Post Flight Functional Performance

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Batson, C. D.; Buxton, R. E.; Feiveson, A. H.; Kofman, I. S.; Laurie, S.; Lee, S. M. C.; Miller, C. A.; Mulavara, A. P.; Peters, B. T.;

Development of an Integrated Countermeasure Device for Long Duration Space Flight and Exploration Missions

NASA Technical Reports Server (NTRS)

Lee, S. M. C.; Streeper, T.; Spiering, B. A.; Loehr, J. A.; Guilliams, M. E.; Bloomberg, J. J.; Mulavara, A. P.; Cavanagh, P. R.; Lang, T.

2010-01-01

Musculoskeletal, cardiovascular, and sensorimotor deconditioning have been observed consistently in astronauts and cosmonauts following long-duration spaceflight. Studies in bed rest, a spaceflight analog, have shown that high intensity resistive or aerobic exercise attenuates or prevents musculoskeletal and cardiovascular deconditioning, respectively, but complete protection has not been achieved during spaceflight. Exercise countermeasure hardware used during earlier International Space Station (ISS) missions included a cycle ergometer, a treadmill, and the interim resistive exercise device (iRED). Effectiveness of the countermeasures may have been diminished by limited loading characteristics of the iRED as well as speed restrictions and subject harness discomfort during treadmill exercise. The Advanced Resistive Exercise Device (ARED) and the second generation treadmill were designed to address many of the limitations of their predecessors, and anecdotal reports from ISS crews suggest that their conditioning is better preserved since the new hardware was delivered in 2009. However, several countermeasure devices to protect different physiologic systems will not be practical during exploration missions when the available volume and mass will be severely restricted. The combined countermeasure device (CCD) integrates a suite of hardware into one device intended to prevent spaceflight-induced musculoskeletal, cardiovascular, and sensorimotor deconditioning. The CCD includes pneumatic loading devices with attached cables for resistive exercise, a cycle for aerobic exercise, and a 6 degree of freedom motion platform for balance training. In a proof of concept test, ambulatory untrained subjects increased muscle strength (58%) as well as aerobic capacity (26%) after 12-weeks of exercise training with the CCD (without balance training), improvements comparable to those observed with traditional exercise training. These preliminary results suggest that this CCD can concurrently improve musculoskeletal and cardiovascular conditioning in ambulatory subjects, but further work is required to validate its use as countermeasure to spaceflight-induced deconditioning.

A Challenge-Based Approach to Body Weight-Supported Treadmill Training Poststroke: Protocol for a Randomized Controlled Trial.

PubMed

Naidu, Avantika; Brown, David; Roth, Elliot

2018-05-03

Body weight support treadmill training protocols in conjunction with other modalities are commonly used to improve poststroke balance and walking function. However, typical body weight support paradigms tend to use consistently stable balance conditions, often with handrail support and or manual assistance. In this paper, we describe our study protocol, which involved 2 unique body weight support treadmill training paradigms of similar training intensity that integrated dynamic balance challenges to help improve ambulatory function post stroke. The first paradigm emphasized walking without any handrails or manual assistance, that is, hands-free walking, and served as the control group, whereas the second paradigm incorporated practicing 9 essential challenging mobility skills, akin to environmental barriers encountered during community ambulation along with hands-free walking (ie hands-free + challenge walking). We recruited individuals with chronic poststroke hemiparesis and randomized them to either group. Participants trained for 6 weeks on a self-driven, robotic treadmill interface that provided body weight support and a safe gait-training environment. We assessed participants at pre-, mid- and post 6 weeks of intervention-training, with a 6-month follow-up. We hypothesized greater walking improvements in the hands-free + challenge walking group following training because of increased practice opportunity of essential mobility skills along with hands-free walking. We assessed 77 individuals with chronic hemiparesis, and enrolled and randomized 30 individuals poststroke for our study (hands-free group=19 and hands-free + challenge walking group=20) from June 2012 to January 2015. Data collection along with 6-month follow-up continued until January 2016. Our primary outcome measure is change in comfortable walking speed from pre to post intervention for each group. We will also assess feasibility, adherence, postintervention efficacy, and changes in various exploratory secondary outcome measures. Additionally, we will also assess participant responses to a study survey, conducted at the end of training week, to gauge each group's training experiences. Our treadmill training paradigms, and study protocol represent advances in standardized approaches to selecting body weight support levels without the necessity for using handrails or manual assistance, while progressively providing dynamic challenges for improving poststroke ambulatory function during rehabilitation. ClinicalTrials.gov NCT02787759; https://clinicaltrials.gov/ct2/show/NCT02787759 (Archived by Webcite at http://www.webcitation.org/6yJZCrIea). ©Avantika Naidu, David Brown, Elliot Roth. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 03.05.2018.

Efficacy of Feedback-Controlled Robotics-Assisted Treadmill Exercise to Improve Cardiovascular Fitness Early After Stroke: A Randomized Controlled Pilot Trial

PubMed Central

de Bruin, Eling D.; Schindelholz, Matthias; Schuster-Amft, Corina; de Bie, Rob A.; Hunt, Kenneth J.

2015-01-01

Background and Purpose: Cardiovascular fitness is greatly reduced after stroke. Although individuals with mild to moderate impairments benefit from conventional cardiovascular exercise interventions, there is a lack of effective approaches for persons with severely impaired physical function. This randomized controlled pilot trial investigated efficacy and feasibility of feedback-controlled robotics-assisted treadmill exercise (FC-RATE) for cardiovascular rehabilitation in persons with severe impairments early after stroke. Methods: Twenty individuals (age 61 ± 11 years; 52 ± 31 days poststroke) with severe motor limitations (Functional Ambulation Classification 0-2) were recruited for FC-RATE or conventional robotics-assisted treadmill exercise (RATE) (4 weeks, 3 × 30-minute sessions/wk). Outcome measures focused on peak cardiopulmonary performance parameters, training intensity, and feasibility, with examiners blinded to allocation. Results: All 14 allocated participants (70% of recruited) completed the intervention (7/group, withdrawals unrelated to intervention), without serious adverse events occurring. Cardiovascular fitness increased significantly in both groups, with peak oxygen uptake increasing from 14.6 to 17.7 mL · kg−1 · min−1 (+17.8%) after 4 weeks (45.8%-55.7% of predicted maximal aerobic capacity; time effect P = 0.01; no group-time interaction). Training intensity (% heart rate reserve) was significantly higher for FC-RATE (40% ± 3%) than for conventional RATE (14% ± 2%) (P = 0.001). Discussion and Conclusions: Substantive overall increases in the main cardiopulmonary performance parameters were observed, but there were no significant between-group differences when comparing FC-RATE and conventional RATE. Feedback-controlled robotics-assisted treadmill exercise significantly increased exercise intensity, but recommended intensity levels for cardiovascular training were not consistently achieved. Future research should focus on appropriate algorithms within advanced robotic systems to promote optimal cardiovascular stress. Video abstract available for more insights from the authors (Supplemental Digital Content 1, http://links.lww.com/JNPT/A107). PMID:26050073

Efficacy of Feedback-Controlled Robotics-Assisted Treadmill Exercise to Improve Cardiovascular Fitness Early After Stroke: A Randomized Controlled Pilot Trial.

PubMed

Stoller, Oliver; de Bruin, Eling D; Schindelholz, Matthias; Schuster-Amft, Corina; de Bie, Rob A; Hunt, Kenneth J

2015-07-01

Cardiovascular fitness is greatly reduced after stroke. Although individuals with mild to moderate impairments benefit from conventional cardiovascular exercise interventions, there is a lack of effective approaches for persons with severely impaired physical function. This randomized controlled pilot trial investigated efficacy and feasibility of feedback-controlled robotics-assisted treadmill exercise (FC-RATE) for cardiovascular rehabilitation in persons with severe impairments early after stroke. Twenty individuals (age 61 ± 11 years; 52 ± 31 days poststroke) with severe motor limitations (Functional Ambulation Classification 0-2) were recruited for FC-RATE or conventional robotics-assisted treadmill exercise (RATE) (4 weeks, 3 × 30-minute sessions/wk). Outcome measures focused on peak cardiopulmonary performance parameters, training intensity, and feasibility, with examiners blinded to allocation. All 14 allocated participants (70% of recruited) completed the intervention (7/group, withdrawals unrelated to intervention), without serious adverse events occurring. Cardiovascular fitness increased significantly in both groups, with peak oxygen uptake increasing from 14.6 to 17.7 mL · kg · min (+17.8%) after 4 weeks (45.8%-55.7% of predicted maximal aerobic capacity; time effect P = 0.01; no group-time interaction). Training intensity (% heart rate reserve) was significantly higher for FC-RATE (40% ± 3%) than for conventional RATE (14% ± 2%) (P = 0.001). Substantive overall increases in the main cardiopulmonary performance parameters were observed, but there were no significant between-group differences when comparing FC-RATE and conventional RATE. Feedback-controlled robotics-assisted treadmill exercise significantly increased exercise intensity, but recommended intensity levels for cardiovascular training were not consistently achieved. Future research should focus on appropriate algorithms within advanced robotic systems to promote optimal cardiovascular stress.Video abstract available for more insights from the authors (Supplemental Digital Content 1, http://links.lww.com/JNPT/A107).

The Effects of a 10-day Altitude Training Camp at 1828 Meters on Varsity Cross-Country Runners

PubMed Central

DIEBEL, SEBASTIAN R.; NEWHOUSE, IAN; THOMPSON, DAVID S.; JOHNSON, VINEET B.K.

2017-01-01

Altitude training has been shown to alter blood lactate (BL) levels due to alterations resulting from acclimatization. This study aims to estimate the impact of altitude training on BL changes immediately following an incremental treadmill test and during recovery before and after 10-day altitude training at approximately 1828 meters. Eight varsity cross-country runners performed an incremental treadmill test (ITT), pre and post-altitude training. Resting and post-warm-up BL values were recorded. During ITT, heart rate (HR), oxygen saturation (SpO2), and time to exhaustion were monitored. BL was also measured post-ITT at 0, 2, 4, 6, and 8 minutes. The average of all BL values was higher following altitude intervention (8.8 ± 4.6 mmol/L) compared to pre-intervention (7.4 ± 3.3 mmol/L). These differences were statistically significant (t(6) = −2.40, p = .026). BL immediately (0 minutes) after the ITT was higher following the altitude intervention (13.6 ± 3.6 mmol/L) compared to pre-intervention (9.7 ± 3.8 mmol/L) and was statistically significant (t(7) = −3.30, p = .006). Average HR during the ITT was lower following the altitude intervention (176.9 ± 11.1 bpm) compared to pre (187 ± 9.5 bpm), these differences were statistically significant (t(28)= 18.07, p= <.001. Time to exhaustion was longer after the intervention, however was not statistically significant p = 0.13. These findings indicate that a 10 - day altitude intervention at 1828 meters may benefit varsity cross-country runners. The higher post-exercise BL may be attributed to more anaerobic contributions. Lower HR may suggest a larger stroke volume and/or more efficient O2 carrying capacity. PMID:28479950

Does multicomponent physical exercise with simultaneous cognitive training boost cognitive performance in older adults? A 6-month randomized controlled trial with a 1-year follow-up

PubMed Central

Eggenberger, Patrick; Schumacher, Vera; Angst, Marius; Theill, Nathan; de Bruin, Eling D

2015-01-01

Background Cognitive impairment is a health problem that concerns almost every second elderly person. Physical and cognitive training have differential positive effects on cognition, but have been rarely applied in combination. This study evaluates synergistic effects of multicomponent physical exercise complemented with novel simultaneous cognitive training on cognition in older adults. We hypothesized that simultaneous cognitive–physical components would add training specific cognitive benefits compared to exclusively physical training. Methods Seniors, older than 70 years, without cognitive impairment, were randomly assigned to either: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Cognitive performance was assessed at baseline, after 3 and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were calculated. Results Eighty-nine participants were randomized to the three groups initially, 71 completed the training, while 47 were available at 1-year follow-up. Advantages of the simultaneous cognitive–physical programs were found in two dimensions of executive function. “Shifting attention” showed a time×intervention interaction in favor of DANCE/MEMORY versus PHYS (F[2, 68] =1.95, trend P=0.075, r=0.17); and “working memory” showed a time×intervention interaction in favor of DANCE versus MEMORY (F[1, 136] =2.71, trend P=0.051, R2=0.006). Performance improvements in executive functions, long-term visual memory (episodic memory), and processing speed were maintained at follow-up in all groups. Conclusion Particular executive functions benefit from simultaneous cognitive–physical training compared to exclusively physical multicomponent training. Cognitive–physical training programs may counteract widespread cognitive impairments in the elderly. PMID:26316729

Does multicomponent physical exercise with simultaneous cognitive training boost cognitive performance in older adults? A 6-month randomized controlled trial with a 1-year follow-up.

PubMed

Eggenberger, Patrick; Schumacher, Vera; Angst, Marius; Theill, Nathan; de Bruin, Eling D

2015-01-01

Cognitive impairment is a health problem that concerns almost every second elderly person. Physical and cognitive training have differential positive effects on cognition, but have been rarely applied in combination. This study evaluates synergistic effects of multicomponent physical exercise complemented with novel simultaneous cognitive training on cognition in older adults. We hypothesized that simultaneous cognitive-physical components would add training specific cognitive benefits compared to exclusively physical training. Seniors, older than 70 years, without cognitive impairment, were randomly assigned to either: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Cognitive performance was assessed at baseline, after 3 and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were calculated. Eighty-nine participants were randomized to the three groups initially, 71 completed the training, while 47 were available at 1-year follow-up. Advantages of the simultaneous cognitive-physical programs were found in two dimensions of executive function. "Shifting attention" showed a time×intervention interaction in favor of DANCE/MEMORY versus PHYS (F[2, 68] =1.95, trend P=0.075, r=0.17); and "working memory" showed a time×intervention interaction in favor of DANCE versus MEMORY (F[1, 136] =2.71, trend P=0.051, R (2)=0.006). Performance improvements in executive functions, long-term visual memory (episodic memory), and processing speed were maintained at follow-up in all groups. Particular executive functions benefit from simultaneous cognitive-physical training compared to exclusively physical multicomponent training. Cognitive-physical training programs may counteract widespread cognitive impairments in the elderly.

Kinematic and EMG Comparison of Gait in Normal and Microgravity

NASA Technical Reports Server (NTRS)

DeWitt, John K.; Edwards, W. Brent; Perusek, Gail P.; Lewandowski, Beth E.; Samorezov, Sergey

2009-01-01

Astronauts regularly perform treadmill locomotion as a part of their exercise prescription while onboard the International Space Station. Although locomotive exercise has been shown to be beneficial for bone, muscle, and cardiovascular health, astronauts return to Earth after long duration missions with net losses in all three areas [1]. These losses might be partially explained by fundamental differences in locomotive performance between normal gravity (NG) and microgravity (MG) environments. During locomotive exercise in MG, the subject must wear a waist and shoulder harness that is attached to elastomer bungees. The bungees are attached to the treadmill, and provide forces that are intended to replace gravity. However, unlike gravity, which provides a constant force upon all body parts, the bungees provide a spring force only to the harness. Therefore, subjects are subjected to two fundamental differences in MG: 1) forces returning the subject to the treadmill are not constant, and 2) forces are only applied to the axial skeleton at the waist and shoulders. The effectiveness of the exercise may also be affected by the magnitude of the gravity replacement load. Historically, astronauts have difficulty performing treadmill exercise with loads that approach body weight (BW) due to comfort and inherent stiffness in the bungee system. Although locomotion can be executed in MG, the unique requirements could result in performance differences as compared to NG. These differences may help to explain why long term training effects of treadmill exercise may differ from those found in NG. The purpose of this investigation was to compare locomotion in NG and MG to determine if kinematic or muscular activation pattern differences occur between gravitational environments.

Antigravity treadmill training during the early rehabilitation phase following unicompartmental knee arthroplasty: A case series.

PubMed

Huang, Chun-Hao; Schroeder, E Todd; Powers, Christopher

2018-02-26

Patients who have undergone unicompartmental knee arthroplasty (UKA) have been reported to exhibit altered gait 19-25 months post-surgery. The most common gait impairment in this population is inadequate knee flexion and a corresponding decrease in the knee extensor moment during loading response (i.e., quadriceps avoidance). The purpose of this case series was to determine whether incorporation of antigravity treadmill training into a standard physical therapy program can eliminate quadriceps avoidance gait during the early rehabilitation phase following UKA. Four females who underwent UKA were recruited for this study. Participants completed antigravity treadmill training three times per week for 12 weeks in addition to their standard physical therapy program. Instrumented gait analysis was performed at baseline (pre-intervention), week 6 (mid-intervention), and week 12 (post-intervention). We found that peak knee flexion and the peak knee extensor moment during the weight acceptance phase of gait increased to normal values following the 12-week intervention period (14.1 ± 6.5° to 20.6 ± 1.5° and 0.4 ± 0.3 to 0.7 ± 0.2 Nm/kg respectively). The findings of this case series suggest that a standard physical therapy program that incorporates early gait training using an antigravity treadmill may be beneficial in eliminating "quadriceps avoidance" during the early rehabilitation phase following UKA.

The influence of applying additional weight to the affected leg on gait patterns during aquatic treadmill walking in people poststroke.

PubMed

Jung, Taeyou; Lee, Dokyeong; Charalambous, Charalambos; Vrongistinos, Konstantinos

2010-01-01

Jung T, Lee D, Charalambous C, Vrongistinos K. The influence of applying additional weight to the affected leg on gait patterns during aquatic treadmill walking in people poststroke. To investigate how the application of additional weights to the affected leg influences gait patterns of people poststroke during aquatic treadmill walking. Comparative gait analysis. University-based aquatic therapy center. Community-dwelling volunteers (n=22) with chronic hemiparesis caused by stroke. Not applicable. Spatiotemporal and kinematic gait parameters. The use of an ankle weight showed an increase in the stance phase percentage of gait cycle (3%, P=.015) when compared with no weight. However, the difference was not significant after a Bonferroni adjustment was applied for a more stringent statistical analysis. No significant differences were found in cadence and stride length. The use of an ankle weight showed a significant decrease of the peak hip flexion (7.9%, P=.001) of the affected limb as compared with no weight condition. This decrease was marked as the reduction of unwanted limb flotation because people poststroke typically show excessive hip flexion of the paretic leg in the late swing phase followed by fluctuating hip movements during aquatic treadmill walking. The frontal and transverse plane hip motions did not show any significant differences but displayed a trend of a decrease in the peak hip abduction during the swing phase with additional weights. The use of additional weight did not alter sagittal plane kinematics of the knee and ankle joints. The use of applied weight on the affected limb can reduce unwanted limb flotation on the paretic side during aquatic treadmill walking. It can also assist the stance stability by increasing the stance phase percentage closer to 60% of gait cycle. Both findings can contribute to the development of more efficient motor patterns in gait training for people poststroke. The use of a cuff weight does not seem to reduce the limb circumduction during aquatic treadmill walking. Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Oxygen consumption, oxygen cost, heart rate, and perceived effort during split-belt treadmill walking in young healthy adults.

PubMed

Roper, Jaimie A; Stegemöller, Elizabeth L; Tillman, Mark D; Hass, Chris J

2013-03-01

During split-belt treadmill walking the speed of the treadmill under one limb is faster than the belt under the contralateral limb. This unique intervention has shown evidence of acutely improving gait impairments in individuals with neurologic impairment such as stroke and Parkinson's disease. However, oxygen use, heart rate and perceived effort associated with split-belt treadmill walking are unknown and may limit the utility of this locomotor intervention. To better understand the intensity of this new intervention, this study was undertaken to examine the oxygen consumption, oxygen cost, heart rate, and rating of perceived exertion associated with split-belt treadmill walking in young healthy adults. Fifteen participants completed three sessions of treadmill walking: slow speed with belts tied, fast speed with belts tied, and split-belt walking with one leg walking at the fast speed and one leg walking at the slow speed. Oxygen consumption, heart rate, and rating of perceived exertion were collected during each walking condition and oxygen cost was calculated. Results revealed that oxygen consumption, heart rate, and perceived effort associated with split-belt walking were higher than slow treadmill walking, but only oxygen consumption was significantly lower during both split-belt walking than fast treadmill walking. Oxygen cost associated with slow treadmill walking was significantly higher than fast treadmill walking. These findings have implications for using split-belt treadmill walking as a rehabilitation tool as the cost associated with split-belt treadmill walking may not be higher or potentially more detrimental than that associated with previously used treadmill training rehabilitation strategies.

Effect of locomotor training in completely spinalized cats previously submitted to a spinal hemisection.

PubMed

Martinez, Marina; Delivet-Mongrain, Hugo; Leblond, Hugues; Rossignol, Serge

2012-08-08

After a spinal hemisection in cats, locomotor plasticity occurring at the spinal level can be revealed by performing, several weeks later, a complete spinalization below the first hemisection. Using this paradigm, we recently demonstrated that the hemisection induces durable changes in the symmetry of locomotor kinematics that persist after spinalization. Can this asymmetry be changed again in the spinal state by interventions such as treadmill locomotor training started within a few days after the spinalization? We performed, in 9 adult cats, a spinal hemisection at thoracic level 10 and then a complete spinalization at T13, 3 weeks later. Cats were not treadmill trained during the hemispinal period. After spinalization, 5 of 9 cats were not trained and served as control while 4 of 9 cats were trained on the treadmill for 20 min, 5 d a week for 3 weeks. Using detailed kinematic analyses, we showed that, without training, the asymmetrical state of locomotion induced by the hemisection was retained durably after the subsequent spinalization. By contrast, training cats after spinalization induced a reversal of the left/right asymmetries, suggesting that new plastic changes occurred within the spinal cord through locomotor training. Moreover, training was shown to improve the kinematic parameters and the performance of the hindlimb on the previously hemisected side. These results indicate that spinal locomotor circuits, previously modified by past experience such as required for adaptation to the hemisection, can remarkably respond to subsequent locomotor training and improve bilateral locomotor kinematics, clearly showing the benefits of locomotor training in the spinal state.

Gait Training Interventions for Lower Extremity Amputees: A Systematic Literature Review

PubMed Central

Highsmith, M. Jason; Andrews, Casey R.; Millman, Claire; Fuller, Ashley; Kahle, Jason T.; Klenow, Tyler D.; Lewis, Katherine L.; Bradley, Rachel C.; Orriola, John J.

2016-01-01

Lower extremity (LE) amputation patients who use prostheses have gait asymmetries and altered limb loading and movement strategies when ambulating. Subsequent secondary conditions are believed to be associated with gait deviations and lead to long-term complications that impact function and quality of life as a result. The purpose of this study was to systematically review the literature to determine the strength of evidence supporting gait training interventions and to formulate evidence statements to guide practice and research related to therapeutic gait training for lower extremity amputees. A systematic review of three databases was conducted followed by evaluation of evidence and synthesis of empirical evidence statements (EES). Eighteen manuscripts were included in the review, which covered two areas of gait training interventions: 1) overground and 2) treadmill-based. Eight EESs were synthesized. Four addressed overground gait training, one covered treadmill training, and three statements addressed both forms of therapy. Due to the gait asymmetries, altered biomechanics, and related secondary consequences associated with LE amputation, gait training interventions are needed along with study of their efficacy. Overground training with verbal or other auditory, manual, and psychological awareness interventions was found to be effective at improving gait. Similarly, treadmill-based training was found to be effective: 1) as a supplement to overground training; 2) independently when augmented with visual feedback and/or body weight support; or 3) as part of a home exercise plan. Gait training approaches studied improved multiple areas of gait, including sagittal and coronal biomechanics, spatiotemporal measures, and distance walked. PMID:28066520

Robot-Applied Resistance Augments the Effects of Body Weight-Supported Treadmill Training on Stepping and Synaptic Plasticity in a Rodent Model of Spinal Cord Injury.

PubMed

Hinahon, Erika; Estrada, Christina; Tong, Lin; Won, Deborah S; de Leon, Ray D

2017-08-01

The application of resistive forces has been used during body weight-supported treadmill training (BWSTT) to improve walking function after spinal cord injury (SCI). Whether this form of training actually augments the effects of BWSTT is not yet known. To determine if robotic-applied resistance augments the effects of BWSTT using a controlled experimental design in a rodent model of SCI. Spinally contused rats were treadmill trained using robotic resistance against horizontal (n = 9) or vertical (n = 8) hind limb movements. Hind limb stepping was tested before and after 6 weeks of training. Two control groups, one receiving standard training (ie, without resistance; n = 9) and one untrained (n = 8), were also tested. At the terminal experiment, the spinal cords were prepared for immunohistochemical analysis of synaptophysin. Six weeks of training with horizontal resistance increased step length, whereas training with vertical resistance enhanced step height and movement velocity. None of these changes occurred in the group that received standard (ie, no resistance) training or in the untrained group. Only standard training increased the number of step cycles and shortened cycle period toward normal values. Synaptophysin expression in the ventral horn was highest in rats trained with horizontal resistance and in untrained rats and was positively correlated with step length. Adding robotic-applied resistance to BWSTT produced gains in locomotor function over BWSTT alone. The impact of resistive forces on spinal connections may depend on the nature of the resistive forces and the synaptic milieu that is present after SCI.

Seeing is believing: effects of visual contextual cues on learning and transfer of locomotor adaptation.

PubMed

Torres-Oviedo, Gelsy; Bastian, Amy J

2010-12-15

Devices such as robots or treadmills are often used to drive motor learning because they can create novel physical environments. However, the learning (i.e., adaptation) acquired on these devices only partially generalizes to natural movements. What determines the specificity of motor learning, and can this be reliably made more general? Here we investigated the effect of visual cues on the specificity of split-belt walking adaptation. We systematically removed vision to eliminate the visual-proprioceptive mismatch that is a salient cue specific to treadmills: vision indicates that we are not moving while leg proprioception indicates that we are. We evaluated the adaptation of temporal and spatial features of gait (i.e., timing and location of foot landing), their transfer to walking over ground, and washout of adaptation when subjects returned to the treadmill. Removing vision during both training (i.e., on the treadmill) and testing (i.e., over ground) strongly improved the transfer of treadmill adaptation to natural walking. Removing vision only during training increased transfer of temporal adaptation, whereas removing vision only during testing increased the transfer of spatial adaptation. This dissociation reveals differences in adaptive mechanisms for temporal and spatial features of walking. Finally training without vision increased the amount that was learned and was linked to the variability in the behavior during adaptation. In conclusion, contextual cues can be manipulated to modulate the magnitude, transfer, and washout of device-induced learning in humans. These results bring us closer to our ultimate goal of developing rehabilitation strategies that improve movements beyond the clinical setting.

Effect of Body Weight-supported Walking on Exercise Capacity and Walking Speed in Patients with Knee Osteoarthritis: A Randomized Controlled Trial

PubMed Central

Someya, Fujiko

2013-01-01

Abstract Objective: To compare the effect of body-weight-supported treadmill training (BWSTT) and full-body-weight treadmill training (FBWTT) on patients with knee osteoarthritis (OA). Methods: Design was Randomized controlled trial. Patients with knee osteoarthritis (n = 30; mean age, 76.0±7.5 y) were randomly assigned to BWSTT or FBWTT group. All patients performed 20 min walking exercise twice a week for 6 weeks under the supervision of the therapist. Main measures were 10-meter walking test (10MWT), functional reach test (FRT), timed get up and go test (TUG), one-leg standing test, 6-minute walking test (6MWT), the parameters set on the treadmill, MOS Short-Form 36-Item Health Survey (SF36), Japanese Knee Osteoarthritis Measure (JKOM). Results: Twenty-five patients (10 men, 15 women; mean age, 76.5 ± 8.0 y) completed the experiment. Exercise capacity, indicated by the heart rate, was similar in both groups. After 3 weeks of BWSTT, the patients performed significantly better in the 10-m and 6-min walking tests. This was not the case with FBWTT even after 6 weeks training. Pain levels assessed were significantly improved after 3 weeks of BWSTT and 6 weeks of FBWTT. There were no significant improvements in either group assessed by the FRT, one-leg standing time test, TUG, or SF -36 questionnaire. Conclusions: BWSTT enhanced exercise capacity in terms of walking speed and pain reduction after 3 weeks; however, there was no significant improvement in patients' functional abilities or quality of life. PMID:25792901

THE EFFECT OF CAFFEINE SUPPLEMENTATION ON TRAINED INDIVIDUALS SUBJECTED TO MAXIMAL TREADMILL TEST.

PubMed Central

Salicio, Viviane Martins Mana; Fett, Carlos Alexandre; Salicio, Marcos Adriano; Brandäo, Camila Fernanda Costa Cunha Moraes; Stoppiglia, Luiz Fabrizio; Fett, Waléria Christiane Rezende; Botelho, and Clovis

2017-01-01

Background: Intense physical training increases oxidative stress and inflammation, resulting into muscle and cellular damage. The aim of this study was to analyze the effect of caffeine supplementation on trained young individuals subjected to two treadmill maximal tests. Materials and Methods: It was a double-blind and crossover study comprising 24 active individuals within the age group 18-30 years. The comparisons were conducted: the effect of exercise (week 1 x 2) and caffeine intake (GC x GP) on thiobarbituric acid (TBARS), interleukin 6 (IL-6), interleukin 10 (IL-10) and superoxide dismutase (SOD) variables during pre-exercise time (30 min. after caffeine or placebo intake) and post-exercise (5 min after treadmill test). Results: The comparison between weeks 1 and 2 showed increase in the first week, in the following items: TBARS, IL-6 and IL-10 in the GC and GP groups. The comparison within the same week showed that GC individuals presented lower post-exercise TBARS values in the first and second weeks; IL- 6 presented higher post-exercise values in the GC group in both weeks. The paired analysis comparing pre- and post-exercise, with and without caffeine showed that IL-6 presented higher post-exercise values in the GC group. Conclusion: Caffeine used by athletes can decrease oxidative stress. The increased IL-6 suggest that this ergogenic supplement may stimulate muscle hypertrophy, since IL-6 has myokine effect. However, the caffeine effect on IL-6 level and muscle hypertrophy increase should be better investigated in future studies. PMID:28480382

Matching optical flow to motor speed in virtual reality while running on a treadmill.

PubMed

Caramenti, Martina; Lafortuna, Claudio L; Mugellini, Elena; Abou Khaled, Omar; Bresciani, Jean-Pierre; Dubois, Amandine

2018-01-01

We investigated how visual and kinaesthetic/efferent information is integrated for speed perception in running. Twelve moderately trained to trained subjects ran on a treadmill at three different speeds (8, 10, 12 km/h) in front of a moving virtual scene. They were asked to match the visual speed of the scene to their running speed-i.e., treadmill's speed. For each trial, participants indicated whether the scene was moving slower or faster than they were running. Visual speed was adjusted according to their response using a staircase until the Point of Subjective Equality (PSE) was reached, i.e., until visual and running speed were perceived as equivalent. For all three running speeds, participants systematically underestimated the visual speed relative to their actual running speed. Indeed, the speed of the visual scene had to exceed the actual running speed in order to be perceived as equivalent to the treadmill speed. The underestimation of visual speed was speed-dependent, and percentage of underestimation relative to running speed ranged from 15% at 8km/h to 31% at 12km/h. We suggest that this fact should be taken into consideration to improve the design of attractive treadmill-mediated virtual environments enhancing engagement into physical activity for healthier lifestyles and disease prevention and care.

MIT-Skywalker: considerations on the Design of a Body Weight Support System.

PubMed

Gonçalves, Rogério Sales; Krebs, Hermano Igo

2017-09-06

To provide body weight support during walking and balance training, one can employ two distinct embodiments: support through a harness hanging from an overhead system or support through a saddle/seat type. This paper presents a comparison of these two approaches. Ultimately, this comparison determined our selection of the body weight support system employed in the MIT-Skywalker, a robotic device developed for the rehabilitation/habilitation of gait and balance after a neurological injury. Here we will summarize our results with eight healthy subjects walking on the treadmill without any support, with 30% unloading supported by a harness hanging from an overhead system, and with a saddle/seat-like support system. We compared the center of mass as well as vertical and mediolateral trunk displacements across different walking speeds and support. The bicycle/saddle system had the highest values for the mediolateral inclination, while the overhead harness body weight support showed the lowest values at all speeds. The differences were statistically significant. We selected the bicycle/saddle system for the MIT-Skywalker. It allows faster don-and-doff, better centers the patient to the split treadmill, and allows all forms of training. The overhead harness body weight support might be adequate for rhythmic walking training but limits any potential for balance training.

Physiologic and perceptual responses during treadmill running with ankle weights.

PubMed

Bhambhani, Y N; Gomes, P S; Wheeler, G

1990-03-01

This study examined the effects of ankle weighting on physiologic and perceptual responses during treadmill running in seven healthy, female recreational runners with a mean maximal aerobic power of 48.4 +/- 4.0 ml/kg/min. Each subject completed four experimental one-mile runs at individually selected treadmill running speeds with 0, 1.6, 3.2 and 4.8 kg weights on their ankles. The subjects selected a speed at which they would run (train) if their objectives were to significantly improve cardiovascular function and induce weight loss. Metabolic and cardiovascular responses were continuously monitored, and ratings of perceived exertion were recorded near the end of the activity. During the unweighted run, the subjects selected a running speed of 6.87 +/- 0.63 mph which resulted in a net energy expenditure of 0.153 kcal/kg/min or 1.34 +/- 0.16 kcal/kg/mile. This corresponded to a training intensity of 76.3% +/- 5.1% of maximum oxygen consumption or 88.1% +/- 9.7% of maximum heart rate. Addition of weight to the ankles caused a significant decrease (p less than .05) in the running speed selected and, therefore, did not result in any significant changes (p greater than .05) in the rate of oxygen consumption, heart rate or ratings of perceived exertion when compared to the unweighted condition. These observations are in contrast to previous studies on ankle weighting which were conducted at fixed treadmill running speeds. However, the use of ankle weights did have a tendency to increase gross and net energy expenditure of running when values were expressed in kcal/mile because of slower self-selected running speeds under these conditions. This increase in energy expenditure could be of physiologic significance if running with ankle weights was performed on a regular basis at a fixed distance.

Exploration of Two Training Paradigms Using Forced Induced Weight Shifting With the Tethered Pelvic Assist Device to Reduce Asymmetry in Individuals After Stroke: Case Reports.

PubMed

Bishop, Lauri; Khan, Moiz; Martelli, Dario; Quinn, Lori; Stein, Joel; Agrawal, Sunil

2017-10-01

Many robotic devices in rehabilitation incorporate an assist-as-needed haptic guidance paradigm to promote training. This error reduction model, while beneficial for skill acquisition, could be detrimental for long-term retention. Error augmentation (EA) models have been explored as alternatives. A robotic Tethered Pelvic Assist Device has been developed to study force application to the pelvis on gait and was used here to induce weight shift onto the paretic (error reduction) or nonparetic (error augmentation) limb during treadmill training. The purpose of these case reports is to examine effects of training with these two paradigms to reduce load force asymmetry during gait in two individuals after stroke (>6 mos). Participants presented with baseline gait asymmetry, although independent community ambulators. Participants underwent 1-hr trainings for 3 days using either the error reduction or error augmentation model. Outcomes included the Borg rating of perceived exertion scale for treatment tolerance and measures of force and stance symmetry. Both participants tolerated training. Force symmetry (measured on treadmill) improved from pretraining to posttraining (36.58% and 14.64% gains), however, with limited transfer to overground gait measures (stance symmetry gains of 9.74% and 16.21%). Training with the Tethered Pelvic Assist Device device proved feasible to improve force symmetry on the treadmill irrespective of training model. Future work should consider methods to increase transfer to overground gait.

Habituation of 10-year-old hockey players to treadmill skating.

PubMed

Lockwood, Kelly L; Frost, Gail

2007-05-01

This study assessed changes in selected physiological and kinematic variables over 6 weeks of treadmill skating in an effort to understand the process of habituation to this novel training modality. Seven male, Atom-A hockey players who were injury-free and had no previous treadmill skating experience participated in the study. Players performed four 1-min skating bouts at progressively increasing speeds, each week, for 6 weeks. One speed (10.5 km/h) was repeated weekly to allow for assessment of the habituation process. Our criteria for habituation were: a decrease in stride rate, heart rate and rating of perceived exertion, and an increase in stride length, trunk angle and vertical movement of the centre of mass, leading to a plateau, over the course of the 6-week study. Significant decreases were seen in stride rate, heart rate and ratings of perceived exertion, and significant increases were found in stride length. Some of these changes were evident after only one week of training and all were present by week 4. After 6 weeks (24 min) of exposure to treadmill skating, all participants displayed a visibly more efficient skating style.

Virtual reality training to enhance behavior and cognitive function among children with attention-deficit/hyperactivity disorder: brief report.

PubMed

Shema-Shiratzky, Shirley; Brozgol, Marina; Cornejo-Thumm, Pablo; Geva-Dayan, Karen; Rotstein, Michael; Leitner, Yael; Hausdorff, Jeffrey M; Mirelman, Anat

2018-05-17

To examine the feasibility and efficacy of a combined motor-cognitive training using virtual reality to enhance behavior, cognitive function and dual-tasking in children with Attention-Deficit/Hyperactivity Disorder (ADHD). Fourteen non-medicated school-aged children with ADHD, received 18 training sessions during 6 weeks. Training included walking on a treadmill while negotiating virtual obstacles. Behavioral symptoms, cognition and gait were tested before and after the training and at 6-weeks follow-up. Based on parental report, there was a significant improvement in children's social problems and psychosomatic behavior after the training. Executive function and memory were improved post-training while attention was unchanged. Gait regularity significantly increased during dual-task walking. Long-term training effects were maintained in memory and executive function. Treadmill-training augmented with virtual-reality is feasible and may be an effective treatment to enhance behavior, cognitive function and dual-tasking in children with ADHD.

Immediate and residual effects of low-dose nandrolone decanoate and treadmill training on adipose and reproductive tissues of male Wistar rats.

PubMed

Rodrigues, Josilene M; Oliveira, Vinicius P P; P Furlan, Julia; Munhoz, Ana Claudia; S Rempel, Marcelo R; Brito, Marcia N; Brito, Nilton A; Pedrosa, Maria M D; M Costa, Cecília E

2017-05-01

Residual effects after nandrolone decanoate (ND) treatment are not reported. Immediate and residual effects of low-dose ND and treadmill training were investigated. Male rats were trained and/or ND-treated for four weeks and the assessments were made after this period or four weeks later. The groups did not differ in final plasma glucose or AUC of the ivGTT, but hyperinsulinemia was noticed in some trained/treated groups. Training with ND increased muscle mass and ND decreased the reproductive structures. Decreased fat with training was reversed by detraining. The anabolic action of ND on skeletal muscle was enhanced by training. Fat and lipid changes were more linked to training/detraining, but the effects of ND on the reproductive structures persisted after treatment. The effects of training on fat and muscle were not maintained after detraining, but low-dose ND had persistent effects on the reproductive structures.

Effects of community-based virtual reality treadmill training on balance ability in patients with chronic stroke.

PubMed

Kim, Nara; Park, YuHyung; Lee, Byoung-Hee

2015-03-01

[Purpose] We aimed to examine the effectiveness of a community-based virtual reality treadmill training (CVRTT) program on static balance abilities in patients with stroke. [Subjects and Methods] Patients (n = 20) who suffered a stroke at least 6 months prior to the study were recruited. All subjects underwent conventional physical therapy for 60 min/day, 5 days/week, for 4 weeks. Additionally, the CVRTT group underwent community-based virtual reality scene exposure combined with treadmill training for 30 min/day, 3 days/week, for 4 weeks, whereas the control group underwent conventional physical therapy, including muscle strengthening, balance training, and indoor and outdoor gait training, for 30 min/day, 3 days/week, for 4 weeks. Outcome measurements included the anteroposterior, mediolateral, and total postural sway path lengths and speed, which were recorded using the Balancia Software on a Wii Fit(™) balance board. [Results] The postural sway speed and anteroposterior and total postural sway path lengths were significantly decreased in the CVRTT group. Overall, the CVRTT group showed significantly greater improvement than the control group. [Conclusions] The present study results can be used to support the use of CVRTT for effectively improving balance in stroke patients. Moreover, we determined that a CVRTT program for stroke patients is both feasible and suitable.

Enhancing astronaut performance using sensorimotor adaptability training

PubMed Central

Bloomberg, Jacob J.; Peters, Brian T.; Cohen, Helen S.; Mulavara, Ajitkumar P.

2015-01-01

Astronauts experience disturbances in balance and gait function when they return to Earth. The highly plastic human brain enables individuals to modify their behavior to match the prevailing environment. Subjects participating in specially designed variable sensory challenge training programs can enhance their ability to rapidly adapt to novel sensory situations. This is useful in our application because we aim to train astronauts to rapidly formulate effective strategies to cope with the balance and locomotor challenges associated with new gravitational environments—enhancing their ability to “learn to learn.” We do this by coupling various combinations of sensorimotor challenges with treadmill walking. A unique training system has been developed that is comprised of a treadmill mounted on a motion base to produce movement of the support surface during walking. This system provides challenges to gait stability. Additional sensory variation and challenge are imposed with a virtual visual scene that presents subjects with various combinations of discordant visual information during treadmill walking. This experience allows them to practice resolving challenging and conflicting novel sensory information to improve their ability to adapt rapidly. Information obtained from this work will inform the design of the next generation of sensorimotor countermeasures for astronauts. PMID:26441561

Enhancing astronaut performance using sensorimotor adaptability training.

PubMed

Bloomberg, Jacob J; Peters, Brian T; Cohen, Helen S; Mulavara, Ajitkumar P

2015-01-01

Astronauts experience disturbances in balance and gait function when they return to Earth. The highly plastic human brain enables individuals to modify their behavior to match the prevailing environment. Subjects participating in specially designed variable sensory challenge training programs can enhance their ability to rapidly adapt to novel sensory situations. This is useful in our application because we aim to train astronauts to rapidly formulate effective strategies to cope with the balance and locomotor challenges associated with new gravitational environments-enhancing their ability to "learn to learn." We do this by coupling various combinations of sensorimotor challenges with treadmill walking. A unique training system has been developed that is comprised of a treadmill mounted on a motion base to produce movement of the support surface during walking. This system provides challenges to gait stability. Additional sensory variation and challenge are imposed with a virtual visual scene that presents subjects with various combinations of discordant visual information during treadmill walking. This experience allows them to practice resolving challenging and conflicting novel sensory information to improve their ability to adapt rapidly. Information obtained from this work will inform the design of the next generation of sensorimotor countermeasures for astronauts.

A cable-driven locomotor training system for restoration of gait in human SCI.

PubMed

Wu, Ming; Hornby, T George; Landry, Jill M; Roth, Heidi; Schmit, Brian D

2011-02-01

A novel cable-driven robotic locomotor training system was developed to provide compliant assistance/resistance forces to the legs during treadmill training in patients with incomplete spinal cord injury (SCI). Eleven subjects with incomplete SCI were recruited to participate in two experiments to test the feasibility of the robotic gait training system. Specifically, 10 subjects participated in one experimental session to test the characteristics of the robotic gait training system and one subject participated in repeated testing sessions over 8 weeks with the robotic device to test improvements in locomotor function. Limb kinematics were recorded in one experiment to evaluate the system characteristics of the cable-driven locomotor trainer and the overground gait speed and 6 min walking distance were evaluated at pre, 4 and 8 weeks post treadmill training of a single subject as well. The results indicated that the cable driven robotic gait training system improved the kinematic performance of the leg during treadmill walking and had no significant impact on the variability of lower leg trajectory, suggesting a high backdrivability of the cable system. In addition, results from a patient with incomplete SCI indicated that prolonged robotic gait training using the cable robot improved overground gait speed. Results from this study suggested that a cable driven robotic gait training system is effective in improving leg kinematic performance, yet allows variability of gait kinematics. Thus, it seems feasible to improve the locomotor function in human SCI using this cable driven robotic system, warranting testing with a larger group of patients. Copyright © 2010 Elsevier B.V. All rights reserved.

Therapeutic effects of anti-gravity treadmill (AlterG) training on reflex hyper-excitability, corticospinal tract activities, and muscle stiffness in children with cerebral palsy.

PubMed

Parvin, Sh; Taghiloo, A; Irani, A; Mirbagheri, M Mehdi

2017-07-01

We aimed to study therapeutic effects of antigravity treadmill (AlterG) training on reflex hyper-excitability, muscle stiffness, and corticospinal tract (CST) function in children with spastic hemiplegic cerebral palsy (CP). Three children received AlterG training 3 days per week for 8 weeks as experimental group. Each session lasted 45 minutes. One child as control group received typical occupational therapy for the same amount of time. We evaluated hyper-excitability of lower limb muscles by H-reflex response. We quantified muscle stiffness by sonoelastography images of the affected muscles. We quantified CST activity by transcranial magnetic stimulation (TMS). We performed the evaluations before and after training for both groups. H response latency and maximum M-wave amplitude were improved in experimental group after training compared to control group. Two children of experimental group had TMS response. Major parameters of TMS (i.e. peak-to-peak amplitude of motor evoked potential (MEP), latency of MEP, cortical silent period, and intensity of pulse) improved for both of them. Three parameters of texture analysis of sonoelastography images were improved for experimental group (i.e. contrast, entropy, and shear wave velocity). These findings indicate that AlterG training can improve reflexes, muscle stiffness, and CST activity in children with spastic hemiplegic CP and can be considered as a therapeutic tool to improve neuromuscular abnormalities occurring secondary to CP.

Stroke and neurodegenerative disorders. 3. Stroke: rehabilitation management.

PubMed

Bogey, Ross A; Geis, Carolyn C; Bryant, Phillip R; Moroz, Alex; O'neill, Bryan J

2004-03-01

This self-directed learning module highlights common rehabilitation issues in stroke survivors. Topics include spasticity, constraint-induced movement therapy, partial body weight-supported treadmill training, virtual reality training, vestibular retraining, aphasia treatment, and cognitive retraining. It is part of the study chapter on stroke and neurodegenerative disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. (a) To identify and review the treatment options for poststroke spasticity; (b) to review the use of body weight-supported treadmill training in stroke patients; (c) to describe virtual reality training as an adjunct in stroke rehabilitation; (d) to review vestibular rehabilitation; (e) to discuss advances in aphasia treatment; (f) to discuss cognitive retraining; and (g) to provide an update on treatment of neglect syndromes.

Peak Velocity as an Alternative Method for Training Prescription in Mice

PubMed Central

Picoli, Caroline de Carvalho; Romero, Paulo Vitor da Silva; Gilio, Gustavo R.; Guariglia, Débora A.; Tófolo, Laize P.; de Moraes, Solange M. F.; Machado, Fabiana A.; Peres, Sidney B.

2018-01-01

Purpose: To compare the efficiency of an aerobic physical training program prescribed according to either velocity associated with maximum oxygen uptake (vVO2max) or peak running speed obtained during an incremental treadmill test (Vpeak_K) in mice. Methods: Twenty male Swiss mice, 60 days old, were randomly divided into two groups with 10 animals each: 1. group trained by vVO2max (GVO2), 2. group trained by Vpeak_K (GVP). After the adaptation training period, an incremental test was performed at the beginning of each week to adjust training load and to determine the amount of VO2 and VCO2 fluxes consumed, energy expenditure (EE) and run distance during the incremental test. Mice were submitted to 4 weeks of aerobic exercise training of moderate intensity (velocity referring to 70% of vVO2max and Vpeak_K) in a programmable treadmill. The sessions lasted from 30 to 40 min in the first week, to reach 60 min in the fourth week, in order to provide the mice with a moderate intensity exercise, totaling 20 training sessions. Results: Mice demonstrated increases in VO2max (ml·kg−1·min−1) (GVO2 = 49.1% and GVP = 56.2%), Vpeak_K (cm·s−1) (GVO2 = 50.9% and GVP = 22.3%), EE (ml·kg−0,75·min−1) (GVO2 = 39.9% and GVP = 51.5%), and run distance (cm) (GVO2 = 43.5% and GVP = 33.4%), after 4 weeks of aerobic training (time effect, P < 0.05); there were no differences between the groups. Conclusions: Vpeak_K, as well as vVO2max, can be adopted as an alternative test to determine the performance and correct prescription of systemized aerobic protocol training to mice. PMID:29467664

Multicomponent physical exercise with simultaneous cognitive training to enhance dual-task walking of older adults: a secondary analysis of a 6-month randomized controlled trial with 1-year follow-up.

PubMed

Eggenberger, Patrick; Theill, Nathan; Holenstein, Stefan; Schumacher, Vera; de Bruin, Eling D

2015-01-01

About one-third of people older than 65 years fall at least once a year. Physical exercise has been previously demonstrated to improve gait, enhance physical fitness, and prevent falls. Nonetheless, the addition of cognitive training components may potentially increase these effects, since cognitive impairment is related to gait irregularities and fall risk. We hypothesized that simultaneous cognitive-physical training would lead to greater improvements in dual-task (DT) gait compared to exclusive physical training. Elderly persons older than 70 years and without cognitive impairment were randomly assigned to the following groups: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Gait variables, functional fitness (Short Physical Performance Battery, 6-minute walk), and fall frequencies were assessed at baseline, after 3 months and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were carried out. Eighty-nine participants were randomized to three groups initially; 71 completed the training and 47 were available at 1-year follow-up. DANCE/MEMORY showed a significant advantage compared to PHYS in DT costs of step time variability at fast walking (P=0.044). Training-specific gait adaptations were found on comparing DANCE and MEMORY: DANCE reduced step time at fast walking (P=0.007) and MEMORY reduced gait variability in DT and DT costs at preferred walking speed (both trend P=0.062). Global linear time effects showed improved gait (P<0.05), functional fitness (P<0.05), and reduced fall frequency (-77%, P<0.001). Only single-task fast walking, gait variability at preferred walking speed, and Short Physical Performance Battery were reduced at follow-up (all P<0.05 or trend). Long-term multicomponent cognitive-physical and exclusive physical training programs demonstrated similar potential to counteract age-related decline in physical functioning.

Multicomponent physical exercise with simultaneous cognitive training to enhance dual-task walking of older adults: a secondary analysis of a 6-month randomized controlled trial with 1-year follow-up

PubMed Central

Eggenberger, Patrick; Theill, Nathan; Holenstein, Stefan; Schumacher, Vera; de Bruin, Eling D

2015-01-01

Background About one-third of people older than 65 years fall at least once a year. Physical exercise has been previously demonstrated to improve gait, enhance physical fitness, and prevent falls. Nonetheless, the addition of cognitive training components may potentially increase these effects, since cognitive impairment is related to gait irregularities and fall risk. We hypothesized that simultaneous cognitive–physical training would lead to greater improvements in dual-task (DT) gait compared to exclusive physical training. Methods Elderly persons older than 70 years and without cognitive impairment were randomly assigned to the following groups: 1) virtual reality video game dancing (DANCE), 2) treadmill walking with simultaneous verbal memory training (MEMORY), or 3) treadmill walking (PHYS). Each program was complemented with strength and balance exercises. Two 1-hour training sessions per week over 6 months were applied. Gait variables, functional fitness (Short Physical Performance Battery, 6-minute walk), and fall frequencies were assessed at baseline, after 3 months and 6 months, and at 1-year follow-up. Multiple regression analyses with planned comparisons were carried out. Results Eighty-nine participants were randomized to three groups initially; 71 completed the training and 47 were available at 1-year follow-up. DANCE/MEMORY showed a significant advantage compared to PHYS in DT costs of step time variability at fast walking (P=0.044). Training-specific gait adaptations were found on comparing DANCE and MEMORY: DANCE reduced step time at fast walking (P=0.007) and MEMORY reduced gait variability in DT and DT costs at preferred walking speed (both trend P=0.062). Global linear time effects showed improved gait (P<0.05), functional fitness (P<0.05), and reduced fall frequency (−77%, P<0.001). Only single-task fast walking, gait variability at preferred walking speed, and Short Physical Performance Battery were reduced at follow-up (all P<0.05 or trend). Conclusion Long-term multicomponent cognitive–physical and exclusive physical training programs demonstrated similar potential to counteract age-related decline in physical functioning. PMID:26604719

The Oxidant-Antioxidant Equilibrium and Inflammatory Process Indicators after an Exercise Test on the AlterG Antigravity Treadmill in Young Amateur Female Athletes.

PubMed

Sielski, Łukasz; Sutkowy, Paweł; Skopowska, Agnieszka; Pawlak-Osińska, Katarzyna; Augustyńska, Zofia; Hewelt, Katarzyna; Drapała, Radosław; Woźniak, Alina

2018-01-01

The AlterG antigravity treadmill allows running with a considerable weight reduction. Physical exercise practiced on this treadmill is an innovative method supporting the treatment of injuries in sports and rehabilitation of patients. The aim of the study was to investigate the effect of a 30 min run on the AlterG treadmill with 80% body weight reduction comparing the effect to the similar effort on the classic treadmill on the redox equilibrium and the activity of selected lysosomal enzymes and a serine protease inhibitor in the blood of amateur minor female volleyball players. Venous blood samples were taken before the exercise and 30 minutes and 24 hours after its completion. The obtained results were analysed using Tukey's test and Pearson's linear correlations were calculated. 24 h after the running test on classic treadmill, the erythrocytic superoxide dismutase activity was higher than before and 30 min after it, as well as compared to the run on AlterG treadmill ( p < 0.001). The erythrocytic-conjugated diene concentration 24 h after the exercise on the classic treadmill was meaningly higher compared to that after the exercise on the AlterG treadmill ( p < 0.001). The cathepsin D activity was significantly lower after the exercise in AlterG conditions compared to the baseline value and that measured after the exercise on classic treadmill ( p < 0.001). It seems that the exercise on the AlterG treadmill keeps the oxidant-antioxidant equilibrium and stabilizes lysosomal membranes in young, physically active women in contrast to the exercise on the classic treadmill. This trial is registered with CTRI/2018/01/011344.

The Oxidant–Antioxidant Equilibrium and Inflammatory Process Indicators after an Exercise Test on the AlterG Antigravity Treadmill in Young Amateur Female Athletes

PubMed Central

Sielski, Łukasz; Skopowska, Agnieszka; Pawlak-Osińska, Katarzyna; Augustyńska, Zofia; Hewelt, Katarzyna; Drapała, Radosław

2018-01-01

The AlterG antigravity treadmill allows running with a considerable weight reduction. Physical exercise practiced on this treadmill is an innovative method supporting the treatment of injuries in sports and rehabilitation of patients. The aim of the study was to investigate the effect of a 30 min run on the AlterG treadmill with 80% body weight reduction comparing the effect to the similar effort on the classic treadmill on the redox equilibrium and the activity of selected lysosomal enzymes and a serine protease inhibitor in the blood of amateur minor female volleyball players. Venous blood samples were taken before the exercise and 30 minutes and 24 hours after its completion. The obtained results were analysed using Tukey's test and Pearson's linear correlations were calculated. 24 h after the running test on classic treadmill, the erythrocytic superoxide dismutase activity was higher than before and 30 min after it, as well as compared to the run on AlterG treadmill (p < 0.001). The erythrocytic-conjugated diene concentration 24 h after the exercise on the classic treadmill was meaningly higher compared to that after the exercise on the AlterG treadmill (p < 0.001). The cathepsin D activity was significantly lower after the exercise in AlterG conditions compared to the baseline value and that measured after the exercise on classic treadmill (p < 0.001). It seems that the exercise on the AlterG treadmill keeps the oxidant–antioxidant equilibrium and stabilizes lysosomal membranes in young, physically active women in contrast to the exercise on the classic treadmill. This trial is registered with CTRI/2018/01/011344. PMID:29765494

Whole-Body High-Intensity Interval Training Induce Similar Cardiorespiratory Adaptations Compared With Traditional High-Intensity Interval Training and Moderate-Intensity Continuous Training in Healthy Men.

PubMed

Schaun, Gustavo Z; Pinto, Stephanie S; Silva, Mariana R; Dolinski, Davi B; Alberton, Cristine L

2018-05-07

Schaun, GZ, Pinto, SS, Silva, MR, Dolinski, DB, and Alberton, CL. Sixteen weeks of whole-body high-intensity interval training induce similar cardiorespiratory responses compared with traditional high-intensity interval training and moderate-intensity continuous training in healthy men. J Strength Cond Res XX(X): 000-000, 2018-Low-volume high-intensity interval training (HIIT) protocols that use the body weight as resistance could be an interesting and inexpensive alternative to traditional ergometer-based high-intensity interval training (HIIT-T) and moderate-intensity continuous training (MICT). Therefore, our aim was to compare the effects of 16 weeks of whole-body HIIT (HIIT-WB), HIIT-T, and MICT on maximal oxygen uptake (V[Combining Dot Above]O2max), second ventilatory threshold (VT2), and running economy (RE) outcomes. Fifty-five healthy men (23.7 ± 0.7 years, 1.79 ± 0.01 m, 78.5 ± 1.7 kg) were randomized into 3 training groups (HIIT-T = 17; HIIT-WB = 19; MICT = 19) for 16 weeks (3× per week). The HIIT-T group performed eight 20-second bouts at 130% of the velocity associated to V[Combining Dot Above]O2max (vV[Combining Dot Above]O2max) interspersed by 10-second passive recovery on a treadmill, whereas HIIT-WB group performed the same protocol but used calisthenics exercises at an all-out intensity instead of treadmill running. Finally, MICT group exercised for 30 minutes at 90-95% of the heart rate (HR) associated to VT2. After the intervention, all groups improved V[Combining Dot Above]O2max, vV[Combining Dot Above]O2max, time to exhaustion (Tmax), VT2, velocity associated with VT2 (vVT2), and time to reach VT2 (tVT2) significantly (p < 0.05). Moreover, Tmax, vVT2, and tVT2 were greater after HIIT-T compared with HIIT-WB (p < 0.05), whereas oxygen uptake increased and HR decreased during the RE test in all groups (p < 0.05). Our results demonstrate that HIIT-WB can be as effective as traditional HIIT while also being time-efficient compared with MICT to improve health-related outcomes after 16 weeks of training. However, HIIT-T and MICT seem preferable to enhance performance-related outcomes compared with HIIT-WB.

Walking on an Oscillating Treadmill: Two Paths to Functional Adaptation

NASA Technical Reports Server (NTRS)

Brady, Rachel A.; Peters, Brian T.; Bloomberg, Jacob J.

2010-01-01

We mounted a treadmill on top of a six degree-of-freedom motion base platform to investigate and characterize locomotor responses produced by healthy adults when introduced to a novel walking condition. Subjects were classified into two groups according to how their stride times were affected by the perturbation. Our data suggest that a person's choice of adaptation strategy is influenced by the relationship between his unique, natural stride frequency and the external frequency imposed by the motion base. Our data suggest that a person's stride time response while walking on a laterally oscillating treadmill is influenced by the relationship between his unique, natural stride frequency and the imposed external frequency of the motion base. This relationship may be useful for checking the efficacy of gait training and rehabilitation programs. Preselecting and manipulating a person's EST could be one way to draw him out of his preferred "entrainment well" during therapy or training.

Effect of transcranial direct-current stimulation combined with treadmill training on balance and functional performance in children with cerebral palsy: a double-blind randomized controlled trial.

PubMed

Duarte, Natália de Almeida Carvalho; Grecco, Luanda André Collange; Galli, Manuela; Fregni, Felipe; Oliveira, Cláudia Santos

2014-01-01

Cerebral palsy refers to permanent, mutable motor development disorders stemming from a primary brain lesion, causing secondary musculoskeletal problems and limitations in activities of daily living. The aim of the present study was to determine the effects of gait training combined with transcranial direct-current stimulation over the primary motor cortex on balance and functional performance in children with cerebral palsy. A double-blind randomized controlled study was carried out with 24 children aged five to 12 years with cerebral palsy randomly allocated to two intervention groups (blocks of six and stratified based on GMFCS level (levels I-II or level III).The experimental group (12 children) was submitted to treadmill training and anodal stimulation of the primary motor cortex. The control group (12 children) was submitted to treadmill training and placebo transcranial direct-current stimulation. Training was performed in five weekly sessions for 2 weeks. Evaluations consisted of stabilometric analysis as well as the administration of the Pediatric Balance Scale and Pediatric Evaluation of Disability Inventory one week before the intervention, one week after the completion of the intervention and one month after the completion of the intervention. All patients and two examiners were blinded to the allocation of the children to the different groups. The experimental group exhibited better results in comparison to the control group with regard to anteroposterior sway (eyes open and closed; p<0.05), mediolateral sway (eyes closed; p<0.05) and the Pediatric Balance Scale both one week and one month after the completion of the protocol. Gait training on a treadmill combined with anodal stimulation of the primary motor cortex led to improvements in static balance and functional performance in children with cerebral palsy. Ensaiosclinicos.gov.br/RBR-9B5DH7.

Functional effects of treadmill-based gait training at faster speeds in stroke survivors: a prospective, single-group study.

PubMed

Mohammadi, Roghayeh; Ershad, Navid; Rezayinejad, Marziyeh; Fatemi, Elham; Phadke, Chetan P

2017-09-01

To examine the functional effects of walking retraining at faster than self-selected speed (SSS). Ten individuals with chronic stroke participated in a 4-week training over a treadmill at walking speeds 40% faster than SSS, three times per week, 30 min/session. Outcome measures assessed before, after, and 2 months after the end of intervention were the Timed Up and Go, the 6-Minute Walk, the 10-Meter Walk test, the Modified Ashworth Scale, SSS, and fastest comfortable speed. After 4 weeks of training, all outcome measures showed clinically meaningful and statistically significant improvements (P<0.05) that were maintained at 2 months after the end of the training. The results showed that a strategy of training at a speed 40% faster than SSS can improve functional activity in individuals with chronic stroke, with effects lasting up to 2 months after the intervention.

Partial body weight support treadmill training speed influences paretic and non-paretic leg muscle activation, stride characteristics, and ratings of perceived exertion during acute stroke rehabilitation.

PubMed

Burnfield, Judith M; Buster, Thad W; Goldman, Amy J; Corbridge, Laura M; Harper-Hanigan, Kellee

2016-06-01

Intensive task-specific training is promoted as one approach for facilitating neural plastic brain changes and associated motor behavior gains following neurologic injury. Partial body weight support treadmill training (PBWSTT), is one task-specific approach frequently used to improve walking during the acute period of stroke recovery (<1month post infarct). However, only limited data have been published regarding the relationship between training parameters and physiologic demands during this early recovery phase. To examine the impact of four walking speeds on stride characteristics, lower extremity muscle demands (both paretic and non-paretic), Borg ratings of perceived exertion (RPE), and blood pressure. A prospective, repeated measures design was used. Ten inpatients post unilateral stroke participated. Following three familiarization sessions, participants engaged in PBWSTT at four predetermined speeds (0.5, 1.0, 1.5 and 2.0mph) while bilateral electromyographic and stride characteristic data were recorded. RPE was evaluated immediately following each trial. Stride length, cadence, and paretic single limb support increased with faster walking speeds (p⩽0.001), while non-paretic single limb support remained nearly constant. Faster walking resulted in greater peak and mean muscle activation in the paretic medial hamstrings, vastus lateralis and medial gastrocnemius, and non-paretic medial gastrocnemius (p⩽0.001). RPE also was greatest at the fastest compared to two slowest speeds (p<0.05). During the acute phase of stroke recovery, PBWSTT at the fastest speed (2.0mph) promoted practice of a more optimal gait pattern with greater intensity of effort as evidenced by the longer stride length, increased between-limb symmetry, greater muscle activation, and higher RPE compared to training at the slowest speeds. Copyright © 2016 Elsevier B.V. All rights reserved.

Improving Functional Skills and Physical Fitness in Children with Rett Syndrome

ERIC Educational Resources Information Center

Lotan, M.; Isakov, E.; Merrick, J.

2004-01-01

To investigate the feasibility of a physical exercise programme with treadmill for persons with Rett syndrome (RS) in order to promote fitness and health. A daily training programme on a treadmill was designed for four females with RS over a period of 2 months with tests performed in three intervals, at time 1, 2 and 3, 2 months apart with…

The Effects of a Duathlon Simulation on Ventilatory Threshold and Running Economy

PubMed Central

Berry, Nathaniel T.; Wideman, Laurie; Shields, Edgar W.; Battaglini, Claudio L.

2016-01-01

Multisport events continue to grow in popularity among recreational, amateur, and professional athletes around the world. This study aimed to determine the compounding effects of the initial run and cycling legs of an International Triathlon Union (ITU) Duathlon simulation on maximal oxygen uptake (VO2max), ventilatory threshold (VT) and running economy (RE) within a thermoneutral, laboratory controlled setting. Seven highly trained multisport athletes completed three trials; Trial-1 consisted of a speed only VO2max treadmill protocol (SOVO2max) to determine VO2max, VT, and RE during a single-bout run; Trial-2 consisted of a 10 km run at 98% of VT followed by an incremental VO2max test on the cycle ergometer; Trial-3 consisted of a 10 km run and 30 km cycling bout at 98% of VT followed by a speed only treadmill test to determine the compounding effects of the initial legs of a duathlon on VO2max, VT, and RE. A repeated measures ANOVA was performed to determine differences between variables across trials. No difference in VO2max, VT (%VO2max), maximal HR, or maximal RPE was observed across trials. Oxygen consumption at VT was significantly lower during Trial-3 compared to Trial-1 (p = 0.01). This decrease was coupled with a significant reduction in running speed at VT (p = 0.015). A significant interaction between trial and running speed indicate that RE was significantly altered during Trial-3 compared to Trial-1 (p < 0.001). The first two legs of a laboratory based duathlon simulation negatively impact VT and RE. Our findings may provide a useful method to evaluate multisport athletes since a single-bout incremental treadmill test fails to reveal important alterations in physiological thresholds. Key points Decrease in relative oxygen uptake at VT (ml·kg-1·min-1) during the final leg of a duathlon simulation, compared to a single-bout maximal run. We observed a decrease in running speed at VT during the final leg of a duathlon simulation; resulting in an increase of more than 2 minutes to complete a 5 km run. During our study, highly trained athletes were unable to complete the final 5 km run at the same intensity that they completed the initial 10 km run (in a laboratory setting). A better understanding, and determination, of training loads during multisport training may help to better periodize training programs; additional research is required. PMID:27274661

Novel Kinetic Strategies Adopted in Asymmetric Split-Belt Treadmill Walking.

PubMed

Hinkel-Lipsker, Jacob W; Hahn, Michael E

2016-01-01

The hip and ankle strategies that affect learning of a novel gait have not been fully determined, and could be of importance in design of clinical gait interventions. The authors' purpose was to determine the effects of asymmetric split-belt treadmill walking on ankle and hip work during propulsion. Participants were randomized into either a gradual training group or a sudden training group and later returned for a retention test. The gradual training group performed significantly more work at the hip joint of the slow limb during acquisition, and decreased the hip joint work performed during retention. These findings reveal the hip joint on the slow limb during initial swing as a possible site of adaptation to a novel locomotor pattern.

Gait rehabilitation machines based on programmable footplates.

PubMed

Schmidt, Henning; Werner, Cordula; Bernhardt, Rolf; Hesse, Stefan; Krüger, Jörg

2007-02-09

Gait restoration is an integral part of rehabilitation of brain lesioned patients. Modern concepts favour a task-specific repetitive approach, i.e. who wants to regain walking has to walk, while tone-inhibiting and gait preparatory manoeuvres had dominated therapy before. Following the first mobilization out of the bed, the wheelchair-bound patient should have the possibility to practise complex gait cycles as soon as possible. Steps in this direction were treadmill training with partial body weight support and most recently gait machines enabling the repetitive training of even surface gait and even of stair climbing. With treadmill training harness-secured and partially relieved wheelchair-mobilised patients could practise up to 1000 steps per session for the first time. Controlled trials in stroke and SCI patients, however, failed to show a superior result when compared to walking exercise on the floor. Most likely explanation was the effort for the therapists, e.g. manually setting the paretic limbs during the swing phase resulting in a too little gait intensity. The next steps were gait machines, either consisting of a powered exoskeleton and a treadmill (Lokomat, AutoAmbulator) or an electromechanical solution with the harness secured patient placed on movable foot plates (Gait Trainer GT I). For the latter, a large multi-centre trial with 155 non-ambulatory stroke patients (DEGAS) revealed a superior gait ability and competence in basic activities of living in the experimental group. The HapticWalker continued the end effector concept of movable foot plates, now fully programmable and equipped with 6 DOF force sensors. This device for the first time enables training of arbitrary walking situations, hence not only the simulation of floor walking but also for example of stair climbing and perturbations. Locomotor therapy is a fascinating new tool in rehabilitation, which is in line with modern principles of motor relearning promoting a task-specific repetitive approach. Sophisticated technical developments and positive randomized controlled trials form the basis of a growing acceptance worldwide to the benefits or our patients.

Validation of a method for real time foot position and orientation tracking with Microsoft Kinect technology for use in virtual reality and treadmill based gait training programs.

PubMed

Paolini, Gabriele; Peruzzi, Agnese; Mirelman, Anat; Cereatti, Andrea; Gaukrodger, Stephen; Hausdorff, Jeffrey M; Della Croce, Ugo

2014-09-01

The use of virtual reality for the provision of motor-cognitive gait training has been shown to be effective for a variety of patient populations. The interaction between the user and the virtual environment is achieved by tracking the motion of the body parts and replicating it in the virtual environment in real time. In this paper, we present the validation of a novel method for tracking foot position and orientation in real time, based on the Microsoft Kinect technology, to be used for gait training combined with virtual reality. The validation of the motion tracking method was performed by comparing the tracking performance of the new system against a stereo-photogrammetric system used as gold standard. Foot position errors were in the order of a few millimeters (average RMSD from 4.9 to 12.1 mm in the medio-lateral and vertical directions, from 19.4 to 26.5 mm in the anterior-posterior direction); the foot orientation errors were also small (average %RMSD from 5.6% to 8.8% in the medio-lateral and vertical directions, from 15.5% to 18.6% in the anterior-posterior direction). The results suggest that the proposed method can be effectively used to track feet motion in virtual reality and treadmill-based gait training programs.

Adaptive locomotor training on an end-effector gait robot: evaluation of the ground reaction forces in different training conditions.

PubMed

Tomelleri, Christopher; Waldner, Andreas; Werner, Cordula; Hesse, Stefan

2011-01-01

The main goal of robotic gait rehabilitation is the restoration of independent gait. To achieve this goal different and specific patterns have to be practiced intensively in order to stimulate the learning process of the central nervous system. The gait robot G-EO Systems was designed to allow the repetitive practice of floor walking, stair climbing and stair descending. A novel control strategy allows training in adaptive mode. The force interactions between the foot and the ground were analyzed on 8 healthy volunteers in three different conditions: real floor walking on a treadmill, floor walking on the gait robot in passive mode, floor walking on the gait robot in adaptive mode. The ground reaction forces were measured by a Computer Dyno Graphy (CDG) analysis system. The results show different intensities of the ground reaction force across all of the three conditions. The intensities of force interactions during the adaptive training mode are comparable to the real walking on the treadmill. Slight deviations still occur in regard to the timing pattern of the forces. The adaptive control strategy comes closer to the physiological swing phase than the passive mode and seems to be a promising option for the treatment of gait disorders. Clinical trials will validate the efficacy of this new option in locomotor therapy on the patients. © 2011 IEEE

Exaggerated gonadotropin response to luteinizing hormone-releasing hormone in amenorrheic runners.

PubMed

Yahiro, J; Glass, A R; Fears, W B; Ferguson, E W; Vigersky, R A

1987-03-01

Most studies of exercise-induced amenorrhea have compared amenorrheic athletes (usually runners) with sedentary control subjects. Such comparisons will identify hormonal changes that develop as a result of exercise training but cannot determine which of these changes play a role in causing amenorrhea. To obviate this problem, we assessed reproductive hormone status in a group of five amenorrheic runners and compared them to a group of six eumenorrheic runners matched for body fatness, training intensity, and exercise performance. Compared to the eumenorrheic runners, the amenorrheic runners had lower serum estradiol concentrations, similar basal serum luteinizing hormone and follicle-stimulating hormone concentrations, and exaggerated responses of serum gonadotropins after administration of luteinizing hormone-releasing hormone (100 micrograms intravenous bolus). Serum prolactin levels, both basally and after thyrotropin-releasing hormone administration (500 micrograms intravenous bolus) or treadmill exercise, was similar in the two groups, as were serum thyroid function tests (including thyrotropin response to thyrotropin-releasing hormone). Changes in serum cortisol levels after short-term treadmill exercise were similar in both groups, and serum testosterone levels increased after exercise only in the eumenorrheic group. In neither group did such exercise change serum luteinizing hormone, follicle-stimulating hormone, or thyrotropin levels. We concluded that exercise-induced amenorrhea is not solely related to the development of increased prolactin output after exercise training. The exaggerated gonadotropin response to luteinizing hormone-releasing hormone seen in amenorrheic runners in comparison with matched eumenorrheic runners is consistent with a hypothalamic etiology for the menstrual dysfunction, analogous to that previously described in "stress-induced" or "psychogenic" amenorrhea.

[The influence of locomotor treatment using robotic body-weight-supported treadmill training on rehabilitation outcome of patients suffering from neurological disorders].

PubMed

Schwartz, Isabella; Meiner, Zeev

2013-03-01

Regaining one's ability to walk is of great importance for neurological patients and is a major goal of all rehabilitation programs. Treating neurological patients in the acute phase after the event is technically difficult because of their motor weakness and balance disturbances. Based on studies in spinalized animals, a novel locomotor training that incorporates high repetitions of task-oriented practice by the use of body weight-supported treadmill training (BWSTT) was developed to overcome these obstacles. The use of BWSTT enables early initiation of gait training, integration of weightbearing activities, stepping and balance by the use of a task-specific approach, and a symmetrical gait pattern. However, despite the theoretical potential of BWSTT to become an invaluable therapeutic tool, its effect on walking outcomes was disappointing when compared with conventional training of the same duration. To facilitate the deLivery of BWSTT, a motorized robotic driven gait orthosis (RBWSTT) was recently developed. It has many advantages over the conventional method, including less effort for the physiotherapists, longer session duration, more physiological and reproducible gait patterns, and the possibility of measuring a patient's performances. Several studies have been conducted using RBWSTT in patients after stroke, spinal cord injury, multiple sclerosis and other neurological diseases. Although some of the results were encouraging, there is still uncertainty regarding proper patient selection, timing and protocol for RBWTT treatment following neurological diseases. More large randomized controlled studies are needed in order to answer these questions.

Visual Bias Predicts Gait Adaptability in Novel Sensory Discordant Conditions

NASA Technical Reports Server (NTRS)

Brady, Rachel A.; Batson, Crystal D.; Peters, Brian T.; Mulavara, Ajitkumar P.; Bloomberg, Jacob J.

2010-01-01

We designed a gait training study that presented combinations of visual flow and support-surface manipulations to investigate the response of healthy adults to novel discordant sensorimotor conditions. We aimed to determine whether a relationship existed between subjects visual dependence and their postural stability and cognitive performance in a new discordant environment presented at the conclusion of training (Transfer Test). Our training system comprised a treadmill placed on a motion base facing a virtual visual scene that provided a variety of sensory challenges. Ten healthy adults completed 3 training sessions during which they walked on a treadmill at 1.1 m/s while receiving discordant support-surface and visual manipulations. At the first visit, in an analysis of normalized torso translation measured in a scene-movement-only condition, 3 of 10 subjects were classified as visually dependent. During the Transfer Test, all participants received a 2-minute novel exposure. In a combined measure of stride frequency and reaction time, the non-visually dependent subjects showed improved adaptation on the Transfer Test compared to their visually dependent counterparts. This finding suggests that individual differences in the ability to adapt to new sensorimotor conditions may be explained by individuals innate sensory biases. An accurate preflight assessment of crewmembers biases for visual dependence could be used to predict their propensities to adapt to novel sensory conditions. It may also facilitate the development of customized training regimens that could expedite adaptation to alternate gravitational environments.

Gait parameters associated with responsiveness to treadmill training with body-weight support after stroke: an exploratory study.

PubMed

Mulroy, Sara J; Klassen, Tara; Gronley, JoAnne K; Eberly, Valerie J; Brown, David A; Sullivan, Katherine J

2010-02-01

Task-specific training programs after stroke improve walking function, but it is not clear which biomechanical parameters of gait are most associated with improved walking speed. The purpose of this study was to identify gait parameters associated with improved walking speed after a locomotor training program that included body-weight-supported treadmill training (BWSTT). A prospective, between-subjects design was used. Fifteen people, ranging from approximately 9 months to 5 years after stroke, completed 1 of 3 different 6-week training regimens. These regimens consisted of 12 sessions of BWSTT alternated with 12 sessions of: lower-extremity resistive cycling; lower-extremity progressive, resistive strengthening; or a sham condition of arm ergometry. Gait analysis was conducted before and after the 6-week intervention program. Kinematics, kinetics, and electromyographic (EMG) activity were recorded from the hemiparetic lower extremity while participants walked at a self-selected pace. Changes in gait parameters were compared in participants who showed an increase in self-selected walking speed of greater than 0.08 m/s (high-response group) and in those with less improvement (low-response group). Compared with participants in the low-response group, those in the high-response group displayed greater increases in terminal stance hip extension angle and hip flexion power (product of net joint moment and angular velocity) after the intervention. The intensity of soleus muscle EMG activity during walking also was significantly higher in participants in the high-response group after the intervention. Only sagittal-plane parameters were assessed, and the sample size was small. Task-specific locomotor training alternated with strength training resulted in kinematic, kinetic, and muscle activation adaptations that were strongly associated with improved walking speed. Changes in both hip and ankle biomechanics during late stance were associated with greater increases in gait speed.

Can an anti-gravity treadmill improve stability of children with cerebral palsy?

PubMed

Birgani, P M; Ashtiyani, M; Rasooli, A; Shahrokhnia, M; Shahrokhi, A; Mirbagheri, M M

2016-08-01

We aimed to study the effects of an anti-gravity treadmill (AlterG) training on balance and postural stability in children with cerebral palsy (CP). AlterG training was performed 3 days/week for 8 weeks, with up to 45 minutes of training per session. The subject was evaluated before and after the 8-week training. The effects of training on the balance and postural stability was evaluated based on the Romberg test that was performed by using a posturography device. The parameters quantifying Center-of-Pressure (CoP) were calculated using different analytical approaches including power spectral density and principal components analyses. All of the key parameters including the Stabilogram, the Fast Fourier Transform (FFT) Energy, the Eigenvectors, and the Eigenvalues of CoP were modified between 14%-84%. The results indicated that the balance features were improved substantially after training. The clinical implication is that the AlterG has the potential to effectively improve postural stability in children with cerebral palsy.

Improved clinical status, quality of life, and walking capacity in Parkinson's disease after body weight-supported high-intensity locomotor training.

PubMed

Rose, Martin H; Løkkegaard, Annemette; Sonne-Holm, Stig; Jensen, Bente R

2013-04-01

To evaluate the effect of body weight-supported progressive high-intensity locomotor training in Parkinson's disease (PD) on (1) clinical status; (2) quality of life; and (3) gait capacity. Open-label, fixed sequence crossover study. University motor control laboratory. Patients (N=13) with idiopathic PD (Hoehn and Yahr stage 2 or 3) and stable medication use. Patients completed an 8-week (3 × 1h/wk) training program on a lower-body positive-pressure treadmill. Body weight support was used to facilitate increased intensity and motor challenges during treadmill training. The training program contained combinations of (1) running and walking intervals, (2) the use of sudden changes (eg, in body weight support and speed), (3) different types of locomotion (eg, chassé, skipping, and jumps), and (4) sprints at 50 percent body weight. The Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Parkinson's Disease Questionnaire-39 items (PDQ-39), and the six-minute walk test were conducted 8 weeks before and pre- and posttraining. At the end of training, statistically significant improvements were found in all outcome measures compared with the control period. Total MDS-UPDRS score changed from (mean ± 1SD) 58±18 to 47±18, MDS-UPDRS motor part score changed from 35±10 to 29±12, PDQ-39 summary index score changed from 22±13 to 13±12, and the six-minute walking distance changed from 576±93 to 637±90m. Body weight-supported progressive high-intensity locomotor training is feasible and well tolerated by patients with PD. The training improved clinical status, quality of life, and gait capacity significantly. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

An accelerometry-based comparison of 2 robotic assistive devices for treadmill training of gait.

PubMed

Regnaux, Jean-Philippe; Saremi, Kaveh; Marehbian, Jon; Bussel, Bernard; Dobkin, Bruce H

2008-01-01

Two commercial robotic devices, the Gait Trainer (GT) and the Lokomat (LOKO), assist task-oriented practice of walking. The gait patterns induced by these motor-driven devices have not been characterized and compared. A healthy participant chose the most comfortable gait pattern on each device and for treadmill (TM) walking at 1, 2 (maximum for the GT), and 3 km/h and over ground at similar speeds. A system of accelerometers on the thighs and feet allowed the calculation of spatiotemporal features and accelerations during the gait cycle. At the 1 and 2 km/h speed settings, single-limb stance times were prolonged on the devices compared with overground walking. Differences on the LOKO were decreased by adjusting the hip and knee angles and step length. At the 3 km/h setting, the LOKO approximated the participant's overground parameters. Irregular accelerations and decelerations from toe-off to heel contact were induced by the devices, especially at slower speeds. The LOKO and GT impose mechanical constraints that may alter leg accelerations-decelerations during stance and swing phases, as well as stance duration, especially at their slower speed settings, that are not found during TM and overground walking. The potential impact of these perturbations on training to improve gait needs further study.

Therapeutic effects of an anti-gravity treadmill (AlterG) training on gait and lower limbs kinematics and kinetics in children with cerebral palsy.

PubMed

Lotfian, M; Kharazi, M R; Mirbagheri, A; Dadashi, F; Nourian, R; Mirbagheri, M M

2017-07-01

We aimed to investigate the effects of the lower body weight support treadmill (AlterG) training on kinetics and kinematics of the lower extremities in children with cerebral palsy (CP). We provided a 45-minute training program, 3 times a week for 8 weeks. AlterG can support the subject's weight up to 70% so that the subject will be able to walk more comfortably to reach a more correct walking pattern. The kinematics and kinetics were evaluated using an isokinetic dynamometer. The locomotion parameters were assessed in the gait laboratory. Subjects performance was evaluated at four time points: baseline (prior to training), 1 and 2 months after the beginning of training, and one month after the end of the training (as a follow-up evaluation). The results showed that the major gait, kinematic, and kinetic parameters improved after the AlterG training and were persistent. These findings suggest that the AlterG training can be considered as a therapeutic tool for improving the lower limb performance and locomotion in children with CP.

A comparison of the effects of visual deprivation and regular body weight support treadmill training on improving over-ground walking of stroke patients: a multiple baseline single subject design.

PubMed

Kim, Jeong-Soo; Kang, Sun-Young; Jeon, Hye-Seon

2015-01-01

The body-weight-support treadmill (BWST) is commonly used for gait rehabilitation, but other forms of BWST are in development, such as visual-deprivation BWST (VDBWST). In this study, we compare the effect of VDBWST training and conventional BWST training on spatiotemporal gait parameters for three individuals who had hemiparetic strokes. We used a single-subject experimental design, alternating multiple baselines across the individuals. We recruited three individuals with hemiparesis from stroke; two on the left side and one on the right. For the main outcome measures we assessed spatiotemporal gait parameters using GAITRite, including: gait velocity; cadence; step time of the affected side (STA); step time of the non-affected side (STN); step length of the affected side (SLA); step length of the non-affected side (SLN); step-time asymmetry (ST-asymmetry); and step-length asymmetry (SL-asymmetry). Gait velocity, cadence, SLA, and SLN increased from baseline after both interventions, but STA, ST-asymmetry, and SL-asymmetry decreased from the baseline after the interventions. The VDBWST was significantly more effective than the BWST for increasing gait velocity and cadence and for decreasing ST-asymmetry. VDBWST is more effective than BWST for improving gait performance during the rehabilitation for ground walking.

Exercise Training in Progressive Multiple Sclerosis: A Comparison of Recumbent Stepping and Body Weight-Supported Treadmill Training.

PubMed

Pilutti, Lara A; Paulseth, John E; Dove, Carin; Jiang, Shucui; Rathbone, Michel P; Hicks, Audrey L

2016-01-01

Background: There is evidence of the benefits of exercise training in multiple sclerosis (MS); however, few studies have been conducted in individuals with progressive MS and severe mobility impairment. A potential exercise rehabilitation approach is total-body recumbent stepper training (TBRST). We evaluated the safety and participant-reported experience of TBRST in people with progressive MS and compared the efficacy of TBRST with that of body weight-supported treadmill training (BWSTT) on outcomes of function, fatigue, and health-related quality of life (HRQOL). Methods: Twelve participants with progressive MS (Expanded Disability Status Scale scores, 6.0-8.0) were randomized to receive TBRST or BWSTT. Participants completed three weekly sessions (30 minutes) of exercise training for 12 weeks. Primary outcomes included safety assessed as adverse events and patient-reported exercise experience assessed as postexercise response and evaluation of exercise equipment. Secondary outcomes included the Multiple Sclerosis Functional Composite, the Modified Fatigue Impact Scale, and the Multiple Sclerosis Quality of Life-54 questionnaire scores. Assessments were conducted at baseline and after 12 weeks. Results: Safety was confirmed in both exercise groups. Participants reported enjoying both exercise modalities; however, TBRST was reviewed more favorably. Both interventions reduced fatigue and improved HRQOL (P ≤ .05); there were no changes in function. Conclusions: Both TBRST and BWSTT seem to be safe, well tolerated, and enjoyable for participants with progressive MS with severe disability. Both interventions may also be efficacious for reducing fatigue and improving HRQOL. TBRST should be further explored as an exercise rehabilitation tool for patients with progressive MS.

Impact of mild versus moderate intensity aerobic walking exercise training on markers of bone metabolism and hand grip strength in moderate hemophilic A patients.

PubMed

Al-Sharif, Fadwa Al-Ghalib; Al-Jiffri, Osama Hussien; El-Kader, Shehab Mahmoud Abd; Ashmawy, Eman Mohamed

2014-03-01

Patients with hemophilia A have low bone density than healthy controls. It is now widely recognized that physical activity and sports are beneficial for patients with hemophilia. To compare the effects of mild and moderate intensity treadmill walking exercises on markers of bone metabolism and hand grip strength in male patients with moderate hemophilia A. Fifty male patients with moderate hemophilia, and age range from 25 to 45 years. The subjects were randomly assigned into 2 equal groups; the first group (A) received moderate intensity aerobic exercise training. The second group (B) received mild intensity aerobic exercise training. There was a 32.1% and 24.8% increase in mean values of serum calcium and hand grip strength respectively and 22.7 % reduction in mean values of parathyroid hormone in moderate exercise training group (A). While there was a 15.1 % and 15 % increase in mean values of Serum Calcium and Hand grip strength respectively and 10.3 % reduction in mean values of parathyroid hormone in mild exercise training group(B). The mean values of serum calcium and hand grip strength were significantly increased, while the mean values of parathyroid hormone were significantly decreased in both groups . There were significant differences between mean levels of the investigated parameters in group (A) and group (B) after treatment. Moderate intensity aerobic exercise training on treadmill is appropriate to improve markers of bone metabolism and hand grip strength in male patients with hemophilia A.

Examination of the Combined Effects of Chondroitinase ABC, Growth Factors and Locomotor Training following Compressive Spinal Cord Injury on Neuroanatomical Plasticity and Kinematics

PubMed Central

Alluin, Olivier; Fehlings, Michael G.; Rossignol, Serge; Karimi-Abdolrezaee, Soheila

2014-01-01

While several cellular and pharmacological treatments have been evaluated following spinal cord injury (SCI) in animal models, it is increasingly recognized that approaches to address the glial scar, including the use of chondroitinase ABC (ChABC), can facilitate neuroanatomical plasticity. Moreover, increasing evidence suggests that combinatorial strategies are key to unlocking the plasticity that is enabled by ChABC. Given this, we evaluated the anatomical and functional consequences of ChABC in a combinatorial approach that also included growth factor (EGF, FGF2 and PDGF-AA) treatments and daily treadmill training on the recovery of hindlimb locomotion in rats with mid thoracic clip compression SCI. Using quantitative neuroanatomical and kinematic assessments, we demonstrate that the combined therapy significantly enhanced the neuroanatomical plasticity of major descending spinal tracts such as corticospinal and serotonergic-spinal pathways. Additionally, the pharmacological treatment attenuated chronic astrogliosis and inflammation at and adjacent to the lesion with the modest synergistic effects of treadmill training. We also observed a trend for earlier recovery of locomotion accompanied by an improvement of the overall angular excursions in rats treated with ChABC and growth factors in the first 4 weeks after SCI. At the end of the 7-week recovery period, rats from all groups exhibited an impressive spontaneous recovery of the kinematic parameters during locomotion on treadmill. However, although the combinatorial treatment led to clear chronic neuroanatomical plasticity, these structural changes did not translate to an additional long-term improvement of locomotor parameters studied including hindlimb-forelimb coupling. These findings demonstrate the beneficial effects of combined ChABC, growth factors and locomotor training on the plasticity of the injured spinal cord and the potential to induce earlier neurobehavioral recovery. However, additional approaches such as stem cell therapies or a more adapted treadmill training protocol may be required to optimize this repair strategy in order to induce sustained functional locomotor improvement. PMID:25350665

Overspeed HIIT in Lower-Body Positive Pressure Treadmill Improves Running Performance.

PubMed

Gojanovic, Boris; Shultz, Rebecca; Feihl, Francois; Matheson, Gordon

2015-12-01

Optimal high-intensity interval training (HIIT) regimens for running performance are unknown, although most protocols result in some benefit to key performance factors (running economy (RE), anaerobic threshold (AT), or maximal oxygen uptake (VO2max)). Lower-body positive pressure (LBPP) treadmills offer the unique possibility to partially unload runners and reach supramaximal speeds. We studied the use of LBPP to test an overspeed HIIT protocol in trained runners. Eleven trained runners (35 ± 8 yr, VO2max, 55.7 ± 6.4 mL·kg⁻¹·min⁻¹) were randomized to an LBPP (n = 6) or a regular treadmill (CON, n = 5), eight sessions over 4 wk of HIIT program. Four to five intervals were run at 100% of velocity at VO2max (vVO2max) during 60% of time to exhaustion at vVO2max (Tlim) with a 1:1 work:recovery ratio. Performance outcomes were 2-mile track time trial, VO2max, vVO2max, vAT, Tlim, and RE. LBPP sessions were carried out at 90% body weight. Group-time effects were present for vVO2max (CON, 17.5 vs. 18.3, P = 0.03; LBPP, 19.7 vs. 22.3 km·h⁻¹; P < 0.001) and Tlim (CON, 307.0 vs. 404.4 s, P = 0.28; LBPP, 444.5 vs. 855.5, P < 0.001). Simple main effects for time were present for field performance (CON, -18; LBPP, -25 s; P = 0.002), VO2max (CON, 57.6 vs. 59.6; LBPP, 54.1 vs. 55.1 mL·kg⁻¹·min⁻¹; P = 0.04) and submaximal HR (157.7 vs. 154.3 and 151.4 vs. 148.5 bpm; P = 0.002). RE was unchanged. A 4-wk HIIT protocol at 100% vVO2max improves field performance, vVO2max, VO2max and submaximal HR in trained runners. Improvements are similar if intervals are run on a regular treadmill or at higher speeds on a LPBB treadmill with 10% body weight reduction. LBPP could provide an alternative for taxing HIIT sessions.

Gait Evaluation of Overground Walking and Treadmill Walking Using Compass-Type Walking Model

NASA Astrophysics Data System (ADS)

Nagata, Yousuke; Yamamoto, Masayoshi; Funabiki, Shigeyuki

A treadmill is a useful apparatus for the gait training and evaluation. However, many differences are reported between treadmill and overground walking. Experimental comparisons of the muscle activity of the leg and the heart rate have been carried out. However, the dynamic comparison has not been performed. The dynamic evaluation of the overground walking and the treadmill walking using a compass-type walking model (CTWM) which is a simple bipedal walking model, then their comparison is discussed. It is confirmed that the walking simulation using the CTWM can simulate the difference of that walk, it is clarified that there are the differences of the kick impulse on the ground and the turning impulse of the foot to the variation of the belt speed and then differences are the main factor of two walking.

When is the best moment to apply photobiomodulation therapy (PBMT) when associated to a treadmill endurance-training program? A randomized, triple-blinded, placebo-controlled clinical trial.

PubMed

Miranda, Eduardo Foschini; Tomazoni, Shaiane Silva; de Paiva, Paulo Roberto Vicente; Pinto, Henrique Dantas; Smith, Denis; Santos, Larissa Aline; de Tarso Camillo de Carvalho, Paulo; Leal-Junior, Ernesto Cesar Pinto

2018-05-01

Photobiomodulation therapy (PBMT) employing low-level laser therapy (LLLT) and/or light emitting diode therapy (LEDT) has emerged as an electrophysical intervention that could be associated with aerobic training to enhance beneficial effects of aerobic exercise. However, the best moment to perform irradiation with PBMT in aerobic training has not been elucidated. The aim of this study was to assess the effects of PBMT applied before and/or after each training session and to evaluate outcomes of the endurance-training program associated with PBMT. Seventy-seven healthy volunteers completed the treadmill-training protocol performed for 12 weeks, with 3 sessions per week. PBMT was performed before and/or after each training session (17 sites on each lower limb, using a cluster of 12 diodes: 4 × 905 nm super-pulsed laser diodes, 4 × 875 nm infrared LEDs, and 4 × 640 nm red LEDs, dose of 30 J per site). Volunteers were randomized in four groups according to the treatment they would receive before and after each training session: PBMT before + PBMT after, PBMT before + placebo after, placebo before + PBMT after, and placebo before + placebo after. Assessments were performed before the start of the protocol and after 4, 8, and 12 weeks of training. Primary outcome was time until exhaustion; secondary outcome measures were oxygen uptake and body fat. PBMT applied before and after aerobic exercise training sessions (PBMT before + PBMT after group) significantly increased (p < 0.05) the percentage of change of time until exhaustion and oxygen uptake compared to the group treated with placebo before and after aerobic exercise training sessions (placebo before + placebo after group) at 4th, 8th, and 12th week. PBMT applied before and after aerobic exercise training sessions (PBMT before + PBMT after group) also significantly improved (p < 0.05) the percentage of change of body fat compared to the group treated with placebo before and after aerobic exercise training sessions (placebo before + placebo after group) at 8th and 12th week. PBMT applied before and after sessions of aerobic training during 12 weeks can increase the time-to-exhaustion and oxygen uptake and also decrease the body fat in healthy volunteers when compared to placebo irradiation before and after exercise sessions. Our outcomes show that PBMT applied before and after endurance-training exercise sessions lead to improvement of endurance three times faster than exercise only.

Disparate effects of training on brain activation in Parkinson disease.

PubMed

Maidan, Inbal; Rosenberg-Katz, Keren; Jacob, Yael; Giladi, Nir; Hausdorff, Jeffrey M; Mirelman, Anat

2017-10-24

To compare the effects of 2 forms of exercise, i.e., a 6-week trial of treadmill training with virtual reality (TT + VR) that targets motor and cognitive aspects of safe ambulation and a 6-week trial of treadmill training alone (TT), on brain activation in patients with Parkinson disease (PD). As part of a randomized controlled trial, patients were randomly assigned to 6 weeks of TT (n = 17, mean age 71.5 ± 1.5 years, disease duration 11.6 ± 1.6 years; 70% men) or TT + VR (n = 17, mean age 71.2 ± 1.7 years, disease duration 7.9 ± 1.4 years; 65% men). A previously validated fMRI imagery paradigm assessed changes in neural activation pretraining and post-training. Participants imagined themselves walking in 2 virtual scenes projected in the fMRI: (1) a clear path and (2) a path with virtual obstacles. Whole brain and region of interest analyses were performed. Brain activation patterns were similar between training arms before the interventions. After training, participants in the TT + VR arm had lower activation than the TT arm in Brodmann area 10 and the inferior frontal gyrus (cluster level familywise error-corrected [FWEcorr] p < 0.012), while the TT arm had lower activation than TT + VR in the cerebellum and middle temporal gyrus (cluster level FWEcorr p < 0.001). Changes in fall frequency and brain activation were correlated in the TT + VR arm. Exercise modifies brain activation patterns in patients with PD in a mode-specific manner. Motor-cognitive training decreased the reliance on frontal regions, which apparently resulted in improved function, perhaps reflecting increased brain efficiency. © 2017 American Academy of Neurology.

The application of walking training in the rehabilitation of patients after coronary artery bypass grafting

PubMed Central

Dylewicz, Piotr

2015-01-01

Walking is regarded as one of the most common and utilitarian activities of everyday life. Rehabilitation programs developed on the basis of this form of activity often constitute the primary method of rehabilitating patients after coronary artery bypass grafting. This paper provides a review of literature concerning various forms of walking training, discussing their impact on the parameters of exercise capacity and verifying the training methods with regard to the current guidelines. Attention is drawn to the diversity of the exercise protocols applied during the early and late stages of rehabilitation and pre-rehabilitation programs including: treadmill walking, walking down the corridor, treadmill walking enriched with virtual reality, and walking as an element of training sessions consisting of many different forms of activities. Exercise protocols were also analyzed in terms of their safety, especially in the case of high-intensity interval training. Despite the variety of the available rehabilitation programs, the training methodology requires constant improvement, particularly in terms of load dosage and the supervision of training sessions. PMID:26702291

Use of Visual and Proprioceptive Feedback to Improve Gait Speed and Spatiotemporal Symmetry Following Chronic Stroke: A Case Series

PubMed Central

Feasel, Jeff; Wentz, Erin; Brooks, Frederick P.; Whitton, Mary C.

2012-01-01

Background and Purpose Persistent deficits in gait speed and spatiotemporal symmetry are prevalent following stroke and can limit the achievement of community mobility goals. Rehabilitation can improve gait speed, but has shown limited ability to improve spatiotemporal symmetry. The incorporation of combined visual and proprioceptive feedback regarding spatiotemporal symmetry has the potential to be effective at improving gait. Case Description A 60-year-old man (18 months poststroke) and a 53-year-old woman (21 months poststroke) each participated in gait training to improve gait speed and spatiotemporal symmetry. Each patient performed 18 sessions (6 weeks) of combined treadmill-based gait training followed by overground practice. To assist with relearning spatiotemporal symmetry, treadmill-based training for both patients was augmented with continuous, real-time visual and proprioceptive feedback from an immersive virtual environment and a dual belt treadmill, respectively. Outcomes Both patients improved gait speed (patient 1: 0.35 m/s improvement; patient 2: 0.26 m/s improvement) and spatiotemporal symmetry. Patient 1, who trained with step-length symmetry feedback, improved his step-length symmetry ratio, but not his stance-time symmetry ratio. Patient 2, who trained with stance-time symmetry feedback, improved her stance-time symmetry ratio. She had no step-length asymmetry before training. Discussion Both patients made improvements in gait speed and spatiotemporal symmetry that exceeded those reported in the literature. Further work is needed to ascertain the role of combined visual and proprioceptive feedback for improving gait speed and spatiotemporal symmetry after chronic stroke. PMID:22228605

Trunk Robot Rehabilitation Training with Active Stepping Reorganizes and Enriches Trunk Motor Cortex Representations in Spinal Transected Rats

PubMed Central

Oza, Chintan S.

2015-01-01

Trunk motor control is crucial for postural stability and propulsion after low thoracic spinal cord injury (SCI) in animals and humans. Robotic rehabilitation aimed at trunk shows promise in SCI animal models and patients. However, little is known about the effect of SCI and robot rehabilitation of trunk on cortical motor representations. We previously showed reorganization of trunk motor cortex after adult SCI. Non-stepping training also exacerbated some SCI-driven plastic changes. Here we examine effects of robot rehabilitation that promotes recovery of hindlimb weight support functions on trunk motor cortex representations. Adult rats spinal transected as neonates (NTX rats) at the T9/10 level significantly improve function with our robot rehabilitation paradigm, whereas treadmill-only trained do not. We used intracortical microstimulation to map motor cortex in two NTX groups: (1) treadmill trained (control group); and (2) robot-assisted treadmill trained (improved function group). We found significant robot rehabilitation-driven changes in motor cortex: (1) caudal trunk motor areas expanded; (2) trunk coactivation at cortex sites increased; (3) richness of trunk cortex motor representations, as examined by cumulative entropy and mutual information for different trunk representations, increased; (4) trunk motor representations in the cortex moved toward more normal topography; and (5) trunk and forelimb motor representations that SCI-driven plasticity and compensations had caused to overlap were segregated. We conclude that effective robot rehabilitation training induces significant reorganization of trunk motor cortex and partially reverses some plastic changes that may be adaptive in non-stepping paraplegia after SCI. PMID:25948267

Matching optical flow to motor speed in virtual reality while running on a treadmill

PubMed Central

Lafortuna, Claudio L.; Mugellini, Elena; Abou Khaled, Omar

2018-01-01

We investigated how visual and kinaesthetic/efferent information is integrated for speed perception in running. Twelve moderately trained to trained subjects ran on a treadmill at three different speeds (8, 10, 12 km/h) in front of a moving virtual scene. They were asked to match the visual speed of the scene to their running speed–i.e., treadmill’s speed. For each trial, participants indicated whether the scene was moving slower or faster than they were running. Visual speed was adjusted according to their response using a staircase until the Point of Subjective Equality (PSE) was reached, i.e., until visual and running speed were perceived as equivalent. For all three running speeds, participants systematically underestimated the visual speed relative to their actual running speed. Indeed, the speed of the visual scene had to exceed the actual running speed in order to be perceived as equivalent to the treadmill speed. The underestimation of visual speed was speed-dependent, and percentage of underestimation relative to running speed ranged from 15% at 8km/h to 31% at 12km/h. We suggest that this fact should be taken into consideration to improve the design of attractive treadmill-mediated virtual environments enhancing engagement into physical activity for healthier lifestyles and disease prevention and care. PMID:29641564

Potential of adult mammalian lumbosacral spinal cord to execute and acquire improved locomotion in the absence of supraspinal input

NASA Technical Reports Server (NTRS)

Edgerton, V. R.; Roy, R. R.; Hodgson, J. A.; Prober, R. J.; de Guzman, C. P.; de Leon, R.

1992-01-01

The neural circuitry of the lumbar spinal cord can generate alternating extension and flexion of the hindlimbs. The hindlimbs of adult cats with complete transection of the spinal cord at a low thoracic level (T12-T13) can perform full weight-supporting locomotion on a treadmill belt moving at a range of speeds. Some limitations in the locomotor capacity can be associated with a deficit in the recruitment level of the fast extensors during the stance phase and the flexors during the swing phase of a step cycle. The level of locomotor performance, however, can be enhanced by daily training on a treadmill while emphasizing full weight-support stepping and by providing appropriately timed sensory stimulation, loading, and/or pharmacologic stimulation of the hindlimb neuromuscular apparatus. Furthermore, there appears to be an interactive effect of these interventions. For example, the maximum treadmill speed that a spinal adult cat can attain and maintain is significantly improved with daily full weight-supporting treadmill training, but progressive recruitment of fast extensors becomes apparent only when the hindlimbs are loaded by gently pulling down on the tail during the stepping. Stimulation of the sural nerve at the initiation of the flexion phase of the step cycle can likewise markedly improve the locomotor capability. Administration of clonidine, in particular in combination with an elevated load, resulted in the most distinct and consistent alternating bursts of electromyographic activity during spinal stepping. These data indicate that the spinal cord has the ability to execute alternating activation of the extensor and flexor musculature of the hindlimbs (stepping) and that this ability can be improved by several interventions such as training, sensory stimulation, and use of some pharmacologic agents. Thus, it appears that the spinal cord, without supraspinal input, is highly plastic and has the potential to "learn," that is, to acquire and improve its ability to execute full weight-supporting locomotion on a treadmill belt.

Effects of task-specific and impairment-based training compared with usual care on functional walking ability after inpatient stroke rehabilitation: LEAPS Trial.

PubMed

Nadeau, Stephen E; Wu, Samuel S; Dobkin, Bruce H; Azen, Stanley P; Rose, Dorian K; Tilson, Julie K; Cen, Steven Y; Duncan, Pamela W

2013-05-01

After inpatient stroke rehabilitation, many people still cannot participate in community activities because of limited walking ability. To compare the effectiveness of 2 conceptually different, early physical therapy (PT) interventions to usual care (UC) in improving walking 6 months after stroke. The locomotor experience applied post-stroke (LEAPS) study was a single-blind, randomized controlled trial conducted in 408 adults with disabling hemiparetic stroke. Participants were stratified at baseline (2 months) by impairment in walking speed: severe (<0.4 m/s) or moderate (0.4 to <0.8 m/s). Between 2 and 6 months, they received either only UC (n = 143) or UC plus 36 therapist-provided sessions of either (1) walking training on a treadmill using body-weight support and practice overground at clinics (locomotor training program [LTP], n = 139) or (2) impairment-based strength and balance exercise at home (home exercise program [HEP], n = 126). LTP participants were 18% more likely to transition to a higher functional walking level: severe to >0.4 m/s and moderate to >0.8 m/s than UC participants (95% confidence interval [CI] = 7%-29%), and HEP participants were 17% more likely to transition (95% CI = 5%-29%). Mean gain in walking speed in LTP participants was 0.13 m/s greater (95% CI = 0.09-0.18) and in HEP participants, 0.10 m/s greater (95% CI = 0.05-0.14) than in UC participants. Progressive PT, using either walking training on a treadmill and overground, conducted in a clinic, or strength and balance exercises conducted at home, was superior to UC in improving walking, regardless of severity of initial impairment.

Myosin heavy chain composition in the rat diaphragm - Effect of age and exercise training

NASA Technical Reports Server (NTRS)

Gosselin, Luc E.; Betlach, Michael; Vailas, Arthur C.; Greaser, Marion L.; Thomas, D. P.

1992-01-01

The effects of aging and exercise training on the myosin heavy chain (MHC) composition were determined in both the costal and crural diaphragm regions of female Fischer 344 rats. Treadmill running at 75 percent maximal oxygen consumption resulted in similar increases in plantaris muscle citrate synthase activity in both young (5 mo) and old (23mo) trained animals (P less than 0.05). It was found that the ratio of fast to slow MHC was significantly higher (P less than 0.005) in the crural compared with costal diaphragm region in both age groups. A significant age-related increase in persentage of slow MHC was observed in both diaphragm regions. The relative proportion of slow MHC in either costal or crural region was not changed by exercise training.

Mitochondrial and performance adaptations to exercise training in mice lacking skeletal muscle LKB1

PubMed Central

Tanner, Colby B.; Madsen, Steven R.; Hallowell, David M.; Goring, Darren M. J.; Moore, Timothy M.; Hardman, Shalene E.; Heninger, Megan R.; Atwood, Daniel R.

2013-01-01

LKB1 and its downstream targets of the AMP-activated protein kinase family are important regulators of many aspects of skeletal muscle cell function, including control of mitochondrial content and capillarity. LKB1 deficiency in skeletal and cardiac muscle (mLKB1-KO) greatly impairs exercise capacity. However, cardiac dysfunction in that genetic model prevents a clear assessment of the role of skeletal muscle LKB1 in the observed effects. Our purposes here were to determine whether skeletal muscle-specific knockout of LKB1 (skmLKB1-KO) decreases exercise capacity and mitochondrial protein content, impairs accretion of mitochondrial proteins after exercise training, and attenuates improvement in running performance after exercise training. We found that treadmill and voluntary wheel running capacity was reduced in skmLKB1-KO vs. control (CON) mice. Citrate synthase activity, succinate dehydrogenase activity, and pyruvate dehydrogenase kinase content were lower in KO vs. CON muscles. Three weeks of treadmill training resulted in significantly increased treadmill running performance in both CON and skmLKB1-KO mice. Citrate synthase activity increased significantly with training in both genotypes, but protein content and activity for components of the mitochondrial electron transport chain increased only in CON mice. Capillarity and VEGF protein was lower in skmLKB1-KO vs. CON muscles, but VEGF increased with training only in skmLKB1-KO. Three hours after an acute bout of muscle contractions, PGC-1α, cytochrome c, and VEGF gene expression all increased in CON but not skmLKB1-KO muscles. Our findings indicate that skeletal muscle LKB1 is required for accretion of some mitochondrial proteins but not for early exercise capacity improvements with exercise training. PMID:23982155

Design and Pilot Study of a Gait Enhancing Mobile Shoe.

PubMed

Handzic, Ismet; Barno, Eileen M; Vasudevan, Erin V; Reed, Kyle B

2011-12-01

Hemiparesis is a frequent and disabling consequence of stroke and can lead to asymmetric and inefficient walking patterns. Training on a split-belt treadmill, which has two separate treads driving each leg at a different speed, can correct such asymmetries post-stroke. However, the effects of split-belt treadmill training only partially transfer to everyday walking over ground and extended training sessions are required to achieve long-lasting effects. Our aim is to develop an alternative device, the Gait Enhancing Mobile Shoe (GEMS), that mimics the actions of the split-belt treadmill, but can be used during overground walking and in one's own home, thus enabling long-term training. The GEMS does not require any external power and is completely passive; all necessary forces are redirected from the natural forces present during walking. Three healthy subjects walked on the shoes for twenty minutes during which one GEMS generated a backward motion and the other GEMS generated a forward motion. Our preliminary experiments suggest that wearing the GEMS did cause subjects to modify coordination between the legs and these changes persisted when subjects returned to normal over-ground walking. The largest effects were observed in measures of temporal coordination (e.g., duration of double-support). These results suggest that the GEMS is capable of altering overground walking coordination in healthy controls and could potentially be used to correct gait asymmetries post-stroke.

Methods for a Randomized Trial of Weight-Supported Treadmill Training versus Conventional Training for Walking during Inpatient Rehabilitation after Incomplete Traumatic Spinal Cord Injury

PubMed Central

Dobkin, Bruce H.; Apple, David; Barbeau, Hugues; Basso, Michele; Behrman, Andrea; Deforge, Dan; Ditunno, John; Dudley, Gary; Elashoff, Robert; Fugate, Lisa; Harkema, Susan; Saulino, Michael; Scott, Michael

2014-01-01

The authors describe the rationale and methodology for the first prospective, multicenter, randomized clinical trial (RCT) of a task-oriented walking intervention for subjects during early rehabilitation for an acute traumatic spinal cord injury (SCI). The experimental strategy, body weight–supported treadmill training (BWSTT), allows physical therapists to systematically train patients to walk on a treadmill at increasing speeds typical of community ambulation with increasing weight bearing. The therapists provide verbal and tactile cues to facilitate the kinematic, kinetic, and temporal features of walking. Subjects were randomly assigned to a conventional therapy program for mobility versus the same intensity and duration of a combination of BWSTT and over-ground locomotor retraining. Subjects had an incomplete SCI (American Spinal Injury Association grades B, C, and D) from C-4 to T-10 (upper motoneuron group) or from T-11 to L-3 (lower motoneuron group). Within 8 weeks of a SCI, 146 subjects were entered for 12 weeks of intervention. The 2 single-blinded primary outcome measures are the level of independence for ambulation and, for those who are able to walk, the maximal speed for walking 50 feet, tested 6 and 12 months after randomization. The trial’s methodology offers a model for the feasibility of translating neuroscientific experiments into a RCT to develop evidence-based rehabilitation practices. PMID:14503436

Rewiring of regenerated axons by combining treadmill training with semaphorin3A inhibition

PubMed Central

2014-01-01

Background Rats exhibit extremely limited motor function recovery after total transection of the spinal cord (SCT). We previously reported that SM-216289, a semaphorin3A inhibitor, enhanced axon regeneration and motor function recovery in SCT adult rats. However, these effects were limited because most regenerated axons likely do not connect to the right targets. Thus, rebuilding the appropriate connections for regenerated axons may enhance recovery. In this study, we combined semaphorin3A inhibitor treatment with extensive treadmill training to determine whether combined treatment would further enhance the “rewiring” of regenerated axons. In this study, which aimed for clinical applicability, we administered a newly developed, potent semaphorin3A inhibitor, SM-345431 (Vinaxanthone), using a novel drug delivery system that enables continuous drug delivery over the period of the experiment. Results Treatment with SM-345431 using this delivery system enhanced axon regeneration and produced significant, but limited, hindlimb motor function recovery. Although extensive treadmill training combined with SM-345431 administration did not further improve axon regeneration, hindlimb motor performance was restored, as evidenced by the significant improvement in the execution of plantar steps on a treadmill. In contrast, control SCT rats could not execute plantar steps at any point during the experimental period. Further analyses suggested that this strategy reinforced the wiring of central pattern generators in lumbar spinal circuits, which, in turn, led to enhanced motor function recovery (especially in extensor muscles). Conclusions This study highlights the importance of combining treatments that promote axon regeneration with specific and appropriate rehabilitations that promote rewiring for the treatment of spinal cord injury. PMID:24618249

Daily Supine LBNP Treadmill Exercise Maintains Upright Exercise Capacity During 14 Days of Bed Rest

NASA Technical Reports Server (NTRS)

Ertl, Andy C.; Watenpaugh, D. E.; Hargens, Alan R.; Fortney, S. M.; Lee, S. M. C.; Ballard, R. E.; William, J. M.

1996-01-01

Exposure to microgravity or bed rest reduces upright exercise capacity. Exercise modes, durations, and intensities which will effectively and efficiently counteract such deconditioning are presently unresolved. We that daily supine treadmill interval training with lower body negative pressure (LBNP) would prevent reduction in upright exercise capacity during 14 days of 6 deg. head-down bed rest (BR). Eight healthy male subjects underwent two 14 day BR protocols separated by 3 months. In a crossover design, subjects either remained at strict BR or performed 40 min of daily exercise consisting of supine walking and running at intensities varying from 40-80% of pre-BR upright peak oxygen uptake (VO2). LBNP during supine exercise was used to provide 1.0 to 1.2 times body weight of footward force. An incremental upright treadmill test to measure submaximal and peak exercise responses was given pre- and post-BR. In the non-exercise condition, peak VO2 and time to exhaustion were reduced 16 +/- 4% and 10 +/- 1% (p less than 0.05), respectively, from pre-BR. With LBNP exercise these variables were not significantly different (NS) from pre-BR. During submaximal treadmill speeds after BR, heart rate was higher (11 +/- 11 bpm, p less than 0.05) and respiratory exchange ratio was elevated (p less than 0.05) in the no exercise condition. Both were maintained at pre-BR levels in the LBNP exercise condition (NS from pre-BR). Since this supine treadmill interval training with addition of LBNP maintained upright exercise responses and capacity during BR, this countermeasure may also be effective during space flight.

Chronic treadmill exercise in rats delicately alters the Purkinje cell structure to improve motor performance and toxin resistance in the cerebellum.

PubMed

Huang, Tung-Yi; Lin, Lung-Sheng; Cho, Keng-Chi; Chen, Shean-Jen; Kuo, Yu-Min; Yu, Lung; Wu, Fong-Sen; Chuang, Jih-Ing; Chen, Hsiun-Ing; Jen, Chauying J

2012-09-01

Although exercise usually improves motor performance, the underlying cellular changes in the cerebellum remain to be elucidated. This study aimed to investigate whether and how chronic treadmill exercise in young rats induced Purkinje cell changes to improve motor performance and rendered the cerebellum less vulnerable to toxin insults. After 1-wk familiarization of treadmill running, 6-wk-old male Wistar rats were divided into exercise and sedentary groups. The exercise group was then subjected to 8 wk of exercise training at moderate intensity. The rotarod test was carried out to evaluate motor performance. Purkinje cells in cerebellar slices were visualized by lucifer yellow labeling in single neurons and by calbindin immunostaining in groups of neurons. Compared with sedentary control rats, exercised rats not only performed better in the rotarod task, but also showed finer Purkinje cell structure (higher dendritic volume and spine density with the same dendritic field). The exercise-improved cerebellar functions were further evaluated by monitoring the long-lasting effects of intraventricular application of OX7-saporin. In the sedentary group, OX7-saporin treatment retarded the rotarod performance and induced ∼60% Purkinje cell loss in 3 wk. As a comparison, the exercise group showed much milder injuries in the cerebellum by the same toxin treatment. In conclusion, exercise training in young rats increased the dendritic density of Purkinje cells, which might play an important role in improving the motor performance. Furthermore, as Purkinje cells in the exercise group were relatively toxin resistant, the exercised rats showed good motor performance, even under toxin-treated conditions.

Peak Velocity as an Alternative Method for Training Prescription in Mice.

PubMed

Picoli, Caroline de Carvalho; Romero, Paulo Vitor da Silva; Gilio, Gustavo R; Guariglia, Débora A; Tófolo, Laize P; de Moraes, Solange M F; Machado, Fabiana A; Peres, Sidney B

2018-01-01

Purpose: To compare the efficiency of an aerobic physical training program prescribed according to either velocity associated with maximum oxygen uptake (vVO 2max ) or peak running speed obtained during an incremental treadmill test (V peak_K ) in mice. Methods: Twenty male Swiss mice, 60 days old, were randomly divided into two groups with 10 animals each: 1. group trained by vVO 2max (GVO 2 ), 2. group trained by V peak_K (GVP). After the adaptation training period, an incremental test was performed at the beginning of each week to adjust training load and to determine the amount of VO 2 and VCO 2 fluxes consumed, energy expenditure (EE) and run distance during the incremental test. Mice were submitted to 4 weeks of aerobic exercise training of moderate intensity (velocity referring to 70% of vVO 2max and V peak_K ) in a programmable treadmill. The sessions lasted from 30 to 40 min in the first week, to reach 60 min in the fourth week, in order to provide the mice with a moderate intensity exercise, totaling 20 training sessions. Results: Mice demonstrated increases in VO 2max (ml·kg -1 ·min -1 ) (GVO 2 = 49.1% and GVP = 56.2%), V peak_K (cm·s -1 ) (GVO 2 = 50.9% and GVP = 22.3%), EE (ml·kg -0,75 ·min -1 ) (GVO 2 = 39.9% and GVP = 51.5%), and run distance (cm) (GVO 2 = 43.5% and GVP = 33.4%), after 4 weeks of aerobic training (time effect, P < 0.05); there were no differences between the groups. Conclusions: V peak_K , as well as vVO 2max , can be adopted as an alternative test to determine the performance and correct prescription of systemized aerobic protocol training to mice.

Effects of an Aerobic Rowing Training Regimen in Young Adults with Down Syndrome.

ERIC Educational Resources Information Center

Varela, Ana Maria; Sardinha, Luis Bettencount; Pitetti, Kenneth H.

2001-01-01

Eight young adult males with Down syndrome received a 16-week rowing ergometry training regimen. Following training, no changes in cardiovascular fitness were found but participants did achieve significantly higher levels of work performance on both treadmill and rowing ergometer tests than did a control group. (Contains references.) (Author/DB)

Exergame and Balance Training Modulate Prefrontal Brain Activity during Walking and Enhance Executive Function in Older Adults

PubMed Central

Eggenberger, Patrick; Wolf, Martin; Schumann, Martina; de Bruin, Eling D.

2016-01-01

Different types of exercise training have the potential to induce structural and functional brain plasticity in the elderly. Thereby, functional brain adaptations were observed during cognitive tasks in functional magnetic resonance imaging studies that correlated with improved cognitive performance. This study aimed to investigate if exercise training induces functional brain plasticity during challenging treadmill walking and elicits associated changes in cognitive executive functions. Forty-two elderly participants were recruited and randomly assigned to either interactive cognitive-motor video game dancing (DANCE) or balance and stretching training (BALANCE). The 8-week intervention included three sessions of 30 min per week and was completed by 33 participants (mean age 74.9 ± 6.9 years). Prefrontal cortex (PFC) activity during preferred and fast walking speed on a treadmill was assessed applying functional near infrared spectroscopy pre- and post-intervention. Additionally, executive functions comprising shifting, inhibition, and working memory were assessed. The results showed that both interventions significantly reduced left and right hemispheric PFC oxygenation during the acceleration of walking (p < 0.05 or trend, r = 0.25–0.36), while DANCE showed a larger reduction at the end of the 30-s walking task compared to BALANCE in the left PFC [F(1, 31) = 3.54, p = 0.035, r = 0.32]. These exercise training induced modulations in PFC oxygenation correlated with improved executive functions (p < 0.05 or trend, r = 0.31–0.50). The observed reductions in PFC activity may release cognitive resources to focus attention on other processes while walking, which could be relevant to improve mobility and falls prevention in the elderly. This study provides a deeper understanding of the associations between exercise training, brain function during walking, and cognition in older adults. PMID:27148041

Treadmill training with partial body weight support after stroke: a review.

PubMed

Hesse, Stefan

2008-01-01

Restoration and improvement of gait after stroke are major aspects of neurorehabilitation. Mobilization out of the bed into the wheelchair and verticalisation with the help of a standing frame are first steps. With the patient cardiovascular stable, gait restoration is put on the agenda. Instead of tone-inhibiting and gait preparatory maneuvers, patients should practice complex gait cycles repetitively. Treadmill training with partial body weight support enables the harness-secured patients to practice numerous steps assisted by two or three therapists. In controlled studies, it proved equally effective as walking on the floor. Gait machines, as the Lokomat or the Gait Trainer GTI, intend to relieve the strenuous effort for the therapists. For the GTI, several controlled trials showed a superior effect in acute stroke patients with respect to walking ability and velocity. For the ambulatory patient, aerobic treadmill training is effective to improve speed and endurance without worsening gait quality. Belt velocity and inclination are gradually increased so that the patients reach a predefined target heart rate. On the belt, patients walk more symmetrically, and higher velocities result in a facilitation of paretic muscles and render gait more efficient. In summary, gait rehabilitation has seen dramatic changes over the last years. More is to be expected.

What Did We Learn from the Animal Studies of Body Weight–Supported Treadmill Training and Where Do We Go from Here?

PubMed Central

Dy, Christine J.

2017-01-01

Abstract Body weight–supported treadmill training (BWSTT) developed from animal studies of spinal cord injury (SCI). Evidence that spinal cats (i.e., cats that have a complete surgical transection of the cord) could regain the ability to step on a moving treadmill indicated a vast potential for spinal circuits to generate walking without the brain. BWSTT represented a means to unlock that potential. As the technique was adapted as a rehabilitation intervention for humans with SCI, shortcomings in the translation to walking in the real world were exposed. Evidence that BWSTT has not been as successful for humans with SCI leads us to revisit key animal studies. In this short review, we describe the task-specific nature of BWSTT and discuss how this specificity may pose limits on the recovery of overground walking. Also discussed are more recent studies that have introduced new strategies and tools that adapt BWSTT ideas to more functionally-relevant tasks. We introduce a new device for weight-supported overground walking in rats called Circular BART (Body weight supported Ambulatory Rat Trainer) and demonstrate that it is relatively easy and inexpensive to produce. Future animal studies will benefit from the development of simple tools that facilitate training and testing of overground walking. PMID:27863455

What Did We Learn from the Animal Studies of Body Weight-Supported Treadmill Training and Where Do We Go from Here?

PubMed

de Leon, Ray D; Dy, Christine J

2017-05-01

Body weight-supported treadmill training (BWSTT) developed from animal studies of spinal cord injury (SCI). Evidence that spinal cats (i.e., cats that have a complete surgical transection of the cord) could regain the ability to step on a moving treadmill indicated a vast potential for spinal circuits to generate walking without the brain. BWSTT represented a means to unlock that potential. As the technique was adapted as a rehabilitation intervention for humans with SCI, shortcomings in the translation to walking in the real world were exposed. Evidence that BWSTT has not been as successful for humans with SCI leads us to revisit key animal studies. In this short review, we describe the task-specific nature of BWSTT and discuss how this specificity may pose limits on the recovery of overground walking. Also discussed are more recent studies that have introduced new strategies and tools that adapt BWSTT ideas to more functionally-relevant tasks. We introduce a new device for weight-supported overground walking in rats called Circular BART (Body weight supported Ambulatory Rat Trainer) and demonstrate that it is relatively easy and inexpensive to produce. Future animal studies will benefit from the development of simple tools that facilitate training and testing of overground walking.

Trunk robot rehabilitation training with active stepping reorganizes and enriches trunk motor cortex representations in spinal transected rats.

PubMed

Oza, Chintan S; Giszter, Simon F

2015-05-06

Trunk motor control is crucial for postural stability and propulsion after low thoracic spinal cord injury (SCI) in animals and humans. Robotic rehabilitation aimed at trunk shows promise in SCI animal models and patients. However, little is known about the effect of SCI and robot rehabilitation of trunk on cortical motor representations. We previously showed reorganization of trunk motor cortex after adult SCI. Non-stepping training also exacerbated some SCI-driven plastic changes. Here we examine effects of robot rehabilitation that promotes recovery of hindlimb weight support functions on trunk motor cortex representations. Adult rats spinal transected as neonates (NTX rats) at the T9/10 level significantly improve function with our robot rehabilitation paradigm, whereas treadmill-only trained do not. We used intracortical microstimulation to map motor cortex in two NTX groups: (1) treadmill trained (control group); and (2) robot-assisted treadmill trained (improved function group). We found significant robot rehabilitation-driven changes in motor cortex: (1) caudal trunk motor areas expanded; (2) trunk coactivation at cortex sites increased; (3) richness of trunk cortex motor representations, as examined by cumulative entropy and mutual information for different trunk representations, increased; (4) trunk motor representations in the cortex moved toward more normal topography; and (5) trunk and forelimb motor representations that SCI-driven plasticity and compensations had caused to overlap were segregated. We conclude that effective robot rehabilitation training induces significant reorganization of trunk motor cortex and partially reverses some plastic changes that may be adaptive in non-stepping paraplegia after SCI. Copyright © 2015 the authors 0270-6474/15/357174-16$15.00/0.

Over ground walking and body weight supported walking improve mobility equally in cerebral palsy: a randomised controlled trial.

PubMed

Swe, Ni Ni; Sendhilnnathan, Sunitha; van Den Berg, Maayken; Barr, Christopher

2015-11-01

To assess partial body weight supported treadmill training versus over ground training for walking ability in children with mild to moderate cerebral palsy. Randomised controlled trial. A Special Needs school in Singapore. Thirty children with cerebral palsy, aged 6-18, with a Gross Motor Function Classification System score of II-III. Two times 30 minute sessions of walking training per week for 8 weeks, progressed as tolerated, either over ground (control) or using partial body weight supported treadmill training (intervention). The 10 metre walk test, and the 6 minute walk test. Secondary measures were sub-sections D and E on the Gross Motor Function Measure. Outcomes were assessed at baseline, and after 4 and 8 weeks of training. There was no effect of group allocation on any outcome measure, while time was a significant factor for all outcomes. Walking speed improved significantly more in the intervention group by week 4 (0.109 (0.067)m/s vs 0.048 (0.071)m/s, P=0.024) however by week 8 the change from baseline was similar (intervention 0.0160 (0.069)m/s vs control 0.173 (0.109)m/s, P=0.697). All gains made by week 4 were significantly improved on by week 8 for the 10 metre walk test, 6 minute walk test, and the gross motor function measure. Partial body weight supported treadmill training is no more effective than over ground walking at improving aspects of walking and function in children with mild to moderate cerebral palsy. Gains seen in 4 weeks can be furthered by 8 weeks. © The Author(s) 2015.

Patient-cooperative control increases active participation of individuals with SCI during robot-aided gait training

PubMed Central

2010-01-01

Background Manual body weight supported treadmill training and robot-aided treadmill training are frequently used techniques for the gait rehabilitation of individuals after stroke and spinal cord injury. Current evidence suggests that robot-aided gait training may be improved by making robotic behavior more patient-cooperative. In this study, we have investigated the immediate effects of patient-cooperative versus non-cooperative robot-aided gait training on individuals with incomplete spinal cord injury (iSCI). Methods Eleven patients with iSCI participated in a single training session with the gait rehabilitation robot Lokomat. The patients were exposed to four different training modes in random order: During both non-cooperative position control and compliant impedance control, fixed timing of movements was provided. During two variants of the patient-cooperative path control approach, free timing of movements was enabled and the robot provided only spatial guidance. The two variants of the path control approach differed in the amount of additional support, which was either individually adjusted or exaggerated. Joint angles and torques of the robot as well as muscle activity and heart rate of the patients were recorded. Kinematic variability, interaction torques, heart rate and muscle activity were compared between the different conditions. Results Patients showed more spatial and temporal kinematic variability, reduced interaction torques, a higher increase of heart rate and more muscle activity in the patient-cooperative path control mode with individually adjusted support than in the non-cooperative position control mode. In the compliant impedance control mode, spatial kinematic variability was increased and interaction torques were reduced, but temporal kinematic variability, heart rate and muscle activity were not significantly higher than in the position control mode. Conclusions Patient-cooperative robot-aided gait training with free timing of movements made individuals with iSCI participate more actively and with larger kinematic variability than non-cooperative, position-controlled robot-aided gait training. PMID:20828422

Performance of a visuomotor walking task in an augmented reality training setting.

PubMed

Haarman, Juliet A M; Choi, Julia T; Buurke, Jaap H; Rietman, Johan S; Reenalda, Jasper

2017-12-01

Visual cues can be used to train walking patterns. Here, we studied the performance and learning capacities of healthy subjects executing a high-precision visuomotor walking task, in an augmented reality training set-up. A beamer was used to project visual stepping targets on the walking surface of an instrumented treadmill. Two speeds were used to manipulate task difficulty. All participants (n = 20) had to change their step length to hit visual stepping targets with a specific part of their foot, while walking on a treadmill over seven consecutive training blocks, each block composed of 100 stepping targets. Distance between stepping targets was varied between short, medium and long steps. Training blocks could either be composed of random stepping targets (no fixed sequence was present in the distance between the stepping targets) or sequenced stepping targets (repeating fixed sequence was present). Random training blocks were used to measure non-specific learning and sequenced training blocks were used to measure sequence-specific learning. Primary outcome measures were performance (% of correct hits), and learning effects (increase in performance over the training blocks: both sequence-specific and non-specific). Secondary outcome measures were the performance and stepping-error in relation to the step length (distance between stepping target). Subjects were able to score 76% and 54% at first try for lower speed (2.3 km/h) and higher speed (3.3 km/h) trials, respectively. Performance scores did not increase over the course of the trials, nor did the subjects show the ability to learn a sequenced walking task. Subjects were better able to hit targets while increasing their step length, compared to shortening it. In conclusion, augmented reality training by use of the current set-up was intuitive for the user. Suboptimal feedback presentation might have limited the learning effects of the subjects. Copyright © 2017 Elsevier B.V. All rights reserved.

Spatiotemporal Parameters are not Substantially Influenced by Load Carriage or Inclination During Treadmill and Overground Walking

PubMed Central

Seay, Joseph F.; Gregorczyk, Karen N.; Hasselquist, Leif

2016-01-01

Abstract Influences of load carriage and inclination on spatiotemporal parameters were examined during treadmill and overground walking. Ten soldiers walked on a treadmill and overground with three load conditions (00 kg, 20 kg, 40 kg) during level, uphill (6% grade) and downhill (-6% grade) inclinations at self-selected speed, which was constant across conditions. Mean values and standard deviations for double support percentage, stride length and a step rate were compared across conditions. Double support percentage increased with load and inclination change from uphill to level walking, with a 0.4% stance greater increase at the 20 kg condition compared to 00 kg. As inclination changed from uphill to downhill, the step rate increased more overground (4.3 ± 3.5 steps/min) than during treadmill walking (1.7 ± 2.3 steps/min). For the 40 kg condition, the standard deviations were larger than the 00 kg condition for both the step rate and double support percentage. There was no change between modes for step rate standard deviation. For overground compared to treadmill walking, standard deviation for stride length and double support percentage increased and decreased, respectively. Changes in the load of up to 40 kg, inclination of 6% grade away from the level (i.e., uphill or downhill) and mode (treadmill and overground) produced small, yet statistically significant changes in spatiotemporal parameters. Variability, as assessed by standard deviation, was not systematically lower during treadmill walking compared to overground walking. Due to the small magnitude of changes, treadmill walking appears to replicate the spatiotemporal parameters of overground walking. PMID:28149338

Commercial Motion Sensor Based Low-Cost and Convenient Interactive Treadmill.

PubMed

Kim, Jonghyun; Gravunder, Andrew; Park, Hyung-Soon

2015-09-17

Interactive treadmills were developed to improve the simulation of overground walking when compared to conventional treadmills. However, currently available interactive treadmills are expensive and inconvenient, which limits their use. We propose a low-cost and convenient version of the interactive treadmill that does not require expensive equipment and a complicated setup. As a substitute for high-cost sensors, such as motion capture systems, a low-cost motion sensor was used to recognize the subject's intention for speed changing. Moreover, the sensor enables the subject to make a convenient and safe stop using gesture recognition. For further cost reduction, the novel interactive treadmill was based on an inexpensive treadmill platform and a novel high-level speed control scheme was applied to maximize performance for simulating overground walking. Pilot tests with ten healthy subjects were conducted and results demonstrated that the proposed treadmill achieves similar performance to a typical, costly, interactive treadmill that contains a motion capture system and an instrumented treadmill, while providing a convenient and safe method for stopping.

Comparison of cardiorespiratory responses during aquatic and land treadmill exercise in patients with coronary artery disease.

PubMed

Choi, Jun Hwan; Kim, Bo Ryun; Joo, Seung Jae; Han, Eun Young; Kim, Song Yi; Kim, Sun Mi; Lee, So Young; Yoon, Ho Min

2015-01-01

To investigate cardiorespiratory responses during exercise stress tests using an aquatic treadmill and a land-based treadmill in patients with coronary artery disease (CAD). Twenty-one stable CAD patients were enrolled. All patients participated in 2 symptom-limited incremental exercise tests, using both an aquatic and a land treadmill. For the aquatic treadmill protocol, patients were submerged to the upper waist in 28°C water. The treadmill speed started at 2.0 km/h and increased 0.5 km/h every minute thereafter. For the land treadmill protocol, the speed and gradient were started at 2.4 km/h and 1.5%, respectively. The speed was increased by 0.3 km/h and grade by 1% every minute thereafter. Oxygen consumption ((Equation is included in full-text article.)O2), heart rate (HR), and respiratory exchange ratio were measured continuously and peak values recorded. Rating of perceived exertion, percentage of age-predicted maximal HR, and total exercise duration were also recorded. Peak cardiorespiratory responses during both protocols were compared. The peak (Equation is included in full-text article.)O2 and peak HR did not show any significant differences. The peak respiratory exchange ratio was significantly greater using the land treadmill than the aquatic treadmill protocol. Rating of perceived exertion, age-predicted maximal HR percentage, and total exercise duration were similar for both protocols. There was a significant linear relationship between HR and (Equation is included in full-text article.)O2 with both protocols. This study demonstrated that aquatic treadmill exercise elicits similar peak cardiorespiratory responses compared with land treadmill exercise, suggesting that aquatic treadmill exercise may be effective for CAD patients in cardiac rehabilitation.

Gait rehabilitation machines based on programmable footplates

PubMed Central

Schmidt, Henning; Werner, Cordula; Bernhardt, Rolf; Hesse, Stefan; Krüger, Jörg

2007-01-01

Background Gait restoration is an integral part of rehabilitation of brain lesioned patients. Modern concepts favour a task-specific repetitive approach, i.e. who wants to regain walking has to walk, while tone-inhibiting and gait preparatory manoeuvres had dominated therapy before. Following the first mobilization out of the bed, the wheelchair-bound patient should have the possibility to practise complex gait cycles as soon as possible. Steps in this direction were treadmill training with partial body weight support and most recently gait machines enabling the repetitive training of even surface gait and even of stair climbing. Results With treadmill training harness-secured and partially relieved wheelchair-mobilised patients could practise up to 1000 steps per session for the first time. Controlled trials in stroke and SCI patients, however, failed to show a superior result when compared to walking exercise on the floor. Most likely explanation was the effort for the therapists, e.g. manually setting the paretic limbs during the swing phase resulting in a too little gait intensity. The next steps were gait machines, either consisting of a powered exoskeleton and a treadmill (Lokomat, AutoAmbulator) or an electromechanical solution with the harness secured patient placed on movable foot plates (Gait Trainer GT I). For the latter, a large multi-centre trial with 155 non-ambulatory stroke patients (DEGAS) revealed a superior gait ability and competence in basic activities of living in the experimental group. The HapticWalker continued the end effector concept of movable foot plates, now fully programmable and equipped with 6 DOF force sensors. This device for the first time enables training of arbitrary walking situations, hence not only the simulation of floor walking but also for example of stair climbing and perturbations. Conclusion Locomotor therapy is a fascinating new tool in rehabilitation, which is in line with modern principles of motor relearning promoting a task-specific repetitive approach. Sophisticated technical developments and positive randomized controlled trials form the basis of a growing acceptance worldwide to the benefits or our patients. PMID:17291335

Mechanical alterations during interval-training treadmill runs in high-level male team-sport players.

PubMed

Girard, Olivier; Brocherie, Franck; Morin, Jean-Benoit; Millet, Grégoire P

2017-01-01

To examine mechanical alterations during interval-training treadmill runs in high-level team-sport players. Within-participants repeated measures. Twenty high-level male field-hockey players performed six 30-s runs at 5.53±0.19ms -1 corresponding to 115% of their velocity associated with maximal oxygen uptake (vVO 2max ) with 30-s passive recovery on an instrumented treadmill. Continuous measurement of running kinetics/kinematics and spring-mass characteristics were performed and values were subsequently averaged over 20s (8th-28ths) for comparison. Contact time (+1.1±4.3%; p=0.044), aerial time (+4.1±5.3%; p=0.001), step length (+2.4±2.2%; p<0.001) along with mean loading rates (+7.1±10.6%; p=0.026) increased from the first to the last interval, whereas step frequency (-2.3±2.1%; p<0.001) decreased. Both centre of mass vertical displacement (+3.0±6.0%; p<0.001) and leg compression (+2.8±9.7%; p=0.036), but not peak vertical forces (0.0±4.1%; p=0.761), increased with fatigue. Vertical stiffness decreased (-2.8±6.9%; p=0.012), whereas leg stiffness did not change across intervals (p=0.149). During interval-training treadmill runs, high-level team-sport players modified their mechanical behaviour towards lower vertical stiffness while preserving a constant leg stiffness. Maintenance of running velocity induced longer step lengths and decreased step frequencies that were also accompanied by increased impact loading rates. These mechanical alterations occurred early during the set. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Virtual reality-enhanced partial body weight-supported treadmill training poststroke: feasibility and effectiveness in 6 subjects.

PubMed

Walker, Martha L; Ringleb, Stacie I; Maihafer, George C; Walker, Robert; Crouch, Jessica R; Van Lunen, Bonnie; Morrison, Steven

2010-01-01

Walker ML, Ringleb SI, Maihafer GC, Walker R, Crouch JR, Van Lunen B, Morrison S. Virtual reality-enhanced partial body weight-supported treadmill training poststroke: feasibility and effectiveness in 6 subjects. To determine whether the use of a low-cost virtual reality (VR) system used in conjunction with partial body weight-supported treadmill training (BWSTT) was feasible and effective in improving the walking and balance abilities of patients poststroke. A before-after comparison of a single group with BWSTT intervention. University research laboratory. A convenience sample of 7 adults who were within 1 year poststroke and who had completed traditional rehabilitation but still exhibited gait deficits. Six participants completed the study. Twelve treatment sessions of BWSTT with VR. The VR system generated a virtual environment that showed on a television screen in front of the treadmill to give participants the sensation of walking down a city street. A head-mounted position sensor provided postural feedback. Functional Gait Assessment (FGA) score, Berg Balance Scale (BBS) score, and overground walking speed. One subject dropped out of the study. All other participants made significant improvements in their ability to walk. FGA scores increased from mean of 13.8 to 18. BBS scores increased from mean of 43.8 to 48.8, although a ceiling effect was seen for this test. Overground walking speed increased from mean of .49m/s to .68m/s. A low-cost VR system combined with BWSTT is feasible for improved gait and balance of patients poststroke. Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Robotic gait trainer in water: development of an underwater gait-training orthosis.

PubMed

Miyoshi, Tasuku; Hiramatsu, Kazuaki; Yamamoto, Shin-Ichiro; Nakazawa, Kimitaka; Akai, Masami

2008-01-01

To develop a robotic gait trainer that can be used in water (RGTW) and achieve repetitive physiological gait patterns to improve the movement dysfunctions. The RGTW is a hip-knee-ankle-foot orthosis with pneumatic actuators; the control software was developed on the basis of the angular motions of the hip and knee joint of a healthy subject as he walked in water. Three-dimensional motions and electromyographic (EMG) activities were recorded in nine healthy subjects to evaluate the efficacy of using the RGTW while walking on a treadmill in water. The device could preserve the angular displacement patterns of the hip and knee and foot trajectories under all experimental conditions. The tibialis anterior EMG activities in the late swing phase and the biceps femoris throughout the stance phase were reduced whose joint torques were assisted by the RGTW while walking on a treadmill in water. Using the RGTW could expect not only the effect of the hydrotherapy but also the standard treadmill gait training, in particular, and may be particularly effective for treating individuals with hip joint movement dysfunction.

Partial Body Weight-Supported Treadmill Training in Patients With Parkinson Disease: Impact on Gait and Clinical Manifestation.

PubMed

Ganesan, Mohan; Sathyaprabha, Talakad N; Pal, Pramod Kumar; Gupta, Anupam

2015-09-01

To evaluate the effect of conventional gait training (CGT) and partial weight-supported treadmill training (PWSTT) on gait and clinical manifestation. Prospective experimental research design. Hospital. Patients with idiopathic Parkinson disease (PD) (N=60; mean age, 58.15±8.7y) on stable dosage of dopaminomimetic drugs were randomly assigned into the 3 following groups (20 patients in each group): (1) nonexercising PD group, (2) CGT group, and (3) PWSTT group. The interventions included in the study were CGT and PWSTT. The sessions of the CGT and PWSTT groups were given in patient's self-reported best on status after regular medications. The interventions were given for 30min/d, 4d/wk, for 4 weeks (16 sessions). Clinical severity was measured by the Unified Parkinson Disease Rating Scale (UPDRS) and its subscores. Gait was measured by 2 minutes of treadmill walking and the 10-m walk test. Outcome measures were evaluated in their best on status at baseline and after the second and fourth weeks. Four weeks of CGT and PWSTT gait training showed significant improvements of UPDRS scores, its subscores, and gait performance measures. Moreover, the effects of PWSTT were significantly better than CGT on most measures. PWSTT is a promising intervention tool to improve the clinical and gait outcome measures in patients with PD. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Treadmill running frequency on anxiety and hippocampal adenosine receptors density in adult and middle-aged rats.

PubMed

Costa, Marcelo S; Ardais, Ana Paula; Fioreze, Gabriela T; Mioranzza, Sabrina; Botton, Paulo Henrique S; Portela, Luis Valmor; Souza, Diogo O; Porciúncula, Lisiane O

2012-01-10

Physical exercise protocols have varied widely across studies raising the question of whether there is an optimal intensity, duration and frequency that would produce maximal benefits in attenuating symptoms related to anxiety disorders. Although physical exercise causes modifications in neurotransmission systems, the involvement of neuromodulators such as adenosine has not been investigated after chronic exercise training. Anxiety-related behavior was assessed in the elevated plus-maze in adult and middle-aged rats submitted to 8 weeks of treadmill running 1, 3 or 7 days/week. The speed of running was weekly adjusted to maintain moderate intensity. The hippocampal adenosine A1 and A2A receptors densities were also assessed. Treadmill running protocol was efficient in increasing physical exercise capacity in adult and middle-aged rats. All frequencies of treadmill running equally decreased the time spent in the open arms in adult animals. Middle-aged treadmill control rats presented lower time spent in the open arms than adult treadmill control rats. However, treadmill running one day/week reversed this age effect. Adenosine A1 receptor was not changed between groups, but treadmill running counteracted the age-related increase in adenosine A2A receptors. Although treadmill running, independent from frequency, triggered anxiety in adult rats and treadmill running one day/week reversed the age-related anxiety, no consistent relationship was found with hippocampal adenosine receptors densities. Thus, our data suggest that as a complementary therapy in the management of mental disturbances, the frequency and intensity of physical exercise should be taken into account according to age. Besides, this is the first study reporting the modulation of adenosine receptors after chronic physical exercise, which could be important to prevent neurological disorders associated to increase in adenosine A2A receptors. Copyright © 2011. Published by Elsevier Inc.

Transient enhancement of GLUT-4 levels in rat epitrochlearis muscle after exercise training

PubMed Central

Reynolds, Thomas H.; Brozinick, Joseph T.; Larkin, Lisa M.; Cushman, Samuel W.

2009-01-01

The purpose of the present study was to examine the effect of detraining on the glucose transport system after short-term swim training (5 days), long-term swim training (5 wk), and treadmill run training (5 wk). Skeletal muscles were isolated from female Wistar rats at 24 or 48 h posttraining. SST produces a 48% increase in GLUT-4 mRNA, a 30% increase in GLUT-4 protein, and a 60% increase in insulin-stimulated glucose transport activity at 24 h posttraining but not at 48 h posttraining. Similar to SST, long-term swim training produces a 60% increase in GLUT-4 mRNA and a 30% increase in GLUT-4 protein content at 24 h posttraining but not at 48 h posttraining. Finally, treadmill run training produces a transient 35% increase in GLUT-4 protein content that is completely reversed at 48 h after the last bout of exercise. These results demonstrate that the increase in GLUT-4 mRNA and GLUT-4 protein occurs during the first week of exercise training and is rapidly lost after training cessation. We believe that the transient enhancement in GLUT-4 protein after exercise training is due to a short GLUT-4 half-life, a process that is primarily regulated by pretranslational mechanisms. PMID:10846041

Transient enhancement of GLUT-4 levels in rat epitrochlearis muscle after exercise training.

PubMed

Reynolds, T H; Brozinick, J T; Larkin, L M; Cushman, S W

2000-06-01

The purpose of the present study was to examine the effect of detraining on the glucose transport system after short-term swim training (5 days), long-term swim training (5 wk), and treadmill run training (5 wk). Skeletal muscles were isolated from female Wistar rats at 24 or 48 h posttraining. SST produces a 48% increase in GLUT-4 mRNA, a 30% increase in GLUT-4 protein, and a 60% increase in insulin-stimulated glucose transport activity at 24 h posttraining but not at 48 h posttraining. Similar to SST, long-term swim training produces a 60% increase in GLUT-4 mRNA and a 30% increase in GLUT-4 protein content at 24 h posttraining but not at 48 h posttraining. Finally, treadmill run training produces a transient 35% increase in GLUT-4 protein content that is completely reversed at 48 h after the last bout of exercise. These results demonstrate that the increase in GLUT-4 mRNA and GLUT-4 protein occurs during the first week of exercise training and is rapidly lost after training cessation. We believe that the transient enhancement in GLUT-4 protein after exercise training is due to a short GLUT-4 half-life, a process that is primarily regulated by pretranslational mechanisms.

Low-fat diet, and medium-fat diets containing coconut oil and soybean oil exert different metabolic effects in untrained and treadmill-trained mice.

PubMed

Manio, Mark Christian; Matsumura, Shigenobu; Inoue, Kazuo

2018-06-18

Diets containing fats of different proportions and types have been demonstrated to influence metabolism. These fats differ in long chain fatty acids (LCFAs) or medium chain fatty acids (MCFAs) content. In our laboratory using swimming as the training modality, MCFAs increased endurance attributed to increased activities of oxidative enzymes. How it affects whole-body metabolism remains unexplored. The present study investigated the metabolic, biochemical and genetic adaptations with treadmill running as the training modality. C57BL/6N mice were divided into untrained and trained groups and provided with low-fat (10% kcal from soybean oil), coconut oil (10% kcal from soybean oil, 20% kcal from coconut oil) or soybean oil (30% kcal from soybean oil) diet. Training was performed on a treadmill for 30 days. After recovery, whole-body metabolism at rest and during exercise, endurance, substrate metabolism, mitochondrial enzyme activities, and gene expression of training-adaptive genes in the muscle and liver were measured. At rest, medium-fat diets decreased respiratory exchange ratio (RER) (p < 0.05). Training increased RER in all diet groups without affecting oxygen consumption (p < 0.05). During exercise, diets had no overt effects on metabolism while training decreased oxygen consumption indicating decreased energy expenditure (p < 0.05). Coconut oil without training improved endurance based on work (p < 0.05). Training improved all endurance parameters without overt effects of diet (p < 0.05). Moreover, training increased the activities of mitochondrial enzymes likely related to the increased expression of estrogen related receptor (ERR) α and ERRβ (p < 0.05). Coconut oil inhibited peroxisome proliferator-activated receptor (PPAR) β/δ activation and glycogen accumulation in the muscle but activated PPARα in the liver in the trained state (p < 0.05). Substrate utilization data suggested that coconut oil and/or resulting ketone bodies spared glycogen utilization in the trained muscle during exercise thereby preserving endurance. Our data demonstrated the various roles of diet and fat types in training adaptation. Diets exerted different roles in PPAR activation and substrate handling in the context of endurance exercise training. However, the role of fat types in training adaptations is limited as training overwhelms and normalizes the effects of diet in the untrained state particularly on endurance performance, mitochondrial biogenesis, and ERR expression.

Metabolic cost of running is greater on a treadmill with a stiffer running platform.

PubMed

Smith, James A H; McKerrow, Alexander D; Kohn, Tertius A

2017-08-01

Exercise testing on motorised treadmills provides valuable information about running performance and metabolism; however, the impact of treadmill type on these tests has not been investigated. This study compared the energy demand of running on two laboratory treadmills: an HP Cosmos (C) and a Quinton (Q) model, with the latter having a 4.5 times stiffer running platform. Twelve experienced runners ran identical bouts on these treadmills at a range of four submaximal velocities (reported data is for the velocity that approximated 75-81% VO 2max ). The stiffer treadmill elicited higher oxygen consumption (C: 46.7 ± 3.8; Q: 50.1 ± 4.3 ml·kg -1 · min -1 ), energy expenditure (C: 16.0 ± 2.5; Q: 17.7 ± 2.9 kcal · min -1 ), carbohydrate oxidation (C: 9.6 ± 3.1; Q: 13.0 ± 3.9 kcal · min -1 ), heart rate (C: 155 ± 16; Q: 163 ± 16 beats · min -1 ) and rating of perceived exertion (C: 13.8 ± 1.2; Q: 14.7 ± 1.2), but lower fat oxidation (C: 6.4 ± 2.3; Q: 4.6 ± 2.5 kcal · min -1 ) (all analysis of variance treadmill comparisons P < 0.01). This study confirms that caution is required when comparing performance and metabolic results between different treadmills and suggests that treadmills will vary in their comparability to over-ground running depending on the running platform stiffness.

Sodium Analysis in Whole Blood of Athletes Using NAA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kovacs, Luciana; Zamboni, Cibele B.; Nunes, Lazaro A. S.

In this investigation the sodium levels in blood were analyzed in athletes submitted to constant load exercise at treadmill (LABEX and UNICAMP) by NAA. These data were compared with the rest condition (before starting the exercise program) as well as with the sodium levels of the healthy group (control group) select from Blood Banks. The results showed alterations in sodium levels of the athletes during the exercise training, mainly increase, suggesting the necessity of its evaluation during physical activities.

Effects of endurance training and competition on exercise tests in relatively untrained people.

PubMed

Verstappen, F T; Janssen, G M; Does, R J

1989-10-01

One hundred fourteen subjects (34 +/- 8 years) without any competition background took part in an endurance training study to be completed after 1.5 years with running a marathon. Ultimately, 60 males and 18 females achieved that goal. The training program, carefully supervised, was divided into three phases with a maximum of 45, 70, and 110 km/week training volume and concluded with a performance race of 15, 25, and 42.195 km, respectively. Three days before and 3 and 5 days after each race, 35 subjects were selected to perform a progressive treadmill test and the remaining subjects participated in performing field tests of running 400 and 1000 m. The maximal velocity achieved in the treadmill test was 4.75 +/- 0.36 m.s-1 for males and 4.18 +/- 0.28 m.s-1 for females; it remained constant throughout the study. However, the running velocity at 4 mmol.1(-1) plasma lactate concentration increased about 10% from phase 1 to 3. In the females this rise already appeared to be completed in phase 2. Heart rate showed a tendency to increase at both submaximal and maximal exercise from training phase 1 to 2 and 3, whereas plasma lactate concentration showed a decreasing tendency. Three days after the 25 km and the marathon race the maximal running velocity in the exercise test was 2%-4% lower compared with the pre-race test (P less than 0.05). Five days after the race this difference again faded away. This small decline in running performance was not reflected in changes of physiologic responses such as heart rate or plasma lactate concentration.

A 3-Month Aerobic Training Program Improves Brain Energy Metabolism in Mild Alzheimer's Disease: Preliminary Results from a Neuroimaging Study.

PubMed

Castellano, Christian-Alexandre; Paquet, Nancy; Dionne, Isabelle J; Imbeault, Hélène; Langlois, Francis; Croteau, Etienne; Tremblay, Sébastien; Fortier, Mélanie; Matte, J Jacques; Lacombe, Guy; Fülöp, Tamás; Bocti, Christian; Cunnane, Stephen C

2017-01-01

Aerobic training has some benefits for delaying the onset or progression of Alzheimer's disease (AD). Little is known about the implication of the brain's two main fuels, glucose and ketones (acetoacetate), associated with thesebenefits. To determine whether aerobic exercise training modifies brain energy metabolism in mild AD. In this uncontrolled study, ten patients with mild AD participated in a 3-month, individualized, moderate-intensity aerobic training on a treadmill (Walking). Quantitative measurement of brain uptake of glucose (CMRglu) and acetoacetate (CMRacac) using neuroimaging and cognitive testing were done before and after the Walking program. Four men and six women with an average global cognitive score (MMSE) of 26/30 and an average age of 73 y completed the Walking program. Average total distance and treadmill speed were 8 km/week and 4 km/h, respectively. Compared to the Baseline, after Walking, CMRacac was three-fold higher (0.6±0.4 versus 0.2±0.1 μmol/100 g/min; p = 0.01). Plasma acetoacetate concentration and the blood-to-brain acetoacetate influx rate constant were also increased by 2-3-fold (all p≤0.03). CMRglu was unchanged after Walking (28.0±0.1 μmol/100 g/min; p = 0.96). There was a tendency toward improvement in the Stroop-color naming test (-10% completion time, p = 0.06). Performance on the Trail Making A&B tests was also directly related to plasma acetoacetate and CMRacac (all p≤0.01). In mild AD, aerobic training improved brain energy metabolism by increasing ketone uptake and utilization while maintaining brain glucose uptake, and could potentially be associated with some cognitive improvement.

Heat acclimation and exercise training interact when combined in an overriding and trade-off manner: physiologic-genomic linkage

PubMed Central

Kodesh, Einat; Nesher, Nir; Simaan, Assi; Hochner, Benny; Beeri, Ronen; Gilon, Dan; Stern, Michael D.; Gerstenblith, Gary

2011-01-01

Combined heat acclimation (AC) and exercise training (EX) enhance exercise performance in the heat while meeting thermoregulatory demands. We tested the hypothesis that different stress-specific adaptations evoked by each stressor individually trigger similar cardiac alterations, but when combined, overriding/trade-off interactions take place. We used echocardiography, isolated cardiomyocyte imaging and cDNA microarray techniques to assay in situ cardiac performance, excitation-contraction (EC) coupling features, and transcriptional programs associated with cardiac contractility. Rat groups studied were controls (sedentary 24°C); AC (sedentary, 34°C, 1 mo); normothermic EX (treadmill at 24°C, 1 mo); and heat-acclimated, exercise-trained (EXAC; treadmill at 34°C, 1 mo). Prolonged heat exposure decreased heart rate and contractile velocity and increased end ventricular diastolic diameter. Compared with controls, AC/EXAC cardiomyocytes demonstrated lower l-type Ca2+ current (ICaL) amplitude, higher Ca2+ transient (Ca2+T), and a greater Ca2+T-to-ICaL ratio; EX alone enhanced ICaL and Ca2+T, whereas aerobic training in general induced cardiac hypertrophy and action potential elongation in EX/EXAC animals. At the genomic level, the transcriptome profile indicated that the interaction between AC and EX yields an EXAC-specific molecular program. Genes affected by chronic heat were linked with the EC coupling cascade, whereas aerobic training upregulated genes involved with Ca2+ turnover via an adrenergic/metabolic-driven positive inotropic response. In the EXAC cardiac phenotype, the impact of chronic heat overrides that of EX on EC coupling components and heart rate, whereas EX regulates cardiac morphometry. We suggest that concerted adjustments induced by AC and EX lead to enhanced metabolic and mechanical performance of the EXAC heart. PMID:21957158

Design and Validation of an Instrumented Uneven Terrain Treadmill.

PubMed

Voloshina, Alexandra S; Ferris, Daniel P

2018-06-01

Studying human and animal locomotion on an uneven terrain can be beneficial to basic science and applied studies for clinical and robotic applications. Traditional biomechanical analysis of human locomotion has often been limited to laboratory environments with flat, smooth runways and treadmills. The authors modified a regular exercise treadmill by attaching wooden blocks to the treadmill belt to yield an uneven locomotion surface. To ensure that these treadmill modifications facilitated biomechanical measurements, the authors compared ground reaction force data collected while a subject ran on the modified instrumented treadmill with a smooth surface with data collected using a conventional instrumented treadmill. Comparisons showed only minor differences. These results suggest that adding an uneven surface to a modified treadmill is a viable option for studying human or animal locomotion on an uneven terrain. Other types of surfaces (eg, compliant blocks) could be affixed in a similar manner for studies on other types of locomotion surfaces.

DEVELOPMENT OF AN INFLIGHT COUNTERMEASURE TO MITIGATE POSTFLIGHT GAIT DYSFUNCTION

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Mulavara, A. P.; Cohen, H. S.; Richards, J. T.; Miller, C. A.

2005-01-01

Following spaceflight crewmembers experience gait and postural instabilities due to inflight adaptive alterations in sensorimotor function. These changes can pose a risk to crew safety if nominal or emergency vehicle egress is required immediately following long-duration spaceflight. At present, no operational countermeasure is available to mitigate postflight locomotor disturbances. Therefore, the goal of this study is to develop an inflight training regimen that facilitates the recovery of locomotor function after long-duration spaceflight. The countermeasure we are developing is based on the concept of variable practice. During this type of training the subject gains experience producing the appropriate adaptive motor behavior under a variety of sensory conditions and response constraints. This countermeasure is built around current ISS treadmill exercise activities. Crewmembers will conduct their nominal inflight treadmill exercise while being exposed to variations in visual flow patterns. These variations will challenge the postural and locomotor systems repeatedly, thereby promoting adaptive reorganization in locomotor behavior. As a result of this training a subject learns to solve a class of motor problems, rather than a specific motor solution to one problem, Le., the subject learns response generalizability or the ability to "learn to learn" under a variety of environmental constraints. We anticipate that this training will accelerate recovery of postural and locomotor function during readaptation to gravitational environments following spaceflight facilitating neural adaptation to unit (Earth) and partial (Mars) gravity after long-duration spaceflight. The study calls for one group of subjects to perform the inflight treadmill training regimen while a control group of subjects performs only the nominal exercise procedures. Locomotor function in both groups is assessed before and after spaceflight using two tests of gait function: The Integrated Treadmill Locomotion Test (ITLT) and the Functional Mobility Test (FMT). The ITLT characterizes alterations in the integrated function of multiple sensorimotor subsystems responsible for the control of locomotion. This test calls for subjects to walk on a motorized treadmill while we assess changes in dynamic postural stability, head-trunk coordination, short-latency head stabilization responses, dynamic visual acuity, lower limb coordination strategies and gait cycle timing. To make these assessments we measure the following parameters while subjects walk on the treadmill: 1) full body 3-dimensional kinematics using a motion capture system (Motion Analysis Corp., Santa Rosa, CA); 2) the shock-wave transmitted from heel-strike to the head using triaxial accelerometers placed on the tibia and head (Entran, Fairfield, NJ); 3) vertical forces using an instrumented treadmill (Kistler Instrument Corp., Amherst, NY); 4) Dynamic visual acuity using Landolt Cs presented on a laptop computer located 4m from the eyes and 5) Gait cycle timing using foot-switches (Motion Lab Systems, Inc., Baton Rouge, LA) attached to the plantar surface of each shoe at the heel and toe. The FMT evaluates a subject's ability to perform challenging locomotor maneuvers similar to those encountered during an egress from a space vehicle. Subjects step over and duck under obstacles along with negotiating a series of pylons set up on a base of 10 cm thick medium density foam. The dependent measures for the FMT are time to complete the course and the number of obstacles touched. To date, we have collected pre and postflight locomotion data from Expeditions 5-9 who will serve as part of the control group for this study. Preliminary results comparing the recovery rates in gait control sub-systems obtained from the ITLT and FMT performance showed two recovery patterns: 1) a concordant recovery trend between gait control parameters and FMT performance indicating a restitution pattern of recovery and 2) gait controecovery that lagged recovery in FMT performance suggesting that improvement in locomotor function was attained through a pattern of substitution. These data suggest that recovery of postflight locomotor function may occur through adaptive mechanisms that lead to either restitution or substitution of function. Understanding the modes of postflight readaptation has implications for countermeasure development and testing and in astronaut postflight rehabilitation.

Development of an Inflight Countermeasure to Mitigate Postflight Gait Dysfunction

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Mulavara, A. P.; Peters, B. T.; Cohen, H. S.; Richards, J. T.; Miller, C. A.; Brady, R.; Warren, L. E.

2005-01-01

Following spaceflight crewmembers experience gait and postural instabilities due to inflight adaptive alterations in sensorimotor function. These changes can pose a risk to crew safety if nominal or emergency vehicle egress is required immediately following long-duration spaceflight. At present, no operational countermeasure is available to mitigate postflight locomotor disturbances. Therefore, the goal of this study is to develop an inflight training regimen that facilitates the recovery of locomotor function after long-duration spaceflight. The countermeasure we are developing is based on the concept of variable practice. During this type of training the subject gains experience producing the appropriate adaptive motor behavior under a variety of sensory conditions and response constraints. This countermeasure is built around current ISS treadmill exercise activities. Crewmembers will conduct their nominal inflight treadmill exercise while being exposed to variations in visual flow patterns. These variations will challenge the postural and locomotor systems repeatedly, thereby promoting adaptive reorganization in locomotor behavior. As a result of this training a subject learns to solve a class of motor problems, rather than a specific motor solution to one problem, Le., the subject learns response generalizability or the ability to "learn to learn" under a variety of environmental constraints. We anticipate that this training will accelerate recovery of postural and locomotor function during readaptation to gravitational environments following spaceflight facilitating neural adaptation to unit (Earth) and partial (Mars) gravity after long-duration spaceflight. The study calls for one group of subjects to perform the inflight treadmill training regimen while a control group of subjects performs only the nominal exercise procedures. Locomotor function in both groups is assessed before and after spaceflight using two tests of gait function: The Integrated Treadmill Locomotion Test (ITLT) and the Functional Mobility Test (FMT). The ITLT characterizes alterations in the integrated function of multiple sensorimotor subsystems responsible for the control of locomotion. This test calls for subjects to walk on a motorized treadmill while we assess changes in dynamic postural stability, head-trunk coordination, short-latency head stabilization responses, dynamic visual acuity, lower limb coordination strategies and gait cycle timing. To make these assessments we measure the following parameters while subjects walk on the treadmill: 1) full body 3-dimensional kinematics using a motion capture system (Motion Analysis Corp., Santa Rosa, CA); 2) the shock-wave transmitted from heel-strike to the head using triaxial accelerometers placed on the tibia and head (Entran, Fairfield, NJ); 3) vertical forces using an instumented treadmill (Kistler Instrument Corp., Amherst, NY); 4) Dynamic visual acuity using Landolt Cs presented on a laptop computer located 4m from the eyes and 5) Gait cycle timing using foot-switches (Motion Lab Systems, Inc., Baton Rouge, LA) attached to the plantar surface of each shoe at the heel and toe. The FMT evaluates s. subject's ability to perform challenging locomotor maneuvers similar to those encountered during an egress from a space vehicle. Subjects step over and duck under obstacles along with negotiating a series of pylons set up on a base of 10 cm thick medium density foam. The dependent measures for the FMT are time to complete the course and the number of obstacles touched. To date, we have collected pre and postflight locomotion data from Expeditions 5-9 who will serve as part of the control group for this study. Preliminary results comparing the recovery rates in gait control sub-systems obtained from the ITLT and FMT performance showed two recovery patterns: 1) a concordant recovery trend between gait control parameters and FMT performance indicating a restitution pattern of recovery and 2) gait controecovery that lagged recovery in FMT performance suggesting that improvement in locomotor function was attained through a pattern of substitution. These data suggest that recovery of postflight locomotor function may occur through adaptive mechanisms that lead to either restitution or substitution of function. Understanding the modes of postflight readaptation has implications for countermeasure development and testing and in astronaut postflight rehabilitation.

Effects of high-intensity interval training on cardiometabolic risk in overweight and obese African-American women: a pilot study.

PubMed

Hornbuckle, Lyndsey M; McKenzie, Michael J; Whitt-Glover, Melicia C

2017-03-01

Little is known about high-intensity interval training (HIIT) in African-American (AA) women. The purpose of this pilot study was to evaluate the effects of HIIT and steady-state (SS) exercise on cardiometabolic risk factors in young AA women. A 16-week exercise intervention was conducted 3x/week. Twenty-seven AA women were randomized to SS (n = 11; 32 continuous minutes of treadmill walking at 60-70% of maximum heart rate (HR max )), or HIIT (n = 16; 32 min of treadmill HIIT alternating 3 min at 60-70% of HR max with 1 min at 80-90% of HR max ). Two-way repeated measures ANOVA with intention-to-treat analysis was used to identify changes between groups. Significance was accepted at P ≤ 0.05. Of the 27 women who entered the study (age: 30.5 ± 6.8 years; BMI: 35.1 ± 5.1 kg/m 2 ; 5274 ± 1646 baseline steps/day), 14 completed the intervention. HIIT significantly decreased waist circumference (107.0 ± 11.3 to 105.1 ± 11.9 cm) compared to SS, which showed no change. There was a significant time effect for steps where HIIT increased steps/day (5334 ± 1586 to 7604 ± 1817 steps/day), and SS had no change. There were no significant changes in either group for any other measurements. HIIT was more effective at reducing waist circumference and increasing daily steps/day than SS treadmill exercise over 16 weeks. Further research in a larger sample is indicated to evaluate the effects of each protocol on cardiometabolic risk factors.

Workload comparison between hiking and indoor physical activity.

PubMed

Fattorini, Luigi; Pittiglio, Giancarlo; Federico, Bruno; Pallicca, Anastasia; Bernardi, Marco; Rodio, Angelo

2012-10-01

Walking is a physical activity able to maintain and improve aerobic fitness. This activity can easily be performed in all seasons both outdoors and indoors, but when it is performed in its natural environment, the use of specific equipment is required. In particular, it has been demonstrated that the use of trekking boots (TBs) induces a larger workload than those used indoors. Because an adequate fitness level is needed to practice hiking in safety, it is useful to know the energy demand of such an activity. This research aims at defining the metabolic engagement of hiking on natural paths with specific equipment at several speeds and comparing this with indoor ones (on a treadmill). This can thence be used to define the load that better reflects the one required to walk on natural paths. The walking energy cost (joules per kilogram per meter) at several speeds (0.28, 0.56, 0.84, 1.11, and 1.39 m·s(-1))-on level natural terrain while wearing suitable footwear (TBs) and on a treadmill at various raising slopes (0, 1, 2, 3, 4%) while wearing running shoes-was measured in 14 healthy young men (age 23.9 ± 2.9 years, stature 1.75 ± 0.04 m, and body mass 72.9 ± 6.3 kg). A physiological evaluation of all the subjects was performed before energy cost measurements. The results showed that outdoors, the oxygen uptake was consistently less than the ventilatory threshold at all speeds tested and that a 3% slope on the treadmill best reflects the outdoor walking energy expenditure. These findings will prove useful to plan proper training for hiking activity or mixed (outdoors and indoors) training program.

Moderate treadmill exercise prevents oxidative stress-induced anxiety-like behavior in rats.

PubMed

Salim, Samina; Sarraj, Nada; Taneja, Manish; Saha, Kaustuv; Tejada-Simon, Maria Victoria; Chugh, Gaurav

2010-04-02

Recent work has suggested correlation of oxidative stress with anxiety-like behavior. There also is evidence for anxiolytic effects of physical exercise. However, a direct role of oxidative stress in anxiety is not clear and a protective role of physical exercise in oxidative stress-mediated anxiety has never been addressed. In this study, we have utilized rats to test direct involvement of oxidative stress with anxiety-like behavior and have identified oxidative stress mechanisms likely involved in anxiolytic effects of physical exercise. Intraperitoneal injections at non-toxic dose of l-buthionine-(S,R)-sulfoximine (BSO), an agent that increases oxidative stress markers, increased anxiety-like behavior of rats compared to vehicle-treated control rats. Prior 2 weeks treatment with the antioxidant, tempol attenuated BSO-induced anxiety-like behavior of rats suggesting a role of oxidative stress in this phenomenon. Moreover, moderate treadmill exercise prevented BSO-induced anxiety-like behavior of rats and also prevented BSO-mediated increase in oxidative stress markers in serum, urine and brain tissue homogenates from hippocampus, amygdala and locus coeruleus. Thus increasing oxidative stress increases anxiety-like behavior of rats. Moreover, antioxidant or treadmill exercise training both reduce oxidative stress in the rat brain regions implicated in anxiety response and prevent anxiety-like behavior of rats. Published by Elsevier B.V.

Change of muscle architecture following body weight support treadmill training for persons after subacute stroke: evidence from ultrasonography.

PubMed

Liu, Peng; Wang, Yanjun; Hu, Huijing; Mao, Yurong; Huang, Dongfeng; Li, Le

2014-01-01

Although the body weight support treadmill training (BWSTT) in rehabilitation therapy has been appreciated for a long time, the biomechanical effects of this training on muscular system remain unclear. Ultrasonography has been suggested to be a feasible method to measure muscle morphological changes after neurological diseases such as stroke, which may help to enhance the understanding of the mechanism underlying the impaired motor function. This study investigated the muscle architectural changes of tibialis anterior and medial gastrocnemius in patients after subacute stroke by ultrasound. As expected, we found the effect of BWSTT on the muscular system. Specifically, the results showed larger pennation angle and muscle thickness of tibialis anterior and longer fascicle length of medial gastrocnemius after the training. The findings of this study suggest that the early rehabilitation training of BWSTT in subacute stage of stroke provides positive changes of the muscle architecture, leading to the potential improvement of the force generation of the muscle. This may not only help us understand changes of subacute stroke in muscular system but also have clinical implications in the evaluation of rehabilitation training after neurological insults.

Comparing handrim biomechanics for treadmill and overground wheelchair propulsion

PubMed Central

Kwarciak, Andrew M.; Turner, Jeffrey T.; Guo, Liyun; Richter, W. Mark

2010-01-01

Study design Cross-sectional study. Objectives To compare handrim biomechanics recorded during overground propulsion to those recorded during propulsion on a motor-driven treadmill. Setting Biomechanics laboratory. Methods Twenty-eight manual wheelchair users propelled their own wheelchairs, at a self-selected speed, on a low-pile carpet and on a wheelchair accessible treadmill. Handrim biomechanics were recorded with an OptiPush instrumented wheelchair wheel. Results Across the two conditions, all handrim biomechanics were found to be similar and highly correlated (r > 0.85). Contact angle, peak force, average force, and peak axle moment differed by 1.6% or less across the two conditions. While not significant, power output and cadence tended to be slightly higher for the treadmill condition (3.5% and 3.6%, respectively), due to limitations in adjusting the treadmill grade. Conclusion Based on the results of this study, a motor-driven treadmill can serve as a valid surrogate for overground studies of wheelchair propulsion. PMID:21042332

Effects of transcranial direct current stimulation over the supplementary motor area body weight-supported treadmill gait training in hemiparetic patients after stroke.

PubMed

Manji, Atsushi; Amimoto, Kazu; Matsuda, Tadamitsu; Wada, Yoshiaki; Inaba, Akira; Ko, Sangkyun

2018-01-01

Transcranial direct current stimulation (tDCS) is used in a variety of disorders after stroke including upper limb motor dysfunctions, hemispatial neglect, aphasia, and apraxia, and its effectiveness has been demonstrated. Although gait ability is important for daily living, there were few reports of the use of tDCS to improve balance and gait ability. The supplementary motor area (SMA) was reported to play a potentially important role in balance recovery after stroke. We aimed to investigate the effect of combined therapy body weight-supported treadmill training (BWSTT) and tDCS on gait function recovery of stroke patients. Thirty stroke inpatients participated in this study. The two BWSTT periods of 1weeks each, with real tDCS (anode: front of Cz, cathode: inion, 1mA, 20min) on SMA and sham stimulation, were randomized in a double-blind crossover design. We measured the time required for the 10m Walk Test (10MWT) and Timed Up and Go (TUG) test before and after each period. We found that the real tDCS with BWSTT significantly improved gait speed (10MWT) and applicative walking ability (TUG), compared with BWSTT+sham stimulation periods (p<0.05). Our findings demonstrated the feasibility and efficacy of tDCS in gait training after stroke. The facilitative effects of tDCS on SMA possibly improved postural control during BWSTT. The results indicated the implications for the use of tDCS in balance and gait training rehabilitation after stroke. Copyright © 2017 Elsevier B.V. All rights reserved.

Manipulating the stride length/stride velocity relationship of walking using a treadmill and rhythmic auditory cueing in non-disabled older individuals. A short-term feasibility study.

PubMed

Eikema, D J A; Forrester, L W; Whitall, J

2014-09-01

One target for rehabilitating locomotor disorders in older adults is to increase mobility by improving walking velocity. Combining rhythmic auditory cueing (RAC) and treadmill training permits the study of the stride length/stride velocity ratio (SL/SV), often reduced in those with mobility deficits. We investigated the use of RAC to increase velocity by manipulating the SL/SV ratio in older adults. Nine participants (6 female; age: 61.1 ± 8.8 years) walked overground on a gait mat at preferred and fast speeds. After acclimatization to comfortable speed on a treadmill, participants adjusted their cadence to match the cue for 3 min at 115% of preferred speed by either (a) increasing stride length only or (b) increasing stride frequency only. Following training, participants walked across the gait mat at preferred velocity without, and then with, RAC. Group analysis determined no immediate overground velocity increase, but reintroducing RAC did produce an increase in velocity after both conditions. Group and single subject analysis determined that the SL/SV ratio changed in the intended direction only in the stride length condition. We conclude that RAC is a powerful organizer of gait parameters, evidenced by its induced after-effects following short duration training. Copyright © 2014 Elsevier B.V. All rights reserved.

Use of an Anti-Gravity Treadmill for Early Postoperative Rehabilitation After Total Knee Replacement: A Pilot Study to Determine Safety and Feasibility.

PubMed

Bugbee, William D; Pulido, Pamela A; Goldberg, Timothy; D'Lima, Darryl D

2016-01-01

The objective was to determine the safety, feasibility, and effects of anti-gravity gait training on functional outcomes (Knee Injury and Osteoarthritis Outcome Score [KOOS], the Timed Up and Go test [TUG], Numerical Rating Scale [NRS] for pain) with the AlterG® Anti-Gravity Treadmill® device for total knee arthroplasty (TKA) rehabilitation. Subjects (N = 30) were randomized to land-based vs anti-gravity gait training over 4 weeks of physical therapy after TKA. Adverse events, complications, and therapist satisfaction were recorded. All patients completed rehabilitation protocols without adverse events. KOOS, TUG, and NRS scores improved in both groups with no significant differences between groups. For the AlterG group, Sports/Recreation and Quality of Life subscales of the KOOS had the most improvement. At the end of physical therapy, TUG and NRS pain scores improved from 14 seconds to 8 seconds and from 2.8 to 1.1, respectively. Subjectively, therapists reported 100% satisfaction with the AlterG. This initial pilot study demonstrated that the AlterG Anti-Gravity Treadmill device was safe and feasible. While functional outcomes improved over time with use of the anti-gravity gait training, further studies are needed to define the role of this device as an alternative or adjunct to established rehabilitation protocols.

Unexpected perturbations training improves balance control and voluntary stepping times in older adults - a double blind randomized control trial.

PubMed

Kurz, Ilan; Gimmon, Yoav; Shapiro, Amir; Debi, Ronen; Snir, Yoram; Melzer, Itshak

2016-03-04

Falls are common among elderly, most of them occur while slipping or tripping during walking. We aimed to explore whether a training program that incorporates unexpected loss of balance during walking able to improve risk factors for falls. In a double-blind randomized controlled trial 53 community dwelling older adults (age 80.1±5.6 years), were recruited and randomly allocated to an intervention group (n = 27) or a control group (n = 26). The intervention group received 24 training sessions over 3 months that included unexpected perturbation of balance exercises during treadmill walking. The control group performed treadmill walking with no perturbations. The primary outcome measures were the voluntary step execution times, traditional postural sway parameters and Stabilogram-Diffusion Analysis. The secondary outcome measures were the fall efficacy Scale (FES), self-reported late life function (LLFDI), and Performance-Oriented Mobility Assessment (POMA). Compared to control, participation in intervention program that includes unexpected loss of balance during walking led to faster Voluntary Step Execution Times under single (p = 0.002; effect size [ES] =0.75) and dual task (p = 0.003; [ES] = 0.89) conditions; intervention group subjects showed improvement in Short-term Effective diffusion coefficients in the mediolateral direction of the Stabilogram-Diffusion Analysis under eyes closed conditions (p = 0.012, [ES] = 0.92). Compared to control there were no significant changes in FES, LLFDI, and POMA. An intervention program that includes unexpected loss of balance during walking can improve voluntary stepping times and balance control, both previously reported as risk factors for falls. This however, did not transferred to a change self-reported function and FES. ClinicalTrials.gov NCT01439451 .

Effects of a virtual reality and treadmill training on gait of subjects with multiple sclerosis: a pilot study.

PubMed

Peruzzi, Agnese; Cereatti, Andrea; Della Croce, Ugo; Mirelman, Anat

2016-01-01

Gait and cognitive deficits are common in multiple sclerosis (MS) and are negatively affected during dual-task walking. Treadmill (TM) training has been previously used to preserve locomotor activity in MS. Virtual reality (VR) engages the user in cognitive and motor activities simultaneously. A training combining TM and VR has been successfully adopted in several neurological diseases, but not in MS. This study aims at investigating the feasibility of a VR-based TM training program on gait of subjects with MS. Eight persons with relapsing-remitting MS were recruited to participate in a six-week VR-based TM training program. Gait analysis was performed both in single and dual task conditions. Clinical tests were used to assess walking endurance and obstacle negotiation. All the evaluations were performed before, immediately and one month after the training. Gait speed and stride length improved in dual task post-intervention and were retained at follow-up. An improved ability in negotiating obstacles was found across the evaluations. VR-based TM training program is feasible and safe for MS subjects with moderate disabilities and may positively affect gait under complex conditions, such as dual tasking and obstacle negotiation. Copyright © 2015. Published by Elsevier B.V.

Can the mammalian lumbar spinal cord learn a motor task?

PubMed

Hodgson, J A; Roy, R R; de Leon, R; Dobkin, B; Edgerton, V R

1994-12-01

Progress toward restoring locomotor function in low thoracic spinal transected cats and the application of similar techniques to patients with spinal cord injury is reviewed. Complete spinal cord transection (T12-T13) in adult cats results in an immediate loss of locomotor function in the hindlimbs. Limited locomotor function returns after several months in cats that have not received specific therapies designed to restore hindlimb stepping. Training transected cats to step on a treadmill for 30 min.d-1 and 5 d.wk-1 greatly improves their stepping ability. The most successful outcome was in cats where training began early, i.e., 1 wk after spinal transection. Cats trained to stand instead of stepping had great difficulty using the hindlimbs for locomotion. These effects were reversible over a 20-month period such that cats unable to step as a result of standing training could be trained to step and, conversely, locomotion in stepping-trained cats could be abolished by standing training. These results indicate that the spinal cord is capable of learning specific motor tasks. It has not been possible to elicit locomotion in patients with clinically complete spinal injuries, but appropriately coordinated EMG activity has been demonstrated in musculature of the legs during assisted locomotion on a treadmill.

The efficacy of treadmill training on balance dysfunction in individuals with chronic stroke: a systematic review.

PubMed

Tally, Zachary; Boetefuer, Laura; Kauk, Courtney; Perez, Gabriela; Schrand, Lorraine; Hoder, Jeffrey

2017-10-01

Physical activity and exercise interventions are useful in facilitating the functional recovery of those with chronic stroke and, routinely, are gait-specific. While treadmill training has proven useful in gait performance recovery post-stroke, its efficacy on balance dysfunction has not been  systematically reviewed. The purpose of this systematic review was to determine the effect of treadmill training (TT) interventions on balance dysfunction in individuals with chronic stroke. A systematic literature search of PubMed, EMBASE, and CINAHL was performed. Eligible randomized controlled trials were published between 2007 and 2016. Selected trials investigated TT interventions in persons with chronic stroke and implemented at least one objective balance measure. Methodological quality was assessed using PEDro criteria. Eight studies met eligibility criteria and were included in the qualitative analysis. Studies differed in TT implementation and use of adjunctive treatments; however, all trials demonstrated improvements in balance measures that were as effective, if not more so, than conventional physical therapy treatments, including targeted balance training. This review recognized moderate evidence in favor of TT interventions in balance and stroke rehabilitation programs. With TT, intensity may be a more critical factor than specificity and may offer additional carryover to recovery parameters of postural control and balance, beyond gait performance. It is recommended that clinicians utilizing TT incorporate objective measures of balance to assess the potential for skill transference and improvements in balance. Higher quality studies and additional research are needed to denote critical parameters by which improvements in balance may be optimized.

A systematic review of the efficacy of gait rehabilitation strategies for spinal cord injury

PubMed Central

Lam, Tania; Eng, Janice J; Wolfe, Dalton L; Hsieh, Jane T; Whittaker, Maura

2012-01-01

OBJECTIVE To systematically review the evidence for the efficacy of different rehabilitation strategies on functional ambulation following spinal cord injury (SCI). METHODS A keyword literature search of original articles was used to identify published literature evaluating the effectiveness of any treatment or therapy on functional ambulation in people with SCI. The rigor and quality of each study were scored on standardized scales by two independent reviewers. RESULTS The search yielded 160 articles, of which 119 were excluded for not meeting our inclusion criteria. The remaining 41 articles covered various strategies for improving gait: bodyweight supported treadmill training (BWSTT) (n=12), functional electrical stimulation (FES) (n=7), braces/orthoses (n=10), or a combination of these (n=12). There is strong evidence from randomized controlled trials that functional ambulation outcomes following body-weight supported treadmill training (BWSTT) are comparable to an equivalent intensity of overground gait training in sub-acute SCI. In chronic SCI, evidence from pre-test/post-test studies shows that BWSTT may be effective in improving functional ambulation. Pre-test/post-test or post-test only studies provide evidence that FES may augment functional ambulation in sub-acute/chronic SCI while braces may afford particular benefits to people with complete SCI to stand up and ambulate with assistive devices. CONCLUSIONS Rehabilitation strategies that facilitate repeated practice of gait offer the greatest benefits to functional ambulation in sub-acute or chronic SCI. Supportive devices may augment functional ambulation particularly in people with incomplete SCI. PMID:22915835

Treadmill training with partial body weight support and an electromechanical gait trainer for restoration of gait in subacute stroke patients: a randomized crossover study.

PubMed

Werner, C; Von Frankenberg, S; Treig, T; Konrad, M; Hesse, S

2002-12-01

The purpose of this study was to compare treadmill and electromechanical gait trainer therapy in subacute, nonambulatory stroke survivors. The gait trainer was designed to provide nonambulatory subjects the repetitive practice of a gait-like movement without overexerting therapists. This was a randomized, controlled study with a crossover design following an A-B-A versus a B-A-B pattern. A consisted of 2 weeks of gait trainer therapy, and B consisted of 2 weeks of treadmill therapy. Thirty nonambulatory hemiparetic patients, 4 to 12 weeks after stroke, were randomly assigned to 1 of the 2 groups receiving locomotor therapy every workday for 15 to 20 minutes for 6 weeks. Weekly gait ability (functional ambulation category [FAC]), gait velocity, and the required physical assistance during both kinds of locomotor therapy were the primary outcome measures, and other motor functions (Rivermead motor assessment score) and ankle spasticity (modified Ashworth score) were the secondary outcome measures. Follow-up occurred 6 months later. The groups did not differ at study onset with respect to the clinical characteristics and effector variables. During treatment, the FAC, gait velocity, and Rivermead scores improved in both groups, and ankle spasticity did not change. Median FAC level was 4 (3 to 4) in group A compared with 3 (2 to 3) in group B at the end of treatment (P=0.018), but the difference at 6-month follow up was not significant. The therapeutic effort was less on the gait trainer, with 1 instead of 2 therapists assisting the patient at study onset. All but seven patients preferred the gait trainer. The newly developed gait trainer was at least as effective as treadmill therapy with partial body weight support while requiring less input from the therapist. Further studies are warranted.

Gait Adaptability Training Improves Both Postural Stability and Dual-Tasking Ability

NASA Technical Reports Server (NTRS)

Brady, Rachel A.; Batson, Crystal D.; Peters, Brian T.; Ploutz-Snyder, Robert J.; Mulavara, Ajitkumar P.; Bloomberg, Jacob J.

2010-01-01

After spaceflight, the process of readapting to Earth's gravity commonly presents crewmembers with a variety of locomotor challenges. Our recent work has shown that the ability to adapt to a novel discordant sensorimotor environment can be increased through preflight training, so one focus of our laboratory has been the development of a gait training countermeasure to expedite the return of normal locomotor function after spaceflight. We used a training system comprising a treadmill mounted on a motion base facing a virtual visual scene that provided a variety of sensory challenges. As part of their participation in a larger retention study, 10 healthy adults completed 3 training sessions during which they walked on a treadmill at 1.1 m/s while receiving discordant support-surface and visual manipulations. After a single training session, subjects stride frequencies improved, and after 2 training sessions their auditory reaction times improved, where improvement was indicated by a return toward baseline values. Interestingly, improvements in reaction time came after stride frequency improvements plateaued. This finding suggests that postural stability was given a higher priority than a competing cognitive task. Further, it demonstrates that improvement in both postural stability and dual-tasking can be achieved with multiple training exposures. We conclude that, with training, individuals become more proficient at walking in discordant sensorimotor conditions and are able to devote more attention to competing tasks.

Effects of Single Bouts of Walking Exercise and Yoga on Acute Mood Symptoms in People with Multiple Sclerosis

PubMed Central

Ensari, Ipek; Sandroff, Brian M.

2016-01-01

Background: Little is known about the acute or immediate effects of walking exercise and yoga on mood in people with multiple sclerosis (MS). Such an examination is important for identifying an exercise modality for inclusion in exercise-training interventions that yields mood benefits in MS. We examined the effects of single bouts of treadmill walking and yoga compared with a quiet, seated-rest control condition on acute mood symptoms in MS. Methods: Twenty-four participants with MS completed 20 minutes of treadmill walking, yoga, or quiet rest in a randomized, counterbalanced order with 1 week between sessions. Participants completed the Profile of Mood States questionnaire before and immediately after each condition. Total mood disturbance (TMD) and the six subscales of the Profile of Mood States were analyzed using repeated-measures analysis of variance and paired-samples t tests. Results: There was a significant condition × time interaction on TMD scores (ηp2 = 0.13). Walking and yoga conditions yielded comparable reductions in TMD scores. There was a significant condition × time interaction on vigor (ηp2 = 0.23) whereby walking but not yoga yielded an improvement in vigor. There was a significant main effect of time on anger, confusion, depression, and tension (P < .05) but not on fatigue. Conclusions: Walking and yoga yielded similar improvements in overall acute mood symptoms, and walking improved feelings of vigor. These effects should be further investigated in long-term exercise-training studies. PMID:26917992

Comparison of metabolic responses of United States Military Academy men and women in acute military load bearing.

PubMed

Stauffer, R W; McCarter, M; Campbell, J L; Wheeler, L F

1987-11-01

Twenty-four first year United States Military Academy (USMA) men and women were studied to compare metabolic response differences in seven horizontal walking velocities, under three military load bearing conditions. The treadmill protocol consisted of walking or jogging on a horizontal treadmill surface for 3-min intervals at velocities of 3, 3.5, 4, 4.5, 5, 5.5, and 6 mph. The three military load bearing conditions weighed 5, 12, and 20 kg. Metabolic measurements taken at each speed in each of the military load bearing conditions were: minute volume, tidal volume, respiratory rate, absolute and relative to body weight oxygen consumption, and respiratory quotient. Two three-way analyses of variance for repeated measures tests with main effects of gender, military load, and speed revealed that USMA men and women metabolically respond to different military load bearing conditions; they metabolically respond to different walking and jogging velocities under military load bearing conditions; and they have identifiable and quantifiable metabolic response differences to military load bearing. This study was designed to improve USMA physical and military training programs by providing information to equally and uniformly administer the USMA Doctrine of Comparable Training to men and women alike; and additionally to clarify the "...minimal essential adjustments...required because of physiological differences between male and female individuals ..." portion of Public Law 94-106 providing for the admission of women to America's Service Academies.

Post-Stroke Rehabilitation

MedlinePlus

... avoid using impaired limbs, a behavior called learned non-use . However, the repetitive use of impaired limbs ... balance and strength rehabilitation in the home was equivalent to treadmill training at a rehabilitation facility in ...

Atypical autonomic dysreflexia during robotic-assisted body weight supported treadmill training in an individual with motor incomplete spinal cord injury.

PubMed

Geigle, Paula R; Frye, Sara Kate; Perreault, John; Scott, William H; Gorman, Peter H

2013-03-01

A 41-year-old man with a history of C6 American Spinal Injury Association (ASIA) Impairment Scale (AIS) C spinal cord injury (SCI), enrolled in an Institutional Review Board (IRB)-approved, robotic-assisted body weight-supported treadmill training (BWSTT), and aquatic exercise research protocol developed asymptomatic autonomic dysreflexia (AD) during training. Little information is available regarding the relationship of robotic-assisted BWSTT and AD. After successfully completing 36 sessions of aquatic exercise, he reported exertional fatigue during his 10th Lokomat intervention and exhibited asymptomatic or silent AD during this and the three subsequent BWSTT sessions. Standard facilitators of AD were assessed and no obvious irritant identified other than the actual physical exertion and positioning required during robotic-assisted BWSTT. Increased awareness of potential silent AD presenting during robotic assisted BWSTT training for individuals with motor incomplete SCI is required as in this case AD clinical signs were not concurrent with occurrence. Frequent vital sign assessment before, during, and at conclusion of each BWSTT session is strongly recommended.

Upright exercise or supine lower body negative pressure exercise maintains exercise responses after bed rest

NASA Technical Reports Server (NTRS)

Lee, S. M.; Bennett, B. S.; Hargens, A. R.; Watenpaugh, D. E.; Ballard, R. E.; Murthy, G.; Ford, S. R.; Fortney, S. M.

1997-01-01

Adaptation to bed rest or space flight is accompanied by an impaired ability to exercise in an upright position. We hypothesized that a daily, 30-min bout of intense, interval exercise in upright posture or supine against lower body negative pressure (LBNP) would maintain upright exercise heart rate and respiratory responses after bed rest. Twenty-four men (31 +/- 3 yr) underwent 5 d of 6 degree head-down tilt: eight performed no exercise (CON), eight performed upright treadmill exercise (UPex), and eight performed supine treadmill exercise against LBNP at -51.3 +/- 0.4 mm Hg (LBNPex). Submaximal treadmill exercise responses (56, 74, and 85% of VO2peak) were measured pre- and post-bed rest. In CON, submaximal heart rate, respiratory exchange ratio, and ventilation were significantly greater (P < or = 0.05) after bed rest. In UPex and LBNPex, submaximal exercise responses were similar pre- and post-bed rest. Our results indicate that a daily 30-min bout of intense, interval upright exercise training or supine exercise training against LBNP is sufficient to maintain upright exercise responses after 5 d of bed rest. These results may have important implications for the development of exercise countermeasures during space flight.

A multi-channel biomimetic neuroprosthesis to support treadmill gait training in stroke patients.

PubMed

Chia, Noelia; Ambrosini, Emilia; Baccinelli, Walter; Nardone, Antonio; Monticone, Marco; Ferrigno, Giancarlo; Pedrocchi, Alessandra; Ferrante, Simona

2015-01-01

This study presents an innovative multi-channel neuroprosthesis that induces a biomimetic activation of the main lower-limb muscles during treadmill gait training to be used in the rehabilitation of stroke patients. The electrostimulation strategy replicates the physiological muscle synergies used by healthy subjects to walk on a treadmill at their self-selected speed. This strategy is mapped to the current gait sub-phases, which are identified in real time by a custom algorithm. This algorithm divides the gait cycle into six sub-phases, based on two inertial sensors placed laterally on the shanks. Therefore, the pre-defined stimulation profiles are expanded or stretched based on the actual gait pattern of each single subject. A preliminary experimental protocol, involving 10 healthy volunteers, was carried out to extract the muscle synergies and validate the gait-detection algorithm, which were afterwards used in the development of the neuroprosthesis. The feasibility of the neuroprosthesis was tested on one healthy subject who simulated different gait patterns, and a chronic stroke patient. The results showed the correct functioning of the system. A pilot study of the neurorehabilitation treatment for stroke patients is currently being carried out.

Peak impact accelerations during track and treadmill running.

PubMed

Bigelow, Erin M R; Elvin, Niell G; Elvin, Alex A; Arnoczky, Steven P

2013-10-01

To determine whether peak vertical and horizontal impact accelerations were different while running on a track or on a treadmill, 12 healthy subjects (average age 32.8 ± 9.8 y), were fitted with a novel, wireless accelerometer capable of recording triaxial acceleration over time. The accelerometer was attached to a custom-made acrylic plate and secured at the level of the L5 vertebra via a tight fitting triathlon belt. Each subject ran 4 miles on a synthetic, indoor track at a self-selected pace and accelerations were recorded on three perpendicular axes. Seven days later, the subjects ran 4 miles on a treadmill set at the individual runner's average pace on the track and the peak vertical and horizontal impact magnitudes between the track and treadmill were compared. There was no difference (P = .52) in the average peak vertical impact accelerations between the track and treadmill over the 4 mile run. However, peak horizontal impact accelerations were greater (P = .0012) on the track when compared with the treadmill. This study demonstrated the feasibility for long-term impact accelerations monitoring using a novel wireless accelerometer.

Effect of long-term exercise training on blood viscosity during endurance exercise at an anaerobic threshold intensity.

PubMed

Adachi, H; Sakurai, S; Tanehata, M; Oshima, S; Taniguchi, K

2000-11-01

Blood viscosity (etaB) is low in athletes, but the effect of exercise training on etaB during endurance exercise at an anaerobic threshold (AT) intensity in non-athletes is not well known, although it is known that exercise training sometimes induces the hyperviscosity syndrome. Fourteen subjects were recruited and divided into 2 groups: those who trained at an AT intensity for 30 min/day, 3 times weekly for 1 year (Group T, n=8), and sedentary subjects (Group C, n=6). The test protocol consisted of a single 30-min treadmill exercise at each individual's AT intensity, which was determined in advance. The etaB, plasma viscosity (etaP), and hematocrit were measured just before and at the end of the treadmill exercise. The subjects were not allowed to drink any water before exercise. In the Group C subjects, the hematocrit and etaP increased significantly and the etaB tended to increase. However, in the Group T subjects, the hematocrit and etaP did not increase and the etaB decreased significantly. These data indicate that long-term exercise training attenuates the increase in blood viscosity during exercise.

Virtual reality-based training improves community ambulation in individuals with stroke: a randomized controlled trial.

PubMed

Yang, Yea-Ru; Tsai, Meng-Pin; Chuang, Tien-Yow; Sung, Wen-Hsu; Wang, Ray-Yau

2008-08-01

This is a single blind randomized controlled trial to examine the effect of virtual reality-based training on the community ambulation in individuals with stroke. Twenty subjects with stroke were assigned randomly to either the control group (n=9) or the experimental group (n=11). Subjects in the control group received the treadmill training. Subjects in the experimental group underwent the virtual reality-based treadmill training. Walking speed, community walking time, walking ability questionnaire (WAQ), and activities-specific balance confidence (ABC) scale were evaluated. Subjects in the experimental group improved significantly in walking speed, community walking time, and WAQ score at posttraining and 1-month follow-up periods. Their ABC score also significantly increased at posttraining but did not maintain at follow-up period. Regarding the between-group comparisons, the experimental group improved significantly more than control group in walking speed (P=0.03) and community walking time (P=0.04) at posttraining period and in WAQ score (P=0.03) at follow-up period. Our results support the perceived benefits of gait training programs that incorporate virtual reality to augment the community ambulation of individuals with stroke.

Exercise training enhances aerobic capacity in juvenile estuarine crocodiles (Crocodylus porosus).

PubMed

Owerkowicz, Tomasz; Baudinette, Russell V

2008-06-01

Aerobic capacity (VO2max) of endothermic vertebrates is known to increase with exercise training, but this effect has not been found to-date in non-avian reptiles. We exercised juvenile estuarine crocodiles (Crocodylus porosus) to walk at 0.75-0.88 km/h on a treadmill for up to 20 min a day over 16 weeks, and compared their aerobic performance with that of unexercised crocodiles. In the exercised group, VO2max increased from 6.9 to 8.5 mLO2/kg/min (+28%), and locomotor endurance increased from 3.8 to 6.9 min (+82%). Neither VO2max nor endurance changed significantly in the sedentary group. This finding extends the exercise training effect onto another vertebrate clade, and demonstrates that ectothermic amniotes are capable of elevating their aerobic capacity in response to exercise training. We propose that differences in cardiopulmonary structure and function in non-avian reptiles may be responsible for the absence (in squamates) or presence (in crocodilians) of a strong training effect on aerobic capacity.

Proinflammatory cytokines correlate with early exercise attenuating anxiety-like behavior after cerebral ischemia.

PubMed

Zhang, Qi; Zhang, Jingjun; Yan, Yuzhong; Zhang, Pengyue; Zhang, Wei; Xia, Rong

2017-11-01

Stroke may cause neuropsychiatric problems, which have negative effects on cognitive functions and behavior. Exercise plays an important role in reducing the occurrence and development of stroke, the concrete mechanism is not fully clarified. In this study, we attempted to determine whether early treadmill exercise attenuates anxiety-like behavior by regulation of inflammation after brain ischemia. We subjected adult male rats to middle cerebral artery occlusion (MCAO) for 90 min and trained rats started to run on a treadmill from postoperative day 1 to day 14. The effects of treadmill on cognitive functions, anxiety-like behavior, and immune activation were analyzed by Morris water maze test, open field test, elevated plus maze test, and enzyme-linked immunosorbent assay. Early treadmill exercise significantly improved cognitive function, alleviated anxiety-like behavior in ischemic rats model; this improvement was associated with significantly decreased activation of astrocytes and microglia cells and proinflammatory markers (platelet-activating factor [PAF], interleukin-6 [IL-6], tumor necrosis factor-alpha [TNF-α], intercellular adhesion molecule-1 [ICAM-1], and vascular cell adhesion molecule-1 [VCAM-1]). Our results indicated that early treadmill exercise attenuated anxiety-like behavior by decreasing inflammation response, exercise conferred a great benefit of attenuating anxiety-like behavior via anti-inflammatory treatment may prove to be a novel neuroprotective strategy for stroke.

Long-term moderate treadmill exercise promotes stress-coping strategies in male and female rats.

PubMed

Lalanza, Jaume F; Sanchez-Roige, Sandra; Cigarroa, Igor; Gagliano, Humberto; Fuentes, Silvia; Armario, Antonio; Capdevila, Lluís; Escorihuela, Rosa M

2015-11-05

Recent evidence has revealed the impact of exercise in alleviating anxiety and mood disorders; however, the exercise protocol that exerts such benefit is far from known. The current study was aimed to assess the effects of long-term moderate exercise on behavioural coping strategies (active vs. passive) and Hypothalamic-Pituitary-Adrenal response in rats. Sprague-Dawley male and female rats were exposed to 32-weeks of treadmill exercise and then tested for two-way active avoidance learning (shuttle-box). Two groups were used as controls: a non-handled sedentary group, receiving no manipulation, and a control group exposed to a stationary treadmill. Female rats displayed shorter escape responses and higher number of avoidance responses, reaching criterion for performance earlier than male rats. In both sexes, exercise shortened escape latencies, increased the total number of avoidances and diminished the number of trials needed to reach criterion for performance. Those effects were greater during acquisition in female rats, but remained over the shuttle-box sessions in treadmill trained male rats. In females, exercise did not change ACTH and corticosterone levels after shuttle-box acquisition. Collectively, treadmill exercise improved active coping strategies in a sex-dependent manner. In a broader context, moderate exercise could serve as a therapeutic intervention for anxiety and mood disorders.

Long-term moderate treadmill exercise promotes stress-coping strategies in male and female rats

PubMed Central

Lalanza, Jaume F.; Sanchez-Roige, Sandra; Cigarroa, Igor; Gagliano, Humberto; Fuentes, Silvia; Armario, Antonio; Capdevila, Lluís; Escorihuela, Rosa M.

2015-01-01

Recent evidence has revealed the impact of exercise in alleviating anxiety and mood disorders; however, the exercise protocol that exerts such benefit is far from known. The current study was aimed to assess the effects of long-term moderate exercise on behavioural coping strategies (active vs. passive) and Hypothalamic-Pituitary-Adrenal response in rats. Sprague-Dawley male and female rats were exposed to 32-weeks of treadmill exercise and then tested for two-way active avoidance learning (shuttle-box). Two groups were used as controls: a non-handled sedentary group, receiving no manipulation, and a control group exposed to a stationary treadmill. Female rats displayed shorter escape responses and higher number of avoidance responses, reaching criterion for performance earlier than male rats. In both sexes, exercise shortened escape latencies, increased the total number of avoidances and diminished the number of trials needed to reach criterion for performance. Those effects were greater during acquisition in female rats, but remained over the shuttle-box sessions in treadmill trained male rats. In females, exercise did not change ACTH and corticosterone levels after shuttle-box acquisition. Collectively, treadmill exercise improved active coping strategies in a sex-dependent manner. In a broader context, moderate exercise could serve as a therapeutic intervention for anxiety and mood disorders. PMID:26538081

Effects of virtual reality training using Nintendo Wii and treadmill walking exercise on balance and walking for stroke patients.

PubMed

Bang, Yo-Soon; Son, Kyung Hyun; Kim, Hyun Jin

2016-11-01

[Purpose] The purpose of this study is to investigate the effects of virtual reality training using Nintendo Wii on balance and walking for stroke patients. [Subjects and Methods] Forty stroke patients with stroke were randomly divided into two exercise program groups: virtual reality training (n=20) and treadmill (n=20). The subjects underwent their 40-minute exercise program three times a week for eight weeks. Their balance and walking were measured before and after the complete program. We measured the left/right weight-bearing and the anterior/posterior weight-bearing for balance, as well as stance phase, swing phase, and cadence for walking. [Results] For balance, both groups showed significant differences in the left/right and anterior/posterior weight-bearing, with significant post-program differences between the groups. For walking, there were significant differences in the stance phase, swing phase, and cadence of the virtual reality training group. [Conclusion] The results of this study suggest that virtual reality training providing visual feedback may enable stroke patients to directly adjust their incorrect weight center and shift visually. Virtual reality training may be appropriate for patients who need improved balance and walking ability by inducing their interest for them to perform planned exercises on a consistent basis.

Effects of virtual reality training using Nintendo Wii and treadmill walking exercise on balance and walking for stroke patients

PubMed Central

Bang, Yo-Soon; Son, Kyung Hyun; Kim, Hyun Jin

2016-01-01

[Purpose] The purpose of this study is to investigate the effects of virtual reality training using Nintendo Wii on balance and walking for stroke patients. [Subjects and Methods] Forty stroke patients with stroke were randomly divided into two exercise program groups: virtual reality training (n=20) and treadmill (n=20). The subjects underwent their 40-minute exercise program three times a week for eight weeks. Their balance and walking were measured before and after the complete program. We measured the left/right weight-bearing and the anterior/posterior weight-bearing for balance, as well as stance phase, swing phase, and cadence for walking. [Results] For balance, both groups showed significant differences in the left/right and anterior/posterior weight-bearing, with significant post-program differences between the groups. For walking, there were significant differences in the stance phase, swing phase, and cadence of the virtual reality training group. [Conclusion] The results of this study suggest that virtual reality training providing visual feedback may enable stroke patients to directly adjust their incorrect weight center and shift visually. Virtual reality training may be appropriate for patients who need improved balance and walking ability by inducing their interest for them to perform planned exercises on a consistent basis. PMID:27942130

Development of a Countermeasure to Enhance Postflight Locomotor Adaptability

NASA Technical Reports Server (NTRS)

Bloomberg, Jacob J.

2006-01-01

Astronauts returning from space flight experience locomotor dysfunction following their return to Earth. Our laboratory is currently developing a gait adaptability training program that is designed to facilitate recovery of locomotor function following a return to a gravitational environment. The training program exploits the ability of the sensorimotor system to generalize from exposure to multiple adaptive challenges during training so that the gait control system essentially learns to learn and therefore can reorganize more rapidly when faced with a novel adaptive challenge. We have previously confirmed that subjects participating in adaptive generalization training programs using a variety of visuomotor distortions can enhance their ability to adapt to a novel sensorimotor environment. Importantly, this increased adaptability was retained even one month after completion of the training period. Adaptive generalization has been observed in a variety of other tasks requiring sensorimotor transformations including manual control tasks and reaching (Bock et al., 2001, Seidler, 2003) and obstacle avoidance during walking (Lam and Dietz, 2004). Taken together, the evidence suggests that a training regimen exposing crewmembers to variation in locomotor conditions, with repeated transitions among states, may enhance their ability to learn how to reassemble appropriate locomotor patterns upon return from microgravity. We believe exposure to this type of training will extend crewmembers locomotor behavioral repertoires, facilitating the return of functional mobility after long duration space flight. Our proposed training protocol will compel subjects to develop new behavioral solutions under varying sensorimotor demands. Over time subjects will learn to create appropriate locomotor solution more rapidly enabling acquisition of mobility sooner after long-duration space flight. Our laboratory is currently developing adaptive generalization training procedures and the associated flight hardware to implement such a training program during regular inflight treadmill operations. A visual display system will provide variation in visual flow patterns during treadmill exercise. Crewmembers will be exposed to a virtual scene that can translate and rotate in six-degrees-of freedom during their regular treadmill exercise period. Associated ground based studies are focused on determining optimal combinations of sensory manipulations (visual flow, body loading and support surface variation) and training schedules that will produce the greatest potential for adaptive flexibility in gait function during exposure to challenging and novel environments. An overview of our progress in these areas will be discussed during the presentation.

VO[subscript 2] Prediction and Cardiorespiratory Responses during Underwater Treadmill Exercise

ERIC Educational Resources Information Center

Greene, Nicholas P.; Greene, Elizabeth S.; Carbuhn, Aaron F.; Green, John S.; Crouse, Stephen F.

2011-01-01

We compared cardiorespiratory responses to exercise on an underwater treadmill (UTM) and land treadmill (LTM) and derived an equation to estimate oxygen consumption (VO[subscript 2]) during UTM exercise. Fifty-five men and women completed one LTM and five UTM exercise sessions on separate days. The UTM sessions consisted of chest-deep immersion,…

Comparison of different volumes of high intensity interval training on cardiac autonomic function in sedentary young women.

PubMed

Bhati, Pooja; Bansal, Vishal; Moiz, Jamal Ali

2017-08-24

Purpose The present study was conducted to compare the effects of low volume of high intensity interval training (LVHIIT) and high volume of high intensity interval training (HVHIIT) on heart rate variability (HRV) as a primary outcome measure, and on maximum oxygen consumption (VO2max), body composition, and lower limb muscle strength as secondary outcome measures, in sedentary young women. Methods Thirty-six participants were recruited in this study. The LVHIIT group (n = 17) performed one 4-min bout of treadmill running at 85%-95% maximum heart rate (HRmax), followed by 3 min of recovery by running at 70% HRmax, three times per week for 6 weeks. The HVHIIT group (n = 15) performed four times 4-min bouts of treadmill running at 85%-95% HRmax, interspersed with 3-min of recovery by running at 70% HRmax, 3 times per week for 6 weeks. All criterion measures were measured before and after training in both the groups. Results Due to attrition of four cases, data of 32 participants was used for analysis. A significant increase in high frequency (HF) power (p < 0.001) and decrease in the ratio of low frequency to high frequency power (LF/HF) ratio (p < 0.001) in HRV parameters, was observed post-HVHIIT, whereas, these variables did not change significantly (HF: p = 0.92, LF/HF ratio: p = 0.52) in LVHIIT group. Nevertheless, both the interventions proved equally effective in improving aerobic capacity (VO2max), body composition, and muscle strength. Conclusion The study results suggest that both LVHIIT and HVHIIT are equally effective in improving VO2max, body composition, and muscle strength, in sedentary young women. However, HVHIIT induces parasympathetic dominance as well, as measured by HRV.

A randomized trial of functional electrical stimulation for walking in incomplete spinal cord injury: Effects on walking competency

PubMed Central

Kapadia, Naaz; Masani, Kei; Catharine Craven, B.; Giangregorio, Lora M.; Hitzig, Sander L.; Richards, Kieva; Popovic, Milos R.

2014-01-01

Background Multi-channel surface functional electrical stimulation (FES) for walking has been used to improve voluntary walking and balance in individuals with spinal cord injury (SCI). Objective To investigate short- and long-term benefits of 16 weeks of thrice-weekly FES-assisted walking program, while ambulating on a body weight support treadmill and harness system, versus a non-FES exercise program, on improvements in gait and balance in individuals with chronic incomplete traumatic SCI, in a randomized controlled trial design. Methods Individuals with traumatic and chronic (≥18 months) motor incomplete SCI (level C2 to T12, American Spinal Cord Injury Association Impairment Scale C or D) were recruited from an outpatient SCI rehabilitation hospital, and randomized to FES-assisted walking therapy (intervention group) or aerobic and resistance training program (control group). Outcomes were assessed at baseline, and after 4, 6, and 12 months. Gait, balance, spasticity, and functional measures were collected. Results Spinal cord independence measure (SCIM) mobility sub-score improved over time in the intervention group compared with the control group (baseline/12 months: 17.27/21.33 vs. 19.09/17.36, respectively). On all other outcome measures the intervention and control groups had similar improvements. Irrespective of group allocation walking speed, endurance, and balance during ambulation all improved upon completion of therapy, and majority of participants retained these gains at long-term follow-ups. Conclusions Task-oriented training improves walking ability in individuals with incomplete SCI, even in the chronic stage. Further randomized controlled trials, involving a large number of participants are needed, to verify if FES-assisted treadmill training is superior to aerobic and strength training. PMID:25229735

Effects of physical exercise programs on cognitive function in Parkinson’s disease patients: A systematic review of randomized controlled trials of the last 10 years

PubMed Central

Iop, Rodrigo da Rosa; de Oliveira, Laiana Cândido; Boll, Alice Mathea; de Alvarenga, José Gustavo Souza; Gutierres Filho, Paulo José Barbosa; de Melo, Lídia Mara Aguiar Bezerra; Xavier, André Junqueira; da Silva, Rudney

2018-01-01

Background Given the relative importance of cognitive impairment, there was considerable interest in identifying the cognitive profile of PD patients, in order to ensure specific and appropriate therapeutic interventions. Purpose To determine the effects of physical exercise programs on cognitive function in PD patients, compared with the control group. Data sources Medline, Cochrane, Scopus, PEDro and Web of Science (last searched in September 2016). Study selection Randomized clinical trials examining the effects of physical exercise programs and cognitive function in PD patients. Nine studies fulfilled the selection criteria and were included in this review. Data extraction Characteristics of the publication, characteristics of the participants, test used for cognitive screening, cognitive domain assessed, tools used to assess cognitive function, characteristics of the experimental intervention, characteristics of the control group, mean results and standard deviation of function cognitive. The PEDro score was used to evaluate methodological quality. Data synthesis Most eligible studies showed good methodological quality based on the PEDro scale. Studies have shown that adapted tango for PD patients, cognitive training combined with motor training, and treadmill training promote the preservation or improvement of cognitive function in PD patients. Limitations The diversity of cognitive tests used to assess cognitive function and the high heterogeneity identified between the physical exercise programs. Conclusions Physical exercise programs promote positive and significant effects on global cognitive function, processing speed, sustained attention and mental flexibility in PD patients, at a mild to moderate stage for patients with a 6-year clinical diagnosis of PD. However, treadmill training performed 3 times a week for about 60 minutes and for a period of 24 weeks produced larger improvements in cognition. PMID:29486000

Effects of Task-Specific Augmented Feedback on Deficit Modification During Performance of the Tuck-Jump Exercise

PubMed Central

Stroube, Benjamin W.; Myer, Gregory D.; Brent, Jensen L.; Ford, Kevin R.; Heidt, Robert S.; Hewett, Timothy E.

2014-01-01

Context Anterior cruciate ligament (ACL) injuries are prevalent in female athletes. Specific factors have possible links to increasing a female athlete’s chances of suffering an ACL injury. However, it is unclear if augmented feedback may be able to decrease possible risk factors. Objective To compare the effects of task-Specific feedback on a repeated tuck-jump maneuver. Design Double-blind randomized controlled trial. Setting Sports-medicine biodynamics center. Patients 37 female subjects (14.7 ± 1.5 y, 160.9 ± 6.8 cm, 54.5 ± 7.2 kg). Intervention All athletes received standard off-season training consisting of strength training, plyometrics, and conditioning. They were also videotaped during each session while running on a treadmill at a standardized speed (8 miles/h) and while performing a repeated tuck-jump maneuver for 10 s. The augmented feedback group (AF) received feedback on deficiencies present in a 10-s tuck jump, while the control group (CTRL) received feedback on 10-s treadmill running. Main Outcome Measures Outcome measurements of tuck-jump deficits were scored by a blinded rater to determine the effects of group (CTRL vs AF) and time (pre- vs posttesting) on changes in measured deficits. Results A significant interaction of time by group was noted with the task-Specific feedback training (P = .03). The AF group reduced deficits measured during the tuck-jump assessment by 23.6%, while the CTRL training reduced deficits by 10.6%. Conclusions The results of the current study indicate that task-Specific feedback is effective for reducing biomechanical risk factors associated with ACL injury. The data also indicate that Specific components of the tuck-jump assessment are potentially more modifiable than others. PMID:23238301

Effects of physical exercise programs on cognitive function in Parkinson's disease patients: A systematic review of randomized controlled trials of the last 10 years.

PubMed

da Silva, Franciele Cascaes; Iop, Rodrigo da Rosa; de Oliveira, Laiana Cândido; Boll, Alice Mathea; de Alvarenga, José Gustavo Souza; Gutierres Filho, Paulo José Barbosa; de Melo, Lídia Mara Aguiar Bezerra; Xavier, André Junqueira; da Silva, Rudney

2018-01-01

Given the relative importance of cognitive impairment, there was considerable interest in identifying the cognitive profile of PD patients, in order to ensure specific and appropriate therapeutic interventions. To determine the effects of physical exercise programs on cognitive function in PD patients, compared with the control group. Medline, Cochrane, Scopus, PEDro and Web of Science (last searched in September 2016). Randomized clinical trials examining the effects of physical exercise programs and cognitive function in PD patients. Nine studies fulfilled the selection criteria and were included in this review. Characteristics of the publication, characteristics of the participants, test used for cognitive screening, cognitive domain assessed, tools used to assess cognitive function, characteristics of the experimental intervention, characteristics of the control group, mean results and standard deviation of function cognitive. The PEDro score was used to evaluate methodological quality. Most eligible studies showed good methodological quality based on the PEDro scale. Studies have shown that adapted tango for PD patients, cognitive training combined with motor training, and treadmill training promote the preservation or improvement of cognitive function in PD patients. The diversity of cognitive tests used to assess cognitive function and the high heterogeneity identified between the physical exercise programs. Physical exercise programs promote positive and significant effects on global cognitive function, processing speed, sustained attention and mental flexibility in PD patients, at a mild to moderate stage for patients with a 6-year clinical diagnosis of PD. However, treadmill training performed 3 times a week for about 60 minutes and for a period of 24 weeks produced larger improvements in cognition.

Effects of home-based locomotor treadmill training on gross motor function in young children with cerebral palsy: a quasi-randomized controlled trial.

PubMed

Mattern-Baxter, Katrin; McNeil, Stefani; Mansoor, Jim K

2013-11-01

To examine the effects of an intensive home-based program of treadmill training on motor skills related to walking in preambulatory children with cerebral palsy (CP). Quasi-randomized controlled trial. Homes of the participants. Children with CP (N=12) with Gross Motor Function Classification System levels I and II were assigned to the intervention group (n=6; mean age ± SD, 21.76±6.50mo) and control group (n=6; 21.25±6.07mo). All children were tested preintervention, postintervention, at a 1-month follow-up, and at a 4-month follow-up. All children received their weekly scheduled physical therapy sessions at their homes. In addition, children in the intervention group walked on a portable treadmill in their homes 6 times per week, twice daily for 10- to 20-minute sessions, for 6 weeks. The intervention was carried out by the children's parents with weekly supervision by a physical therapist. Gross Motor Function Measure-66 Dimensions D/E, Peabody Developmental Motor Scales-2 (PDMS-2), Pediatric Evaluation of Disability Inventory (PEDI), timed 10-m walk test (10MWT), and Functional Mobility Scale (FMS). The Friedman test and Mann-Whitney U test were conducted for within-group and between-group differences, respectively. There was a significant between-group treatment effect for the PDMS-2 at posttest (P=.01) and 1-month postintervention follow-up (P=.09), as well as for the PEDI at posttest (P=.01), the 1-month postintervention follow-up (P=.009), and the 4-month postintervention follow-up (P=.04). The FMS was significant at the posttest (P=.04). Home-based treadmill training accelerates the attainment of walking skills and decreases the amount of support used for walking in young children with CP. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Isocapnic hyperpnea training improves performance in competitive male runners.

PubMed

Leddy, John J; Limprasertkul, Atcharaporn; Patel, Snehal; Modlich, Frank; Buyea, Cathy; Pendergast, David R; Lundgren, Claes E G

2007-04-01

The effects of voluntary isocapnic hyperpnea (VIH) training (10 h over 4 weeks, 30 min/day) on ventilatory system and running performance were studied in 15 male competitive runners, 8 of whom trained twice weekly for 3 more months. Control subjects (n = 7) performed sham-VIH. Vital capacity (VC), FEV1, maximum voluntary ventilation (MVV), maximal inspiratory and expiratory mouth pressures, VO2max, 4-mile run time, treadmill run time to exhaustion at 80% VO2max, serum lactate, total ventilation (V(E)), oxygen consumption (VO2) oxygen saturation and cardiac output were measured before and after 4 weeks of VIH. Respiratory parameters and 4-mile run time were measured monthly during the 3-month maintenance period. There were no significant changes in post-VIH VC and FEV1 but MVV improved significantly (+10%). Maximal inspiratory and expiratory mouth pressures, arterial oxygen saturation and cardiac output did not change post-VIH. Respiratory and running performances were better 7- versus 1 day after VIH. Seven days post-VIH, respiratory endurance (+208%) and treadmill run time (+50%) increased significantly accompanied by significant reductions in respiratory frequency (-6%), V(E) (-7%), VO2 (-6%) and lactate (-18%) during the treadmill run. Post-VIH 4-mile run time did not improve in the control group whereas it improved in the experimental group (-4%) and remained improved over a 3 month period of reduced VIH frequency. The improvements cannot be ascribed to improved blood oxygen delivery to muscle or to psychological factors.

Cardiovascular responses to a high-volume continuous circuit resistance training protocol.

PubMed

Gotshalk, Lincoln A; Berger, Richard A; Kraemer, William J

2004-11-01

The purpose of this investigation was to determine the level of cardiovascular stress elicited by continuous and prolonged circuit resistance training (CRT). Each of the 11 men who volunteered as a subject were tested to determine oxygen consumption and heart rate responses to a submaximal and maximal treadmill protocol and a CRT session consisting of 10 exercises and 10 repetitions at 40% of 1 repetition maximum (1RM) for each station with 4.6 circuits performed. The physiological stress of the CRT in this study was evident by the sustained heart rate of more than 70% of maximum for 16.6 minutes, with the last 12 minutes at more than 80%. Despite the large anaerobic component in CRT, Vo(2) was sustained at 50% or more of maximum for the final 12 minutes. Treadmill running, involving large muscle groups, increased Vo(2) more rapidly than CRT, where alternating larger and smaller muscle groups were used. In addition, at the same Vo(2) heart rate differed significantly between the 2 modes of activity. Heart rate in CRT was higher (at 165) than the heart rate of 150 found during treadmill running at the same 50% Vo(2). Such workouts may be used in a training cycle in classical linear periodization or in a nonlinear program day targeting local muscular endurance under intense cardiorespiratory conditions, which may help individuals develop enhanced toleration of physiological environments where high cardiovascular demands and higher lactate concentrations are present.

Efficacy of treadmill exercises on arterial blood oxygenation, oxygen consumption and walking distance in healthy elderly people: a controlled trial.

PubMed

Bichay, Ashraf Adel Fahmy; Ramírez, Juan M; Núñez, Víctor M; Lancho, Carolina; Poblador, María S; Lancho, José L

2016-05-25

Regular physical exercise and healthy lifestyle can improve aerobic power of the elderly, although lung capacity gradually deteriorates with age. The aims of the study are: a) to evaluate the therapeutic effect of a treadmill exercise program on arterial blood oxygenation (SaO2), maximum oxygen consumption (VO2max) and maximum walking distance (MWD) in healthy elderly people; b) to examine the outcome of the program at a supervised short-term and at an unsupervised long-term. A prospective, not-randomized controlled intervention trial (NRCT) was conducted. Eighty participants were allocated into two homogeneous groups (training group, TG, n = 40; control group, CG, n = 40). Each group consisted of 20 men and 20 women. Pre-intervention measures of SaO2, VO2max and MWD were taken of each participant 1-week before the training program to establish the baseline. Also, during the training program, the participants were followed up at the 12, 30 and 48th week. The exercise program consisted of walking on a treadmill with fixed 0 % grade of inclination 3 times weekly for 48 weeks; the first 12 weeks were supervised and the remaining 36 weeks of the program were unsupervised. Participants in the control group were encouraged to walk twice a week during 45 min, and received standard recommendations for proper health. Related to the baseline, the SaO2, VO2max, and MWD is greater in the intervention group at the 12(th) (p <.001), 30(th) (p <.001) and 48(th) week (p <.001). Compared with the control group, there was also a significant improvement of SaO2, VO2max, and MWD valuesin the intervention group (p <.001) at the 12(th) (p <.001), 30(th) (p <.001) and 48(th) week (p <.001). Supervised intervention shows greater improvement of SaO2, VO2max, and MWD values than in the unsupervised one. These results show that performing moderate exercise, specifically walking 3 days a week, is highly recommended for healthy older people, improving aerobic power. Current Controlled Trials ISRCTN12621097 .

Kinematic Differences Between Motorized and Nonmotorized Treadmill Locomotion

NASA Technical Reports Server (NTRS)

DeWitt, John K.; Bentley, Jason R.; Lee, Stuart M. C.; Norcross, Jason; Smith, Cassie; Hagan, R. Donald

2006-01-01

There are few scientific publications comparing human locomotion between motorized and nonmotorized treadmills. Lakomy (1987) and Gamble et al (1988) reported that forward lean is greater on a nonmotorized treadmill to aid in the generation of horizontal force necessary for belt propulsion, but there are no data concerning lower limb kinematics. During long-term spaceflight, astronauts use locomotive exercise to mitigate the physiological effects caused by long-term exposure to microgravity. A critical decision for mission planners concerns the requirements for a treadmill to be used during potential trips to the Moon and Mars. Treadmill operation in an un-powered configuration could reduce mission resource demands, but also may impact the efficacy of treadmill exercise countermeasures. To ascertain the most appropriate type of treadmill to be used, it is important to understand biomechanical differences between motorized (M) and nonmotorized (NM) locomotion. The purpose of this evaluation was to test for differences in lower limb kinematics that occur during M and NM treadmill locomotion at two speeds. It was hypothesized that hip and knee joint angle trajectories would differ between the conditions.

Rhythm perturbations in acoustically paced treadmill walking after stroke.

PubMed

Roerdink, Melvyn; Lamoth, Claudine J C; van Kordelaar, Joost; Elich, Peter; Konijnenbelt, Manin; Kwakkel, Gert; Beek, Peter J

2009-09-01

In rehabilitation, acoustic rhythms are often used to improve gait after stroke. Acoustic cueing may enhance gait coordination by creating a stable coupling between heel strikes and metronome beats and provide a means to train the adaptability of gait coordination to environmental changes, as required in everyday life ambulation. To examine the stability and adaptability of auditory-motor synchronization in acoustically paced treadmill walking in stroke patients. Eleven stroke patients and 10 healthy controls walked on a treadmill at preferred speed and cadence under no metronome, single-metronome (pacing only paretic or nonparetic steps), and double-metronome (pacing both footfalls) conditions. The stability of auditory-motor synchronization was quantified by the variability of the phase relation between footfalls and beats. In a separate session, the acoustic rhythms were perturbed and adaptations to restore auditory-motor synchronization were quantified. For both groups, auditory-motor synchronization was more stable for double-metronome than single-metronome conditions, with stroke patients exhibiting an overall weaker coupling of footfalls to metronome beats than controls. The recovery characteristics following rhythm perturbations corroborated the stability findings and further revealed that stroke patients had difficulty in accelerating their steps and instead preferred a slower-step response to restore synchronization. In gait rehabilitation practice, the use of acoustic rhythms may be more effective when both footfalls are paced. In addition, rhythm perturbations during acoustically paced treadmill walking may not only be employed to evaluate the stability of auditory-motor synchronization but also have promising implications for evaluation and training of gait adaptations in neurorehabilitation practice.

Acute aquatic treadmill exercise improves gait and pain in people with knee osteoarthritis.

PubMed

Roper, Jaimie A; Bressel, Eadric; Tillman, Mark D

2013-03-01

To examine the acute effects of aquatic and land treadmill exercise on gait kinematics as well as the level of disease-specific and movement-related pain for individuals with osteoarthritis. Quasi-experimental crossover design. Biomechanics laboratory. Participants (N=14; age, 43-64y) diagnosed with osteoarthritis at the knee (n=12), osteoarthritis at the knee and ankle (n=1), or osteoarthritis at the knee and hip (n=1). Participants performed 3 exercise sessions separated by at least 24 hours in 1 week for each mode of exercise (aquatic treadmill and land treadmill). Gait kinematics and pain were measured before and after each intervention. The angular velocity gain score during stance for left knee extension was improved by 38% after aquatic treadmill exercise (P=.004). Similarly, during swing, the gain scores for angular velocity were also greater for left knee internal rotation and extension by 65% and 20%, respectively (P=.004, P=.008, respectively). During stance, the joint angle gain score for left hip flexion was 7.23% greater after land exercise (P=.007). During swing, the angular velocity gain score for right hip extension was significantly greater for aquatic exercise by 28% (P=.01). Only the joint angle gain score for left ankle abduction during stance was significantly higher after land exercise (4.72%, P=.003). No other joint angle gain scores for either stance or swing were significantly different for either condition (P=.06-.96). Perceived pain was 100% greater after land than aquatic treadmill exercise (P=.02). Step rate and step length were not different between conditions (P=.31-.92). An acute training period on an aquatic treadmill positively influenced joint angular velocity and arthritis-related joint pain. Acute aquatic treadmill exercise may be useful as a conservative treatment to improve angular speed of the lower-extremity joints and pain related to osteoarthritis. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Forced treadmill running suppresses postincisional pain and inhibits upregulation of substance P and cytokines in rat dorsal root ganglion.

PubMed

Chen, Yu-Wen; Tzeng, Jann-Inn; Lin, Min-Fei; Hung, Ching-Hsia; Wang, Jhi-Joung

2014-08-01

Exercise causes a variety of psychophysical effects (eg, alterations in pain sensation). Tissue injury induces mediator releases in the spinal cord resulting in pain hypersensitivity; however, the contribution of the dorsal root ganglion (DRG) is poorly understood. In this study, we tested if forced treadmill running can attenuate postoperative pain and alter substance P (SP) or proinflammatory cytokine level in the DRG by using a rat model of skin/muscle incision and retraction (SMIR). We evaluated mechanical sensitivity to von Frey stimuli (6 and 15 g) and expression of SP, interleukin-1β, and interleukin-6 in the DRG of sham-operated sedentary rats, SMIR sedentary rats, sham-operated rats with forced treadmill running, and SMIR rats with forced treadmill running. At postoperative day 8, trained rats ran for 5 days per week for 4 weeks on a treadmill 70 minutes/d with an intensity of 18 m/min. On postoperative day 6, SMIR sedentary rats displayed a significant mechanical hypersensitivity that persisted until postoperative day 35. By comparison, SMIR-operated rats, which received forced treadmill running, exhibited a quick recovery from mechanical hypersensitivity. SMIR sedentary rats showed an upregulation of SP, interleukin-1β, and interleukin-6 in the DRG at postoperative days 14 and 28, whereas SMIR-operated rats receiving forced treadmill running reversed this upregulation at postoperative day 28. We concluded that forced treadmill running alleviated persistent postincisional pain caused by SMIR surgery. This appears to be protective against postoperative pain, which probably relates to the downturn in excess SP, interleukin-1β, and interleukin-6 in the DRG. Controlling the expression of SP, interleukin-6, and interleukin-1β in the DRG can help manage postoperative pain. This finding could potentially help clinicians and physical therapists who seek to examine how exercise may attenuate postsurgical pain and its mechanism. Copyright © 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.

Wrist-worn accelerometers in assessment of energy expenditure during intensive training.

PubMed

Kinnunen, H; Tanskanen, M; Kyröläinen, H; Westerterp, K R

2012-11-01

We assessed the ability of the Polar activity recorder (AR) to measure energy expenditure (EE) during military training. Twenty-four voluntary male conscripts participated in the study and wore an AR on the non-dominant wrist 24 h a day for 7 d. The AR analyzed and stored the frequency of hand movements (f_hand) into memory at 1 min intervals. The relationship between f_hand and EE was studied over a 7 d period of military training using the doubly labeled water (DLW) technique. In addition, the relationship between f_hand and EE was analyzed during walking and running on a treadmill with an indirect calorimeter (IC), and f_hand was measured during a supervised 45 min field march test where the conscripts carried combat gear. EE was expressed as physical activity level (PAL), total energy expenditure (TEE), and activity-induced energy expenditure adjusted for body mass (AEE/BM). Over the 7 d period, f_hand alone explained 46% of inter-individual variation in PAL(DLW). After inclusion of body height and mass in the model used to predict PAL(DLW) from f_hand, a very high positive correlation and a low standard error of estimate (SEE) were observed between the AR and DLW techniques: for TEE r = 0.86 (p < 0.001), the SEE was 6.3%, and for AEE/BM r = 0.84 (p < 0.001), the SEE was 12.8%. In the treadmill exercise, f_hand correlated highly with PAL(IC) (r = 0.97 ± 0.02). In the 45 min field march test, the AR measured similar f_hand as on the treadmill at the same speed. In conclusion, the wrist-worn AR can be regarded as a reliable and valid method for assessing EE during intensive training.

Comparison of Gait During Treadmill Exercise While Supine in Lower Body Negative Pressure (LBNP), Supine with Bungee Resistance and Upright in Normal Gravity

NASA Technical Reports Server (NTRS)

Boda, Wanda; Hargens, Alan R.; Aratow, Michael; Ballard, Richard E.; Hutchinson, Karen; Murthy, Gita; Campbell, James

1994-01-01

The purpose of this study is to compare footward forces, gait kinematics, and muscle activation patterns (EMG) generated during supine treadmill exercise against LBNP with the same parameters during supine bungee resistance exercise and upright treadmill exercise. We hypothesize that the three conditions will be similar. These results will help validate treadmill exercise during LBNP as a viable technique to simulate gravity during space flight. We are evaluating LBNP as a means to load the musculoskeletal and cardiovascular systems without gravity. Such loading should help prevent physiologic deconditioning during space flight. The best ground-based simulation of LBNP treadmill exercise in microgravity is supine LBNP treadmill exercise on Earth because the supine footward force vector is neither directed nor supplemented by Earth's gravity.

Comparison of forward versus backward walking using body weight supported treadmill training in an individual with a spinal cord injury: a single subject design.

PubMed

Moriello, Gabriele; Pathare, Neeti; Cirone, Cono; Pastore, Danielle; Shears, Dacia; Sulehri, Sahira

2014-01-01

Body weight supported treadmill training (BWSTT) is a task-specific intervention that promotes functional locomotion. There is no research evaluating the effect of backward walking (BW) using BWSTT in individuals with spinal cord injury (SCI). The purpose of this single subject design was to examine the differences between forward walking (FW) and BW training using BWSTT in an individual with quadriparesis. The participant was a 57-year-old male with incomplete C3-C6 SCI. An ABABAB design (A = BW; B = FW; each phase = 3 weeks of biweekly sessions) was utilized. Outcome measures included: gait parameters; a timed 4-meter walk; the 5-repetition sit-to-stand test (STST); tandem stance time; and 6-minute walk test (6MWT). Data was analyzed with split level method of trend estimation. Improvements in gait parameters, on the timed 4-meter walk, 6MWT, tandem balance and aerobic endurance were similar with FW and BW training. The only difference between FW and BW training was that BW training resulted in greater improvements in the STST. The results of this study suggest that in this individual backward walking training was advantageous, resulting in improved ability to perform the 5-repetition STST. It is suspected that these changes can be attributed to the differences in muscle activation and task difficulty between FW and BW.

Kinetic comparison of walking on a treadmill versus over ground in children with cerebral palsy.

PubMed

van der Krogt, Marjolein M; Sloot, Lizeth H; Buizer, Annemieke I; Harlaar, Jaap

2015-10-15

Kinetic outcomes are an essential part of clinical gait analysis, and can be collected for many consecutive strides using instrumented treadmills. However, the validity of treadmill kinetic outcomes has not been demonstrated for children with cerebral palsy (CP). In this study we compared ground reaction forces (GRF), center of pressure, and hip, knee and ankle moments, powers and work, between overground (OG) and self-paced treadmill (TM) walking for 11 typically developing (TD) children and 9 children with spastic CP. Considerable differences were found in several outcome parameters. In TM, subjects demonstrated lower ankle power generation and more absorption, and increased hip moments and work. This shift from ankle to hip strategy was likely due to a more backward positioning of the hip and a slightly more forward trunk lean. In mediolateral direction, GRF and hip and knee joint moments were increased in TM due to wider step width. These findings indicate that kinetic data collected on a TM cannot be readily compared with OG data in TD children and children with CP, and that treadmill-specific normative data sets should be used when performing kinetic gait analysis on a treadmill. Copyright © 2015 Elsevier Ltd. All rights reserved.

Heart ABCA1 and PPAR- α Genes Expression Responses in Male rats: Effects of High Intensity Treadmill Running Training and Aqueous Extraction of Black Crataegus-Pentaegyna.

PubMed

Ghanbari-Niaki, Abbass; Ghanbari-Abarghooi, Safieyh; Rahbarizadeh, Fatemeh; Zare-Kookandeh, Navabeh; Gholizadeh, Monireh; Roudbari, Fatemeh; Zare-Kookandeh, Asghar

2013-11-01

Heart as a high metabolic and aerobic tissue is consuming lipid as a fuel for its energy provision at rest during light and moderate exercise, except when lactate level is higher in blood circulation. It has been shown that any type of regular exercise and crataegus species would improve cardiovascular function and minimizes several risk factors via stimulating lipid metabolism by acting on enzymes and genes expression such as ABCA1 and PPAR α which are involving in this process. Twenty Wistar male rats (4-6 weeks old, 140-173 g weight) were used. Animals were randomly classified into training (n = 10) and control (n = 10) groups and then divided into saline-control (SC), saline-training (ST), Crataegus-Pentaegyna -control (CPC), and Crataegus-Pentaegyna -training (CPT) groups. Training groups have performed a high-intensity running program (at 34 m/min (0% grade), 60 min/day, 5 days/week) on a motor-driven treadmill for eight weeks. Animals were orally fed with Crataegus-Pentaegyna extraction (500mg/kg) and saline solution for six weeks. Seventy- two hours after the last training session, rats were sacrificed, hearts were excised, cleaned and immediately frozen in liquid nitrogen and stored at -80 °C until RNA extraction. Plasma also was collected for plasma variable measurements. Statistical analysis was performed using a two way analysis of variance, and significance was accepted at P < 0.05. A non-significant (P < 0.4, P < 0.79, respectively) increase in ABCA1 and PPAR α genes expression was accompanied by a significant (P < 0.01, P < 0.04, P < 0.04, respectively) reduction in TC, TG, and VLDL-C levels in Crataegus-Pentaegyna groups. Our findings show that a high intensity treadmill running was able to express ABCA1 and PPAR α in rat heart. Data also possibly indicate that the Crataeguse-Pentaegyna supplementation solely could mimic training effect on the mentioned genes and lipid profiles via different mechanism(s).

Heart ABCA1 and PPAR- α Genes Expression Responses in Male rats: Effects of High Intensity Treadmill Running Training and Aqueous Extraction of Black Crataegus-Pentaegyna

PubMed Central

Ghanbari-Niaki, Abbass; Ghanbari-Abarghooi, Safieyh; Rahbarizadeh, Fatemeh; Zare-Kookandeh, Navabeh; Gholizadeh, Monireh; Roudbari, Fatemeh; Zare-Kookandeh, Asghar

2013-01-01

Introduction: Heart as a high metabolic and aerobic tissue is consuming lipid as a fuel for its energy provision at rest during light and moderate exercise, except when lactate level is higher in blood circulation. It has been shown that any type of regular exercise and crataegus species would improve cardiovascular function and minimizes several risk factors via stimulating lipid metabolism by acting on enzymes and genes expression such as ABCA1 and PPAR α which are involving in this process. Materials and Methods: Twenty Wistar male rats (4-6 weeks old, 140-173 g weight) were used. Animals were randomly classified into training (n = 10) and control (n = 10) groups and then divided into saline-control (SC), saline-training (ST), Crataegus-Pentaegyna -control (CPC), and Crataegus-Pentaegyna -training (CPT) groups. Training groups have performed a high-intensity running program (at 34 m/min (0% grade), 60 min/day, 5 days/week) on a motor-driven treadmill for eight weeks. Animals were orally fed with Crataegus-Pentaegyna extraction (500mg/kg) and saline solution for six weeks. Seventy- two hours after the last training session, rats were sacrificed, hearts were excised, cleaned and immediately frozen in liquid nitrogen and stored at -80 °C until RNA extraction. Plasma also was collected for plasma variable measurements. Statistical analysis was performed using a two way analysis of variance, and significance was accepted at P < 0.05. Results: A non-significant (P < 0.4, P < 0.79, respectively) increase in ABCA1 and PPAR α genes expression was accompanied by a significant (P < 0.01, P < 0.04, P < 0.04, respectively) reduction in TC, TG, and VLDL-C levels in Crataegus-Pentaegyna groups. Conclusions: Our findings show that a high intensity treadmill running was able to express ABCA1 and PPAR α in rat heart. Data also possibly indicate that the Crataeguse-Pentaegyna supplementation solely could mimic training effect on the mentioned genes and lipid profiles via different mechanism(s). PMID:25478513

κ-opioid receptor is involved in the cardioprotection induced by exercise training

PubMed Central

Li, Juan; Tian, Fei; Feng, Na; Fan, Rong; Jia, Min; Guo, Haitao; Cheng, Liang; Liu, Jincheng; Chen, Wensheng; Pei, Jianming

2017-01-01

The present study was designed to test the hypothesis that exercise training elicited a cardioprotective effect against ischemia and reperfusion (I/R) via the κ-opioid receptor (κ-OR)-mediated signaling pathway. Rats were randomly divided into four groups: the control group, the moderate intensity exercise (ME) group, the high intensity exercise (HE) group, and the acute exercise (AE) group. For the exercise training protocols, the rats were subjected to one week of adaptive treadmill training, while from the second week, the ME and HE groups were subjected to eight weeks of exercise training, and the AE group was subjected to three days of adaptive treadmill training and one day of vigorous exercise. After these protocols, the three exercise training groups were divided into different treatment groups, and the rats were subjected to 30 min of ischemia and 120 min of reperfusion. Changes in infarct size and serum cTnT (cardiac troponin T) caused by I/R were reduced by exercise training. Moreover, cardiac dysfunction caused by I/R was also alleviated by exercise training. These effects of exercise training were reversed by nor-BNI (a selective κ-OR antagonist), Compound C (a selective AMPK inhibitor), Akt inhibitor and L-NAME (a non-selective eNOS inhibitor). Expression of κ-OR and phosphorylation of AMPK, Akt and eNOS were significantly increased in the ME, HE and AE groups. These findings demonstrated that the cardioprotective effect of exercise training is possibly mediated by the κ-OR-AMPK-Akt-eNOS signaling pathway. PMID:28301473

Ground Reaction Forces and Gait Parameters during Motorized and Non-Motorized Treadmill Walking and Runing on the International Space Station Treadmill

NASA Technical Reports Server (NTRS)

Hagan, Ronald Donald; Norcross, Jason; DeWitt, John; Lee, Stuart M.; McCleary, Frank; Edwards, W. Brent

2006-01-01

Both motorized (T-M) and non-motorized (T-NM) treadmill locomotion are used on the International Space Station (ISS) as countermeasures to the deleterious effects of prolonged weightlessness. However, the ground reaction forces (GRF) and gait parameters of these exercise modes have not been examined. The purpose of this study was to determine if differences in GRF and gait parameters exist while walking (1.34 m/s) and running (3.13 m/s) on T-M and T-NM. Dissimilar GRF and gait parameters suggest that T-M and T-NM locomotion may elicit different physiologic effects. T-NM may result in a reduced stimulus to bone formation due to a lower LR, but an increased energy cost as a result of shorter, more frequent strides. Therefore, the usage of each mode should depend upon the desired training stimulus.

Performance parameters and post exercise heart rate recovery in Warmblood sports horses of different performance levels.

PubMed

Bitschnau, C; Wiestner, T; Trachsel, D S; Auer, J A; Weishaupt, M A

2010-11-01

Standardised exercise tests are used for fitness evaluation of sports horses. Standards are described for Thoroughbreds and Standardbreds; however, limited information is available for Warmbloods. To establish normative standards of performance parameters and heart rate recovery (HRR) in Warmblood riding horses of different levels of fitness using a submaximal incremental exercise test (SIET) performed on a treadmill. A SIET was carried out with 29 healthy and treadmill-accustomed Warmbloods: eleven 3-day event horses (TDE) and 18 horses from the National Equestrian Centre (NEC) competing in amateur jumping and/or dressage events. After a warm-up phase, horses performed 2 stages at trot and 3-5 stages at gallop at 6% incline. The first stage lasted 120 s, all others 90 s. Velocity (V) and heart rate (HR) were measured continuously and blood lactate concentration (LAC) at the end of each exercise stage. V at HR 150 and 200 beats/min (V(150), V(200)), V and HR at 2 and 4 mmol/l LAC (V(2), V(4) and HR(2), HR(4), respectively) were calculated and compared between discipline groups. For reference values, horses were divided on the basis of the V(4) -results in good (GP) and average performers (AP) (performance groups). Five minute passive HRR was compared between performance groups. Fifteen NEC horses were retested within 1-3 months. Groups were compared with t tests and P < 0.05 considered significant. Three-day event horses had higher V(150), V(2) and V(4) values than NEC. GP had higher values in all performance parameters compared to AP. No differences were found between test and retest. GP mean recovery HR was different from that of AP from 120 s of recovery onwards. Treadmill SIETs are suitable to objectify aerobic capacity in Warmblood riding horses. Normative standards were assessed for well and averagely-trained horses. The results can be referred to when diagnosing patients with exercise intolerance. © 2010 EVJ Ltd.

Body weight-supported bedside treadmill training facilitates ambulation in ICU patients: An interventional proof of concept study.

PubMed

Sommers, Juultje; Wieferink, Denise C; Dongelmans, Dave A; Nollet, Frans; Engelbert, Raoul H H; van der Schaaf, Marike

2017-10-01

Early mobilisation is advocated to improve recovery of intensive care unit (ICU) survivors. However, severe weakness in combination with tubes, lines and machinery are practical barriers for the implementation of ambulation with critically ill patients. The aim of this study was to explore the feasibility of Body Weight-Supported Treadmill Training (BWSTT) in critically ill patients in the ICU. A custom build bedside Body Weight-Supported Treadmill was used and evaluated in medical and surgical patients in the ICU. Feasibility was evaluated according to eligibility, successful number of BWSTT, number of staff needed, adverse events, number of patients that could not have walked without BWSTT, patient satisfaction and anxiety. Twenty participants, underwent 54 sessions BWSTT. Two staff members executed the BWSTT and no adverse events occurred. Medical equipment did not have to be disconnected during all treatment sessions. In 74% of the sessions, the participants would not have been able to walk without the BWSTT. Patient satisfaction with BWSTT was high and anxiety low. This proof of concept study demonstrated that BWSTT is safe, reduces staff resource, and facilitates the first time to ambulation in critically ill patients with severe muscle weakness in the ICU. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of Inclined Treadmill Walking on Pelvic Anterior Tilt Angle, Hamstring Muscle Length, and Trunk Muscle Endurance of Seated Workers with Flat-back Syndrome.

PubMed

Kim, Min-Hee; Yoo, Won-Gyu

2014-06-01

[Purpose] This study investigated the effects of inclined treadmill walking on pelvic anterior tilt angle, hamstring muscle length, and back muscle endurance of seated workers with flat-back syndrome. [Subjects] Eight seated workers with flat-back syndrome who complained of low-back pain in the L3-5 region participated in this study. [Methods] The subjects performed a walking exercise on a 30° inclined treadmill. We measured the pelvic anterior tilt angle, hamstring muscle length, and back muscle endurance before and after inclined treadmill walking. [Results] Anterior pelvic tilt angle and active knee extension angle significantly increased after inclined treadmill walking. Trunk extensor and flexor muscle endurance times were also significantly increased compared to the baseline. [Conclusion] Inclined treadmill walking may be an effective approach for the prevention or treatment of low-back pain in flat-back syndrome.

Effects of synchronous music on treadmill running among elite triathletes.

PubMed

Terry, Peter C; Karageorghis, Costas I; Saha, Alessandra Mecozzi; D'Auria, Shaun

2012-01-01

Music can provide ergogenic, psychological, and psychophysical benefits during physical activity, especially when movements are performed synchronously with music. The present study developed the train of research on synchronous music and extended it to elite athletes. Repeated-measures laboratory experiment. Elite triathletes (n=11) ran in time to self-selected motivational music, a neutral equivalent and a no-music control during submaximal and exhaustive treadmill running. Measured variables were time-to-exhaustion, mood responses, feeling states, RPE, blood lactate concentration, oxygen consumption and running economy. Time-to-exhaustion was 18.1% and 19.7% longer, respectively, when running in time to motivational and neutral music, compared to no music. Mood responses and feeling states were more positive with motivational music compared to either neutral music or no music. RPE was lowest for neutral music and highest for the no-music control. Blood lactate concentrations were lowest for motivational music. Oxygen consumption was lower with music by 1.0%-.7%. Both music conditions were associated with better running economy than the no-music control. Although neutral music did not produce the same level of psychological benefits as motivational music, it proved equally beneficial in terms of time-to-exhaustion and oxygen consumption. In functional terms, the motivational qualities of music may be less important than the prominence of its beat and the degree to which participants are able to synchronise their movements to its tempo. Music provided ergogenic, psychological and physiological benefits in a laboratory study and its judicious use during triathlon training should be considered. Copyright © 2011 Sports Medicine Australia. All rights reserved.

Adaptive Effects on Locomotion Performance Following Exposure to a Rotating Virtual Environment

NASA Technical Reports Server (NTRS)

Mulavara, A. P.; Richards, J. T.; Marshburn, A. M.; Bucello, R.; Bloomberg, J. J.

2003-01-01

During long-duration spaceflight, astronauts experience alterations in vestibular and somatosensory cues that result in adaptive disturbances in balance and coordination upon return to Earth. These changes can pose a risk to crew safety and to mission objectives if nominal or emergency vehicle egress is required immediately following long-duration spaceflight. At present, no operational countermeasure is available to mitigate the adaptive sensorimotor component underlying the locomotor disturbances that occur after spaceflight. Therefore, the goal of this study is to develop an inflight training regimen that facilitates recovery of locomotor function after long-duration spaceflight. The countermeasure we are proposing is based on the concept of adaptive generalization. During this type of training the subject gains experience producing the appropriate adaptive motor behavior under a variety of sensory conditions and response constraints. As a result of this training a subject learns to solve a class of motor problems, rather than a specific motor solution to one problem, i.e., the subject learns response generalizability or the ability to "learn to learn." under a variety of environmental constraints. We are developing an inflight countermeasure built around treadmill exercise activities. By manipulating the sensory conditions of exercise by varying visual flow patterns, body load and speed we will systematically and repeatedly promote adaptive change in locomotor behavior. It has been shown that variable practice training increases adaptability to novel visuo-motor situations. While walking over ground in a stereoscopic virtual environment that oscillated in roll, subjects have shown compensatory torso rotation in the direction of scene rotation that resulted in positional variation away from a desired linear path. Thus, postural sway and locomotor stability in 1-g can be modulated by visual flow patterns and used during inflight treadmill training to promote adaptive generalization. The purpose of this study was to determine if adaptive modification in locomotor performance could be achieved by viewing simulated self-motion in a passive-immersive virtual ' environment over a prolonged period during treadmill locomotion.

Task-oriented treadmill exercise training in chronic hemiparetic stroke

PubMed Central

Ivey, Frederick M.; Hafer-Macko, Charlene E.; Macko, Richard F.

2010-01-01

Patients with stroke have elevated hemiparetic gait costs secondary to low activity levels and are often severely deconditioned. Decrements in peak aerobic capacity affect functional ability and cardiovascular-metabolic health and may be partially mediated by molecular changes in hemiparetic skeletal muscle. Conventional rehabilitation is time delimited in the subacute stroke phase and does not provide adequate aerobic intensity to reverse the profound detriments to fitness and function that result from stroke. Hence, we have studied progressive full body weight-support treadmill (TM) training as an adjunct therapy in the chronic stroke phase. Task-oriented TM training has produced measurable changes in fitness, function, and indices of cardiovascular-metabolic health after stroke, but the precise mechanisms for these changes remain under investigation. Further, the optimal dose of this therapy has yet to be identified for individuals with stroke and may vary as a function of deficit severity and outcome goals. This article summarizes the functional and metabolic decline caused by inactivity after stroke and provides current evidence that supports the use of TM training during the chronic stroke phase, with protocols and inclusion/exclusion criteria described. Our research findings are discussed in relation to associated research. PMID:18566943

Resveratrol enhances exercise training responses in rats selectively bred for high running performance.

PubMed

Hart, Nikolett; Sarga, Linda; Csende, Zsolt; Koltai, Erika; Koch, Lauren G; Britton, Steven L; Davies, Kelvin J A; Kouretas, Dimitris; Wessner, Barbara; Radak, Zsolt

2013-11-01

High Capacity Runner (HCR) rats have been developed by divergent artificial selection for treadmill endurance running capacity to explore an aerobic biology-disease connection. The beneficial effects of resveratrol supplementation have been demonstrated in endurance running and the antioxidant capacity of resveratrol is also demonstrated. In this study we examine whether 12 weeks of treadmill exercise training and/or resveratrol can enhance performance in HCR. Indeed, resveratrol increased aerobic performance and strength of upper limbs of these rats. Moreover, we have found that resveratrol activated the AMP-activated protein kinase, SIRT1, and mitochondrial transcription factor A (p<0.05). The changes in mitochondrial fission/fusion and Lon protease/HSP78 levels suggest that exercise training does not significantly induce damage of proteins. Moreover, neither exercise training nor resveratrol supplementation altered the content of protein carbonyls. Changes in the levels of forkhead transcription factor 1 and SIRT4 could suggest increased fat utilization and improved insulin sensitivity. These data indicate, that resveratrol supplementation enhances aerobic performance due to the activation of the AMPK-SIRT1-PGC-1α pathway. Copyright © 2013 Elsevier Ltd. All rights reserved.

Effects of HRV-Guided vs. Predetermined Block Training on Performance, HRV and Serum Hormones.

PubMed

Nuuttila, Olli-Pekka; Nikander, Aku; Polomoshnov, Dmitry; Laukkanen, Jari Antero; Häkkinen, Keijo

2017-11-01

The aim of this study was to compare heart rate variability -guided (HRVG) and predetermined (PD) block periodization of high intensity aerobic training (HIT). Endurance performance, neuromuscular performance, heart rate variability (HRV) and serum hormone concentrations were measured before, in the middle and after the 8-week training period in 24 endurance trained males. Both groups improved significantly maximal treadmill velocity (V max ) (p<0.001) and 3000 m running performance (HRVG; p<0.001 and PD; p=0.001). The relative changes in V max and countermovement jump were significantly greater in HRVG (p<0.05). Nocturnal heart rate decreased in both groups (p<0.01), but HRV (RMSSD, LF and TP) increased significantly only in HRVG (p<0.05). The significant increase in serum testosterone concentration was observed from mid to post in HRVG (p<0.05). Significant correlations were found between individual V max changes and absolute serum testosterone levels. Individual baseline level of HF correlated significantly with V max changes in PD. Block periodization of HIT seems to be an effective way to improve endurance and running performance in already endurance trained males. Based on training induced increases in endurance and neuromuscular performance combined with significant changes in HRV and serum testosterone levels observed in HRVG, individually HRV -guided block training may be more optimal compared to predetermined training. © Georg Thieme Verlag KG Stuttgart · New York.

Increasing physician activity with treadmill desks.

PubMed

Thompson, Warren G; Koepp, Gabriel A; Levine, James A

2014-01-01

Prolonged sitting has been shown to increase mortality and obesity. We sought to determine whether physicians would use a treadmill desk, increase their daily physical activity and lose weight. 20 overweight and obese physicians aged 25 to 70 with Body Mass Index > 25. Participants used a treadmill desk, a triaxial accelerometer, and received exercise counseling in a randomized, cross-over trial over 24 weeks. Group 1 received exercise counseling, accelerometer feedback, and a treadmill desk for 12 weeks and then accelerometer only for 12 weeks. Group 2 received an accelerometer without feedback for 12 weeks followed by exercise counseling, accelerometer feedback, and the treadmill desk for 12 weeks. Daily physical activity increased while using the treadmill desk compared to not using the desk by 197 kcal per day (p=0.003). The difference in weight during the two 12 week periods was 1.85 kg (p=0.03). Percent body fat was 1.9% lower while using the treadmill desk (p=0.02). There were no differences in metabolic or well-being measures. This study suggests that physicians will use a treadmill desk, that it does increase their activity, and that it may help with weight loss. Further studies are warranted.

Effect of Voluntary Ethanol Consumption Combined with Testosterone Treatment on Cardiovascular Function in Rats: Influence of Exercise Training

PubMed Central

Engi, Sheila A.; Planeta, Cleopatra S.; Crestani, Carlos C.

2016-01-01

This study evaluated the effects of voluntary ethanol consumption combined with testosterone treatment on cardiovascular function in rats. Moreover, we investigated the influence of exercise training on these effects. To this end, male rats were submitted to low-intensity training on a treadmill or kept sedentary while concurrently being treated with ethanol for 6 weeks. For voluntary ethanol intake, rats were given access to two bottles, one containing ethanol and other containing water, three 24-hour sessions per week. In the last two weeks (weeks 5 and 6), animals underwent testosterone treatment concurrently with exercise training and exposure to ethanol. Ethanol consumption was not affected by either testosterone treatment or exercise training. Also, drug treatments did not influence the treadmill performance improvement evoked by training. However, testosterone alone, but not in combination with ethanol, reduced resting heart rate. Moreover, combined treatment with testosterone and ethanol reduced the pressor response to the selective α1-adrenoceptor agonist phenylephrine. Treatment with either testosterone or ethanol alone also affected baroreflex activity and enhanced depressor response to acetylcholine, but these effects were inhibited when drugs were coadministrated. Exercise training restored most cardiovascular effects evoked by drug treatments. Furthermore, both drugs administrated alone increased pressor response to phenylephrine in trained animals. Also, drug treatments inhibited the beneficial effects of training on baroreflex function. In conclusion, the present results suggest a potential interaction between toxic effects of testosterone and ethanol on cardiovascular function. Data also indicate that exercise training is an important factor influencing the effects of these substances. PMID:26760038

A Comparison of Robotic, Body Weight-Supported Locomotor Training and Aquatic Therapy in Chronic Motor Incomplete Spinal Cord Injury Subjects

DTIC Science & Technology

2014-10-01

Award Number:W81XWH-10-1-0981 TITLE:“A Comparison of Robotic, Body Weight-Supported Locomotor Training and Aquatic Therapy in Chronic Motor...three months, three times a week aquatic therapy with similar intensity robotically assisted, body weight supported aerobic treadmill training upon...incomplete spinal cord injury (MISCI). Thirty-seven individuals with chronic MISCI enrolled in this study. We hypothesized aquatic therapy would be

NeuroRecovery Network provides standardization of locomotor training for persons with incomplete spinal cord injury.

PubMed

Morrison, Sarah A; Forrest, Gail F; VanHiel, Leslie R; Davé, Michele; D'Urso, Denise

2012-09-01

To illustrate the continuity of care afforded by a standardized locomotor training program across a multisite network setting within the Christopher and Dana Reeve Foundation NeuroRecovery Network (NRN). Single patient case study. Two geographically different hospital-based outpatient facilities. This case highlights a 25-year-old man diagnosed with C4 motor incomplete spinal cord injury with American Spinal Injury Association Impairment Scale grade D. Standardized locomotor training program 5 sessions per week for 1.5 hours per session, for a total of 100 treatment sessions, with 40 sessions at 1 center and 60 at another. Ten-meter walk test and 6-minute walk test were assessed at admission and discharge across both facilities. For each of the 100 treatment sessions percent body weight support, average, and maximum treadmill speed were evaluated. Locomotor endurance, as measured by the 6-minute walk test, and overground gait speed showed consistent improvement from admission to discharge. Throughout training, the patient decreased the need for body weight support and was able to tolerate faster treadmill speeds. Data indicate that the patient continued to improve on both treatment parameters and walking function. Standardization across the NRN centers provided a mechanism for delivering consistent and reproducible locomotor training programs across 2 facilities without disrupting training or recovery progression. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Renal hypertension prevents run training modification of cardiomyocyte diastolic Ca2+ regulation in male rats.

PubMed

Palmer, B M; Lynch, J M; Snyder, S M; Moore, R L

2001-06-01

The combined effects of endurance run training and renal hypertension on cytosolic Ca2+ concentration ([Ca2+]c) dynamics and Na+-dependent Ca2+ regulation in rat left ventricular cardiomyocytes were examined. Male Fischer 344 rats underwent stenosis of the left renal artery [hypertensive (Ht), n = 18] or a sham operation [normotensive (Nt), n = 20]. One-half of the rats from each group were treadmill trained for >16 wk. Cardiomyocyte fura 2 fluorescence ratio transients were recorded for 7 min during electrical pacing at 0.5 Hz, 2 mM extracellular Ca2+ concentration, and 29 degrees C. The rate of [Ca2+]c decline was not changed by run training in the Nt group but was reduced in the Ht group. At 7 min, cardiomyocytes were exposed to 10 mM caffeine in the absence of Na+ and Ca2+, which triggered sarcoplasmic reticular Ca2+ release and suppressed Ca2+ efflux via Na+/Ca2+ exchanger. External Na+ was then added, and Na+-dependent Ca2+ efflux rate was recorded. Treadmill training significantly enhanced Na+-dependent Ca2+ efflux rate under these conditions in the Nt group but not in the Ht group. These data provide evidence that renal hypertension prevents the normal run training-induced modifications in diastolic [Ca2+]c regulation mechanisms, including Na+/Ca2+ exchanger.

Comparison of energy expenditure on a treadmill vs. an elliptical device at a self-selected exercise intensity.

PubMed

Brown, Gregory A; Cook, Chad M; Krueger, Ryan D; Heelan, Kate A

2010-06-01

Treadmills (TM) and elliptical devices (EL) are popular forms of exercise equipment. The differences in the training stimulus presented by TM or EL are unknown. The purpose of this investigation was to evaluate oxygen consumption, energy expenditure, and heart rate on a TM or EL when persons exercise at the same perceived level of exertion. After measuring peak oxygen uptake (VO2peak) in 9 male and 9 female untrained college-aged participants, the subjects performed 2 separate 15-minute submaximal exercise tests on the TM and EL at a rating of perceived exertion (RPE) of 12-13. VO2peak was higher (p<0.05) in the males (48.6+/-1.5 vs. 45.2+/-1.6 ml/kg/min) than the females (41.7+/-1.8 vs. 38.8+/-2.2 ml/kg/min) for both TM and EL (means+/-standard error of the mean; for TM vs. EL respectively), but there were no differences in the measured VO2peak between TM or EL. During submaximal exercise there were no differences in RPE between TM and EL. Total oxygen consumption was higher (p<0.05) in males (30.8+/-2.2 vs. 34.9+/-2.2 L) than females (24.1+/-1.8 vs. 26.9+/-1.7 L) but did not differ between TM and EL. Energy expenditure was not different between TM (569+/-110 J) or EL (636+/-120 kJ). Heart rate was higher (p<0.05) on the EL (164+/-16 beats/min) compared to the TM (145+/-15 beats/min). When subjects exercise at the same RPE on TM or EL, oxygen consumption and energy expenditure are similar in spite of a higher heart rate on the EL. These data indicate that during cross training or noncompetition-specific exercise, an elliptical device is an acceptable alternative to a treadmill.

Influence of the amount of body weight support on lower limb joints' kinematics during treadmill walking at different gait speeds: Reference data on healthy adults to define trajectories for robot assistance.

PubMed

Ferrarin, Maurizio; Rabuffetti, Marco; Geda, Elisabetta; Sirolli, Silvia; Marzegan, Alberto; Bruno, Valentina; Sacco, Katiuscia

2018-06-01

Several robotic devices have been developed for the rehabilitation of treadmill walking in patients with movement disorders due to injuries or diseases of the central nervous system. These robots induce coordinated multi-joint movements aimed at reproducing the physiological walking or stepping patterns. Control strategies developed for robotic locomotor training need a set of predefined lower limb joint angular trajectories as reference input for the control algorithm. Such trajectories are typically taken from normative database of overground unassisted walking. However, it has been demonstrated that gait speed and the amount of body weight support significantly influence joint trajectories during walking. Moreover, both the speed and the level of body weight support must be individually adjusted according to the rehabilitation phase and the residual locomotor abilities of the patient. In this work, 10 healthy participants (age range: 23-48 years) were asked to walk in movement analysis laboratory on a treadmill at five different speeds and four different levels of body weight support; besides, a trial with full body weight support, that is, with the subject suspended on air, was performed at two different cadences. The results confirm that lower limb kinematics during walking is affected by gait speed and by the amount of body weight support, and that on-air stepping is radically different from treadmill walking. Importantly, the results provide normative data in a numerical form to be used as reference trajectories for controlling robot-assisted body weight support walking training. An electronic addendum is provided to easily access to such reference data for different combinations of gait speeds and body weight support levels.

Effects of voluntary and treadmill exercise on spontaneous withdrawal signs, cognitive deficits and alterations in apoptosis-associated proteins in morphine-dependent rats.

PubMed

Mokhtari-Zaer, Amin; Ghodrati-Jaldbakhan, Shahrbanoo; Vafaei, Abbas Ali; Miladi-Gorji, Hossein; Akhavan, Maziar M; Bandegi, Ahmad Reza; Rashidy-Pour, Ali

2014-09-01

Chronic exposure to morphine results in cognitive deficits and alterations of apoptotic proteins in favor of cell death in the hippocampus, a brain region critically involved in learning and memory. Physical activity has been shown to have beneficial effects on brain health. In the current work, we examined the effects of voluntary and treadmill exercise on spontaneous withdrawal signs, the associated cognitive defects, and changes of apoptotic proteins in morphine-dependent rats. Morphine dependence was induced through bi-daily administrations of morphine (10mg/kg) for 10 days. Then, the rats were trained under two different exercise protocols: mild treadmill exercise or voluntary wheel exercise for 10 days. After exercise training, their spatial learning and memory and aversive memory were examined by a water maze and by an inhibitory avoidance task, respectively. The expression of the pro-apoptotic protein Bax and the anti-apoptotic protein Bcl-2 in the hippocampus were determined by immunoblotting. We found that chronic exposure to morphine impaired spatial and aversive memory and remarkably suppressed the expression of Bcl-2, but Bax expression remained constant. Both voluntary and treadmill exercise alleviated memory impairment, increased the expression of Bcl-2 protein, and only the later suppressed the expression of Bax protein in morphine-dependent animals. Moreover, both exercise protocols diminished the occurrence of spontaneous morphine withdrawal signs. Our findings showed that exercise reduces the spontaneous morphine-withdrawal signs, blocks the associated impairment of cognitive performance, and overcomes morphine-induced alterations in apoptotic proteins in favor of cell death. Thus, exercise may be a useful therapeutic strategy for cognitive and behavioral deficits in addict individuals. Copyright © 2014 Elsevier B.V. All rights reserved.

Prior exercise training blunts short-term high-fat diet-induced weight gain.

PubMed

Snook, Laelie A; MacPherson, Rebecca E K; Monaco, Cynthia M F; Frendo-Cumbo, Scott; Castellani, Laura; Peppler, Willem T; Anderson, Zachary G; Buzelle, Samyra L; LeBlanc, Paul J; Holloway, Graham P; Wright, David C

2016-08-01

High-fat diets rapidly cause weight gain and glucose intolerance. We sought to determine whether these changes could be mitigated with prior exercise training. Male C57BL/6J mice were exercise-trained by treadmill running (1 h/day, 5 days/wk) for 4 wk. Twenty-four hours after the final bout of exercise, mice were provided with a high-fat diet (HFD; 60% kcal from lard) for 4 days, with no further exercise. In mice fed the HFD prior to exercise training, the results were blunted weight gain, reduced fat mass, and a slight attenuation in glucose intolerance that was mirrored by greater insulin-induced Akt phosphorylation in skeletal muscle compared with sedentary mice fed the HFD. When ad libitum-fed sedentary mice were compared with sedentary high-fat fed mice that were calorie restricted (-30%) to match the weight gain of the previously trained high-fat fed mice, the same attenuated impairments in glucose tolerance were found. Blunted weight gain was associated with a greater capacity to increase energy expenditure in trained compared with sedentary mice when challenged with a HFD. Although mitochondrial enzymes in white adipose tissue and UCP-1 protein content in brown adipose tissue were increased in previously exercised compared with sedentary mice fed a HFD, ex vivo mitochondrial respiration was not increased in either tissue. Our data suggest that prior exercise training attenuates high-fat diet-induced weight gain and glucose intolerance and is associated with a greater ability to increase energy expenditure in response to a high-fat diet. Copyright © 2016 the American Physiological Society.

Quantifying cardiorespiratory responses resulting from speed and slope increments during motorized treadmill propulsion among manual wheelchair users.

PubMed

Gauthier, Cindy; Grangeon, Murielle; Ananos, Ludivine; Brosseau, Rachel; Gagnon, Dany H

2017-09-01

Cardiorespiratory fitness assessment and training among manual wheelchair (MW) users are predominantly done with an arm-crank ergometer. However, arm-crank ergometer biomechanics differ substantially from MW propulsion biomechanics. This study aimed to quantify cardiorespiratory responses resulting from speed and slope increments during MW propulsion on a motorized treadmill and to calculate a predictive equation based on speed and slope for estimating peak oxygen uptake (VO 2peak ) in MW users. In total, 17 long-term MW users completed 12 MW propulsion periods (PP), each lasting 2min, on a motorized treadmill, in a random order. Each PP was separated by a 2-min rest. PPs were characterized by a combination of 3 speeds (0.6, 0.8 and 1.0m/s) and 4 slopes (0°, 2.7°, 3.6° and 4.8°). Six key cardiorespiratory outcome measures (VO 2 , heart rate, respiratory rate, minute ventilation and tidal volume) were recorded by using a gas-exchange analysis system. Rate of perceived exertion (RPE) was measured by using the modified 10-point Borg scale after each PP. For the 14 participants who completed the test, cardiorespiratory responses increased in response to speed and/or slope increments, except those recorded between the 3.6 o and 4.8 o slope, for which most outcome measures were comparable. The RPE was positively associated with cardiorespiratory response (r s ≥0.85). A VO 2 predictive equation (R 2 =99.7%) based on speed and slope for each PP was computed. This equation informed the development of a future testing protocol to linearly increase VO 2 via 1-min stages during treadmill MW propulsion. Increasing speed and slope while propelling a MW on a motorized treadmill increases cardiorespiratory response along with RPE. RPE can be used to easily and accurately monitor cardiorespiratory responses during MW exercise. The VO 2 can be predicted to some extent by speed and slope during MW propulsion. A testing protocol is proposed to assess cardiorespiratory fitness during motorized MW propulsion. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Robot-assisted gait training in multiple sclerosis patients: a randomized trial.

PubMed

Schwartz, Isabella; Sajin, Anna; Moreh, Elior; Fisher, Iris; Neeb, Martin; Forest, Adina; Vaknin-Dembinsky, Adi; Karusis, Dimitrios; Meiner, Zeev

2012-06-01

Preservation of locomotor activity in multiple sclerosis (MS) patients is of utmost importance. Robotic-assisted body weight-supported treadmill training is a promising method to improve gait functions in neurologically impaired patients, although its effectiveness in MS patients is still unknown. To compare the effectiveness of robot-assisted gait training (RAGT) with that of conventional walking treatment (CWT) on gait and generalized functions in a group of stable MS patients. A prospective randomized controlled trial of 12 sessions of RAGT or CWT in MS patients of EDSS score 5-7. Primary outcome measures were gait parameters and the secondary outcomes were functional and quality of life parameters. All tests were performed at baseline, 3 and 6 months post-treatment by a blinded rater. Fifteen and 17 patients were randomly allocated to RAGT and CWT, respectively. Both groups were comparable at baseline in all parameters. As compared with baseline, although some gait parameters improved significantly following the treatment at each time point there was no difference between the groups. Both FIM and EDSS scores improved significantly post-treatment with no difference between the groups. At 6 months, most gait and functional parameters had returned to baseline. Robot-assisted gait training is feasible and safe and may be an effective additional therapeutic option in MS patients with severe walking disabilities.

A Comparison of Locomotor Therapy Interventions: Partial-Body Weight-Supported Treadmill, Lokomat, and G-EO Training in People With Traumatic Brain Injury.

PubMed

Esquenazi, Alberto; Lee, Stella; Wikoff, Amanda; Packel, Andrew; Toczylowski, Theresa; Feeley, John

2017-09-01

Literature in the application of gait training techniques in persons with traumatic brain injury (TBI) is limited. Current techniques require multiple staff and are physically demanding. The use of a robotic locomotor training may provide improved training capacity for this population. To examine the impact of 3 different modes of locomotor therapy on gait velocity and spatiotemporal symmetry using an end effector robot (G-EO); a robotic exoskeleton (Lokomat), and manual assisted partial-body weight-supported treadmill training (PBWSTT) in participants with traumatic brain injury. Randomized, prospective study. Tertiary rehabilitation hospital. A total of 22 individuals with ≥12 months chronic TBI with hemiparetic pattern able to walk overground without assistance at velocities between 0.2 and 0.6 m/s. Eighteen sessions of 45 minutes of assigned locomotor training. Overground walking self-selected velocity (SSV), maximal velocity (MV), spatiotemporal asymmetry ratio, 6-Minute Walk Test (6MWT), and mobility domain of Stroke Impact Scale (MSIS). Severity in walking dysfunction was similar across groups as determined by walking velocity data. At baseline, participants in the Lokomat group had a baseline velocity that was slightly slower compared with the other groups. Training elicited a statistically significant median increase in SSV for all groups compared with pretraining (Lokomat, P = .04; G-EO, P = .03; and PBWSTT, P = .02) and MV excluding the G-EO group (Lokomat, P = .04; PBWSTT, P = .03 and G-EO, P = .15). There were no pre-post significant differences in swing time, stance time, and step length asymmetry ratios at SSV or MV for any of the interventions. Mean rank in the change of SSV and MV was not statistically significantly different between groups. Participants in the G-EO and PBWSTT groups significantly improved their 6MWT posttraining (P = .04 and .03, respectively). The MSIS significantly improved only for the Lokomat group (P = .04 and .03). The data did not elicit between-groups significant differences for 6MWT and MSIS. There was less use of staff for Lokomat than G-EO. Locomotor therapy using G-EO, Lokomat, or PBWSTT in individuals with chronic TBI increased SSV and MV without significant changes in gait symmetry. Staffing needed for therapy provision was the least for the Lokomat. A larger study may further elucidate changes in gait symmetry and other training parameters. II. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Effects of Two Training Programs on Transcriptional Levels of Neurotrophins and Glial Cells Population in Hippocampus of Experimental Multiple Sclerosis.

PubMed

Naghibzadeh, Maryam; Ranjbar, Rouhollah; Tabandeh, Mohammad Reza; Habibi, Abdolhamid

2018-05-18

The aim of the present study was to investigate the effects of high-intensity interval training (HIIT) versus low-intensity continuous training (LICT) on transcriptional levels of neurotrophic factors and oligodendrocyte/microglia cell loss in a cuprizone (CP) induced animal model of demyelination. Male C57BL/6 mice were assigned to six groups: control (C), cuprizone-induced demyelination (CP), interval training (IT), continuous training (CT), IT plus CP (ITCP), and CT plus CP (CTCP). Training programs on the treadmill were performed for four weeks, and then demyelination was induced by feeding mice a diet containing 0.2% cuprizone for five weeks. Animals that received cuprizone showed poorer motor function, lower expression of BDNF, GDNF, NGF, and fewer oligodendrocytes in the hippocampus compared to the control animals. The numbers of oligodendrocyte and microglia cells increased in the ITCP group compared to the CTCP group (P<0.05). Both training programs increased the mRNA levels of BDNF, GDNF and NGF, and the HIIT program was more effective than the LICT program (P<0.05). Both exercise programs prevented the abnormal neurological movements induced by cuprizone. Our results indicated that HIIT versus LICT had a greater neuroprotective effect against multiple sclerosis by improving gene expression for abnormal neurotrophins and cellular loss in the hippocampus. © Georg Thieme Verlag KG Stuttgart · New York.

Executive Function and the P300 after Treadmill Exercise and Futsal in College Soccer Players

PubMed Central

Won, Junyeon; Wu, Shanshan; Ji, Hongqing; Smith, J. Carson; Park, Jungjun

2017-01-01

(1) Background: Although a body of evidence demonstrates that acute exercise improves executive function, few studies have compared more complex, laboratory-based modes of exercise, such as soccer that involve multiple aspects of the environment. (2) Methods: Twelve experienced soccer players (24.8 ± 2 years) completed three counterbalanced 20 min sessions of (1) seated rest; (2) moderate intensity treadmill exercise; and (3) a game of futsal. Once heart rate returned to within 10% of pre-activity levels, participants completed the Stroop Color Word Conflict Task while reaction time (RT) and P300 event-related potentials were measured. (3) Results: Reaction time during Stroop performance was significantly faster following the futsal game and treadmill exercise compared to the seated rest. The P300 amplitude during Stroop performance was significantly greater following futsal relative to both treadmill and seated-rest conditions. (4) Conclusions: These findings suggest that single bouts of indoor soccer among college-aged soccer players, compared to treadmill and seated-rest conditions, may engender the greatest effect on brain networks controlling attention allocation and classification speed during the performance of an inhibitory control task. Future research is needed to determine if cognitively engaging forms of aerobic exercise may differentially impact executive control processes in less experienced and older adult participants.

Effects on motor development of kicking and stepping exercise in preterm infants with periventricular brain injury: a pilot study.

PubMed

Campbell, Suzann K; Gaebler-Spira, Deborah; Zawacki, Laura; Clark, April; Boynewicz, Kara; deRegnier, Raye-Ann; Kuroda, Maxine M; Bhat, Rama; Yu, Jinsheng; Campise-Luther, Rose; Kale, Dipti; Bulanda, Michelle; Zhou, Xiaohong Joe

2012-01-01

Preterm infants with periventricular brain injury (PBI) have a high incidence of atypical development and leg movements. Determine whether kicking and treadmill stepping intervention beginning at 2 months corrected age (CA) in children with PBI improves motor function at 12 months CA when compared with control subjects. In a multi-center pilot study for a controlled clinical trial, sixteen infants with PBI were randomly assigned to home exercise consisting of kicking and treadmill stepping or a no-training control condition. Development was assessed at 2, 4, 6, 10, and 12 months CA with the Alberta Infant Motor Scale (AIMS). At 12 months children were classified as normal, delayed, or with cerebral palsy (CP). At 12 months CA 3 of 7 (43%) of the exercise group children walked alone or with one hand held versus 1 of 9 (11%) in the control group (p=0.262), but no significant differences in AIMS scores were found at any age. Half of the subjects had CP or delay; the outcomes of these infants were not improved by exercise. Compliance with the home program was lower than requested and may have affected results. Although not statistically significant with a small sample size, self-produced kicking and treadmill exercise may lower age at walking in infants with normal development following PBI, but improvements of the protocol to increase and document compliance are needed before a larger study is implemented.

Effects on Motor Development of Kicking and Stepping Exercise in Preterm Infants with Periventricular Brain Injury: A Pilot Study

PubMed Central

Campbell, Suzann K.; Gaebler-Spira, Deborah; Zawacki, Laura; Clark, April; Boynewicz, Kara; deRegnier, Raye-Ann; Kuroda, Maxine M.; Bhat, Rama; Yu, Jinsheng; Campise-Luther, Rose; Kale, Dipti; Bulanda, Michelle; Zhou, Xiaohong Joe

2013-01-01

Background Preterm infants with periventricular brain injury (PBI) have a high incidence of atypical development and leg movements. Objective Determine whether kicking and treadmill stepping intervention beginning at 2 months corrected age (CA) in children with PBI improves motor function at 12 months CA when compared with control subjects. Method In a multi-center pilot study for a controlled clinical trial, sixteen infants with PBI were randomly assigned to home exercise consisting of kicking and treadmill stepping or a no-training control condition. Development was assessed at 2, 4, 6, 10, and 12 months CA with the Alberta Infant Motor Scale (AIMS). At 12 months children were classified as normal, delayed, or with cerebral palsy (CP). Results At 12 months CA 3 of 7 (43%) of the exercise group children walked alone or with one hand held versus 1 of 9 (11%) in the control group (p=.262), but no significant differences in AIMS scores were found at any age. Half of the subjects had CP or delay; the outcomes of these infants were not improved by exercise. Compliance with the home program was lower than requested and may have affected results. Conclusion Although not statistically significant with a small sample size, self-produced kicking and treadmill exercise may lower age at walking in infants with normal development following PBI, but improvements of the protocol to increase and document compliance are needed before a larger study is implemented. PMID:22543889

Effects of Repeated Treadmill Testing and Electrical Stimulation on Post-Stroke Gait Kinematics

PubMed Central

Awad, Louis N.; Kesar, Trisha M.; Reisman, Darcy; Binder-Macleod, Stuart A.

2012-01-01

Improvements in task performance due to repeated testing have previously been documented in healthy and patient populations. The existence of a similar change in performance due to repeated testing has not been previously investigated at the level of gait kinematics in the post-stroke population. The presence of such changes may define the number of testing sessions necessary for measuring a stable baseline of pre-training gait performance, which is a necessary prerequisite for determining the effectiveness of gait interventions. Considering the emergence of treadmills as a popular tool for gait evaluation and retraining and the common addition of functional electrical stimulation (FES) to gait retraining protocols, the stability of gait kinematics during the repeated testing of post-stroke individuals on a treadmill, either with or without FES, needs to be determined. Nine individuals (age: 58.1 +/− 7.3 years), with hemi-paresis secondary to a stroke (onset: 7.3 +/− 6.0 years) participated in this study. An 8-camera motion analysis system was used to measure sagittal plane knee and ankle joint kinematics. Gait kinematics were compared across two (N=9) and five (N=5) testing sessions. No consistent changes in knee or ankle kinematics were observed during repeated testing. These findings indicate that clinicians and researchers may not need to spend valuable time and resources performing multiple testing and acclimatization sessions when assessing baseline gait kinematics in the post-stroke population for use in determining the effectiveness of gait interventions. PMID:22796242

Running speed increases plantar load more than per cent body weight on an AlterG® treadmill.

PubMed

Thomson, Athol; Einarsson, Einar; Witvrouw, Erik; Whiteley, Rod

2017-02-01

AlterG® treadmills allow for running at different speeds as well as at reduced bodyweight (BW), and are used during rehabilitation to reduce the impact load. The aim of this study was to quantify plantar loads borne by the athlete during rehabilitation. Twenty trained male participants ran on the AlterG® treadmill in 36 conditions: all combinations of indicated BW (50-100%) paired with different walking and running speeds (range 6-16 km · hr -1 ) in a random order. In-shoe maximum plantar force (Fmax) was recorded using the Pedar-X system. Fmax was lowest at the 6 km · hr -1 at 50% indicated BW condition at 1.02 ± 0.21BW and peaked at 2.31 ± 0.22BW for the 16 km · hr -1 at 100% BW condition. Greater increases in Fmax were seen when increasing running speed while holding per cent BW constant than the reverse (0.74BW-0.91BW increase compared to 0.19-0.31BW). A table is presented with each of the 36 combinations of BW and running speed to allow a more objective progression of plantar loading during rehabilitation. Increasing running speed rather than increasing indicated per cent BW was shown to have the strongest effect on the magnitude of Fmax across the ranges of speeds and indicated per cent BWs examined.

Does dual task training improve walking performance of older adults with concern of falling?

PubMed

Wollesen, B; Schulz, S; Seydell, L; Delbaere, K

2017-09-11

Older adults with concerns of falling show decrements of gait stability under single (ST) and dual task (DT) conditions. To compare the effects of a DT training integrating task managing strategies for independent living older adults with and without concern about falling (CoF) to a non-training control group on walking performance under ST and DT conditions. Single center parallel group single blind randomized controlled trial with group-based interventions (DT-managing balance training) compared to a control group (Ninety-five independent living older adults; 71.5 ± 5.2 years). A progressive DT training (12 sessions; 60 min each; 12 weeks) including task-managing strategies was compared to a non-training control group. group based intervention for independent living elderly in a gym. ST and DT walking (visual verbal Stroop task) were measured on a treadmill. Gait parameters (step length, step width, and gait line) and cognitive performance while walking were compared with a 2x2x2 Repeated Measures Analyses of Variance. Participants in the intervention group showed an increased step length under ST and DT conditions following the intervention, for both people with and without CoF compared to their respective control groups. Foot rolling movement and cognitive performance while walking however only improved in participants without CoF. The results showed that DT managing training can improve walking performance under ST and DT conditions in people with and without CoF. Additional treatment to directly address CoF, such as cognitive behavioural therapy, should be considered to further improve the cautious gait pattern (as evidenced by reduced foot rolling movements). The study was retrospectively registered in the German Clinical Trials Register (DRKS; Identification number DRKS00012382 , 11.05.2017).

Comparison of standardbred trotters exercising on a treadmill and a race track with identical draught resistances.

PubMed

Gottlieb-Vedi, M; Lindholm, A

1997-05-17

The responses in heart rate, plasma lactate and rectal temperature of standardbred trotters to draught loaded interval exercise on a treadmill and a race track were studied. The horses were exercised with incrementally increasing trotting speeds for two-minute intervals with draught loads of 10, 20 and 30 kilopond (kp) in three different tests. Each trotting interval was followed by two-minute periods at a walk without a draught load. Measurements of heart rate and plasma lactate were made at the end of each interval and the rectal temperature was taken at the end of the exercise. The heart rate and plasma lactate levels were significantly lower on the treadmill than on the track in the tests with 10 kp, but no significant differences were found between the treadmill and track exercise tests with the heavier draught resistances. No differences were observed in rectal temperature between treadmill and track conditions. From these findings it was concluded that the workload was significantly greater on the race track compared to the treadmill when the draught resistance was low (10 kp). Although the workload increased on both the race track and the treadmill as draught resistance increased, at the heavier draught resistances track exercise was no longer more demanding than exercise on the treadmill.

Biomechanical Analysis of Treadmill Locomotion on the International Space Station

NASA Technical Reports Server (NTRS)

De Witt, J. K.; Fincke, R. S.; Guilliams, M. E.; Ploutz-Snyder, L. L.

2011-01-01

Treadmill locomotion exercise is an important aspect of ISS exercise countermeasures. It is widely believed that an optimized treadmill exercise protocol could offer benefits to cardiovascular and bone health. If training heart rate is high enough, treadmill exercise is expected to lead to improvements in aerobic fitness. If impact or bone loading forces are high enough, treadmill exercise may be expected to contribute to improved bone outcomes. Ground-based research suggests that joint loads increase with increased running speed. However, it is unknown if increases in locomotion speed results in similar increases in joint loads in microgravity. Although data exist regarding the biomechanics of running and walking in microgravity, a majority were collected during parabolic flight or during investigations utilizing a microgravity analog. The Second Generation Treadmill (T2) has been in use on the International Space Station (ISS) and records the ground reaction forces (GRF) produced by crewmembers during exercise. Biomechanical analyses will aid in understanding potential differences in typical gait motion and allow for modeling of the human body to determine joint and muscle forces during exercise. By understanding these mechanisms, more appropriate exercise prescriptions can be developed that address deficiencies. The objective of this evaluation is to collect biomechanical data from crewmembers during treadmill exercise prior to and during flight. The goal is to determine if locomotive biomechanics differ between normal and microgravity environments and to determine how combinations of subject load and speed influence joint loading during in-flight treadmill exercise. Further, the data will be used to characterize any differences in specific bone and muscle loading during locomotion in these two gravitational conditions. This project maps to the HRP Integrated Research Plan risks including Risk of Bone Fracture (Gap B15), Risk of Early Onset Osteoporosis Due to Spaceflight (Gap B15), Risk of Impaired Performance Due to Reduced Muscle Mass, Strength, and Endurance (Gaps M3, M4, M6, Ml, M8, M9) and Risk of reduced Physical Performance Capabilities Due to Reduce Aerobic Capacity (Gaps M7, M8, M9).

A functional murine model of hindlimb demand ischemia.

PubMed

Peck, Michael A; Crawford, Robert S; Abularrage, Christopher J; Patel, Virendra I; Conrad, Mark F; Yoo, Jin Hyung; Watkins, Michael T; Albadawi, Hassan

2010-05-01

To date, murine models of treadmill exercise have been used to study general exercise physiology and angiogenesis in ischemic hindlimbs. The purpose of these experiments was to develop a murine model of demand ischemia in an ischemic limb to mimic claudication in humans. The primary goal was to determine whether treadmill exercise reflected a hemodynamic picture which might be consistent with the hyperemic response observed in humans. Aged hypercholesterolemic ApoE null mice (ApoE(-/-), n = 13) were subjected to femoral artery ligation (FAL) and allowed to recover from the acute ischemic response. Peripheral perfusion of the hindlimbs at rest was determined by serial evaluation using laser Doppler imaging (LDI) on days 0, 7, and 14 following FAL. During the experiments, mice were also assessed on an established five-point clinical ischemic score, which assessed the degree of digital amputation, necrosis, and cyanosis compared to the nonischemic contralateral limb. After stabilization of the LDI ratio (ischemic limb flux/contralateral nonischemic limb flux) and clinical ischemic score, mice underwent 2 days of treadmill training (10 min at 10 m/min, incline of 10 degrees ) followed by 60 min of daily treadmill exercise (13 m/min, incline of 10 degrees ) through day 25. An evaluation of preexercise and postexercise perfusion using LDI was performed on two separate occasions following the onset of daily exercise. During the immediate 15 min postexercise evaluation, LDI scanning was obtained in quadruplicate, to allow identification of peak flux ratios. Statistical analysis included unpaired t-tests and analysis of variance. After FAL, the LDI flux ratio reached a nadir between days 1 and 2, then stabilized by day 14 and remained stable through day 25. The clinical ischemic score stabilized at day 7 and remained stable throughout the rest of the experiment. Based on stabilization of both the clinical ischemic score and LDI ratio, exercise training began on day 15. The peak 15 min postexercise LDI ratio increased significantly compared to the preexercise ratio on day 17 (0.48 +/- 0.04 vs. 0.34 +/- 0.04, p < 0.05) and day 25 (0.37 +/- 0.03 vs. 0.27 +/- 0.03, p < 0.01). Within 2 hr of exercise, the LDI ratio returned to preexercise levels on both days 17 and 25. Clinical and hemodynamic stabilization of limb perfusion is evident by 14 days after FAL. FAL followed by demand ischemia results in a reversible relative hyperemic response similar to that observed in exercising human claudicants. A murine model of FAL associated with demand ischemia may be useful to evaluate the metabolic, inflammatory, and flow-related changes associated with claudication in humans. Copyright 2010 Annals of Vascular Surgery Inc. All rights reserved.

Effects of unilateral robotic limb loading on gait characteristics in subjects with chronic stroke.

PubMed

Khanna, Ira; Roy, Anindo; Rodgers, Mary M; Krebs, Hermano I; Macko, Richard M; Forrester, Larry W

2010-05-21

Hemiparesis after stroke often leads to impaired ankle motor control that impacts gait function. In recent studies, robotic devices have been developed to address this impairment. While capable of imparting forces to assist during training and gait, these devices add mass to the paretic leg which might encumber patients' gait pattern. The purpose of this study was to assess the effects of the added mass of one of these robots, the MIT's Anklebot, while unpowered, on gait of chronic stroke survivors during overground and treadmill walking. Nine chronic stroke survivors walked overground and on a treadmill with and without the anklebot mounted on the paretic leg. Gait parameters, interlimb symmetry, and joint kinematics were collected for the four conditions. Repeated-measures analysis of variance (ANOVA) tests were conducted to examine for possible differences across four conditions for the paretic and nonparetic leg. The added inertia and friction of the unpowered anklebot had no statistically significant effect on spatio-temporal parameters of gait, including paretic and nonparetic step time and stance percentage, in both overground and treadmill conditions. Noteworthy, interlimb symmetry as characterized by relative stance duration was greater on the treadmill than overground regardless of loading conditions. The presence of the unpowered robot loading reduced the nonparetic knee peak flexion on the treadmill and paretic peak dorsiflexion overground (p < 0.05). Our results suggest that for these subjects the added inertia and friction of this backdriveable robot did not significantly alter their gait pattern.

Comparison of ventilation threshold and heart rate deflection point in fast and standard treadmill test protocols.

PubMed

Vucetić, Vlatko; Sentija, Davor; Sporis, Goran; Trajković, Nebojsa; Milanović, Zoran

2014-06-01

The purpose of this study was to compare two methods for determination of anaerobic threshold from two different treadmill protocols. Forty-eight Croatian runners of national rank (ten sprinters, fifteen 400-m runners, ten middle distance runners and thirteen long distance runners), mean age 21.7 +/- 5.1 years, participated in the study. They performed two graded maximal exercise tests on a treadmill, a standard ramp treadmill test (T(SR), speed increments of 1 km x h(-1) every 60 seconds) and a fast ramp treadmill test (T(FR), speed increments of 1 km x h(-1) every 30 seconds) to determine and compare the parameters at peak values and at heart rate at the deflection point (HR(DP)) and ventilation threshold (VT). There were no significant differences between protocols (p > 0.05) for peak values of oxygen uptake (VO(2max), 4.48 +/- 0.43 and 4.44 +/- 0.45 L x min(-1)), weight related VO(2max) (62.5 +/- 6.2 and 62.0 +/- 6.0 mL x kg(-1) x min(-1)), pulmonary ventilation (VE(max), 163.1 +/- 18.7 and 161.3 +/- 19.9 L x min(-1)) and heart rate (HR(max), 192.3 +/- 8.5 and 194.4 +/- 8.7 bpm) (T(FR) and T(SR), respectively). Moreover, no significant differences between T(FR) and T(SR) where found for VT and HR(DP) when expressed as VO2 and HR. However, there was a significant effect of ramp slope on running speed at VO(2max) and at the anaerobic threshold (AnT), independent of the method used (VT: 16.0 +/- 2.2 vs 14.9 +/- 2.2 km x h(-1);HR(DP): 16.5 +/- 1.9 vs 14.9 +/- 2.0 km x h(-1) for T(FR) and T(SR) respectively). Linear regression analysis revealed high between-test and between-method correlations for VO2, HR and running speed parameters (r = 0.78-0.89, p < 0.01). The present study has indicated that the VT and HR(DP) for running (VO2, ventilation, and heart rate at VT/HR(DP)) are independent of test protocol, while there is a significant effect of ramp slope on VT and HR(DP) when expressed as running speed. Moreover, this study demonstrates that the point of deflection from linearity of heart rate may be an accurate predictor of the anaerobic threshold in trained runners, independently of the protocol used.

Supported treadmill ambulation for amyotrophic lateral sclerosis: a pilot study.

PubMed

Sanjak, Mohammed; Bravver, Elena; Bockenek, William L; Norton, H James; Brooks, Benjamin R

2010-12-01

To determine the feasibility, tolerability, safety, and exercise treatment-effect size of repetitive rhythmic exercise mediated by supported treadmill ambulation training (STAT) for patients with amyotrophic lateral sclerosis (ALS). Interventional with repeated-measures design. Multidisciplinary ALS clinic at academic medical center. Convenience sample of patients with ALS (N=9) who were ambulatory with assistive devices (Sinaki-Mulder stages II-III). Repetitive rhythmic exercise-STAT (30min total; 5min of exercise intercalated with 5min of rest) performed 3 times a week for 8 weeks. ALS Functional Rating Scale-Revised (ALSFRS-R), percentage of predicted vital capacity (VC), total lower-extremities manual muscle test (MMT), rate of perceived exertion (RPE), Fatigue Severity Scale (FSS), and maximum voluntary isometric contraction (MVIC) in 10 lower and 10 upper extremities. Gait performance, which included walking distance, speed, steps, and stride length, was evaluated during treadmill and ground 6-minute walk tests (6MWTs) and 25-foot walk test (25FWT). Feasibility issues decreased screened participants by 4 patients (31%). Nine patients were enrolled, but 6 patients (67%) completed the study and 3 (23% of original cohort; 33% of enrolled cohort) could not complete the exercise intervention because of non-ALS-related medical problems. Tolerability of the intervention measures during the treadmill 6MWT showed improvement in RPE (P≤.05) and FSS score (P≥.05). Safety measures (ALSFRS-R, VC, MMT) showed no decrease and showed statistical improvement in ALSFRS-R score (P≤.05) during the study interval. Exercise treatment-effect size showed variable improvements. Gait speed, distance, and stride length during the treadmill 6MWT improved significantly (P≤.05) after 4 weeks and improvements were maintained after 8 weeks compared with baseline. Walking distance during the ground 6MWT increased significantly after 4 weeks and was maintained after 8 weeks compared with baseline (P≤.05). Walking speed during the 25FWT and lower-extremity MVIC improved, but were not statistically significant. Repetitive rhythmic exercise-STAT is feasible, tolerated, and safe for patients with ALS. Repetitive rhythmic exercise-STAT treatment-effect size across a number of ALS-related measures was consistent with improved work capacity and gait function in patients with ALS who are dependent on assistive devices for ambulation. Repetitive rhythmic exercise-STAT should be evaluated further in larger studies to determine the stability of this improved function in relation to the rate of progression of the underlying ALS. Copyright © 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Agreement between the spatio-temporal gait parameters from treadmill-based photoelectric cell and the instrumented treadmill system in healthy young adults and stroke patients.

PubMed

Lee, Myungmo; Song, Changho; Lee, Kyoungjin; Shin, Doochul; Shin, Seungho

2014-07-14

Treadmill gait analysis was more advantageous than over-ground walking because it allowed continuous measurements of the gait parameters. The purpose of this study was to investigate the concurrent validity and the test-retest reliability of the OPTOGait photoelectric cell system against the treadmill-based gait analysis system by assessing spatio-temporal gait parameters. Twenty-six stroke patients and 18 healthy adults were asked to walk on the treadmill at their preferred speed. The concurrent validity was assessed by comparing data obtained from the 2 systems, and the test-retest reliability was determined by comparing data obtained from the 1st and the 2nd session of the OPTOGait system. The concurrent validity, identified by the intra-class correlation coefficients (ICC [2, 1]), coefficients of variation (CVME), and 95% limits of agreement (LOA) for the spatial-temporal gait parameters, were excellent but the temporal parameters expressed as a percentage of the gait cycle were poor. The test-retest reliability of the OPTOGait System, identified by ICC (3, 1), CVME, 95% LOA, standard error of measurement (SEM), and minimum detectable change (MDC95%) for the spatio-temporal gait parameters, was high. These findings indicated that the treadmill-based OPTOGait System had strong concurrent validity and test-retest reliability. This portable system could be useful for clinical assessments.

Feasibility and safety of exercise stress testing using an anti-gravity treadmill with Tc-99m tetrofosmin single-photon emission computed tomography (SPECT) myocardial perfusion imaging: A pilot non-randomized controlled study.

PubMed

Daly, Patrick; Kayse, Regina; Rudick, Steven; Robbins, Nathan; Scheler, Jennifer; Harris, David; O'Donnell, Robert; Dwivedi, Alok K; Gerson, Myron C

2017-08-31

Exercise is the AHA/ACC guideline-recommended stress modality for myocardial perfusion imaging, but many patients are unable to exercise to target heart rate on a conventional treadmill. We examined the feasibility and safety of stress imaging using an anti-gravity treadmill in patients with perceived poor exercise capacity. 49 patients were recruited for stress testing by anti-gravity treadmill (n = 29) or to a regadenoson control group (n = 20). Seventeen anti-gravity test patients (59%) reached target heart rate obviating the need for a pharmacologic stress agent. Adverse effects of the anti-gravity treadmill were limited to minor muscle aches in 5 subjects. Stress myocardial perfusion image quality judged by 3 blinded readers on a 5-point scale was comparable for the anti-gravity treadmill (4.30 ± SD 0.87) vs pharmacologic stress (4.28 ± SD 0.66). Stress testing using an anti-gravity treadmill is feasible and may help some patients safely achieve target heart rate.

Contribution of sensory feedback to plantar flexor muscle activation during push-off in adults with cerebral palsy.

PubMed

Frisk, Rasmus F; Jensen, Peter; Kirk, Henrik; Bouyer, Laurent J; Lorentzen, Jakob; Nielsen, Jens B

2017-12-01

Exaggerated sensory activity has been assumed to contribute to functional impairment following lesion of the central motor pathway. However, recent studies have suggested that sensory contribution to muscle activity during gait is reduced in stroke patients and children with cerebral palsy (CP). We investigated whether this also occurs in CP adults and whether daily treadmill training is accompanied by alterations in sensory contribution to muscle activity. Seventeen adults with CP and 12 uninjured individuals participated. The participants walked on a treadmill while a robotized ankle-foot orthosis applied unload perturbations at the ankle, thereby removing sensory feedback naturally activated during push-off. Reduction of electromyographic (EMG) activity in the soleus muscle caused by unloads was compared and related to kinematics and ankle joint stiffness measurements. Similar measures were obtained after 6 wk of gait training. We found that sensory contribution to soleus EMG activation was reduced in CP adults compared with uninjured adults. The lowest contribution of sensory feedback was found in participants with lowest maximal gait speed. This was related to increased ankle plantar flexor stiffness. Six weeks of gait training did not alter the contribution of sensory feedback. We conclude that exaggerated sensory activity is unlikely to contribute to impaired gait in CP adults, because sensory contribution to muscle activity during gait was reduced compared with in uninjured individuals. Increased passive stiffness around the ankle joint is likely to diminish sensory feedback during gait so that a larger part of plantar flexor muscle activity must be generated by descending motor commands. NEW & NOTEWORTHY Findings suggest that adults with cerebral palsy have less contribution of sensory feedback to ongoing soleus muscle activation during push-off than uninjured individuals. Increased passive stiffness around the ankle joint is likely to diminish sensory feedback during gait, and/or sensory feedback is less integrated with central motor commands in the activation of spinal motor neurons. Consequently, muscle activation must to a larger extent rely on descending drive, which is already decreased because of the cerebral lesion. Copyright © 2017 the American Physiological Society.

Lumbar muscle inflammation alters spinally mediated locomotor recovery induced by training in a mouse model of complete spinal cord injury.

PubMed

Jeffrey-Gauthier, Renaud; Piché, Mathieu; Leblond, Hugues

2017-09-17

Locomotor networks after spinal cord injury (SCI) are shaped by training-activated proprioceptive and cutaneous inputs. Nociception from injured tissues may alter these changes but has largely been overlooked. The objective of the present study was to ascertain whether lumbar muscle inflammation hinders locomotion recovery in a mouse model of complete SCI. Lower limb kinematics during treadmill training was assessed before and after complete SCI at T8 (2, 7, 14, 21 and 28days post-injury). Locomotor recovery was compared in 4 groups of CD1 mice: control spinal mice; spinal mice with daily locomotor training; spinal mice with lumbar muscle inflammation (Complete Freund's Adjuvant (CFA) injection); and spinal mice with locomotor training and CFA. On day 28, H-reflex excitability and its inhibition at high-frequency stimulation (frequency-dependent depression: FDD) were compared between groups, all of which showed locomotor recovery. Recovery was enhanced by training, whereas lumbar muscle inflammation hindered these effects (knee angular excursion and paw drag: p's<0.05). In addition, lumbar muscle inflammation impaired hind limb coupling during locomotion (p<0.05) throughout recovery. Also, H-reflex disinhibition was prevented by training, with or without CFA injection (p's<0.05). Altogether, these results indicate that back muscle inflammation modulates spinally mediated locomotor recovery in mice with complete SCI, in part, by reducing adaptive changes induced by training. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

Effects of perturbation-based slip training using a virtual reality environment on slip-induced falls.

PubMed

Parijat, Prakriti; Lockhart, Thurmon E; Liu, Jian

2015-04-01

The purpose of the current study was to design and evaluate the effectiveness of virtual reality training in improving recovery reactions and reducing fall frequency in older adults. Twenty-four older adults were recruited and randomly assigned to two groups (virtual reality training and control). Both groups underwent three sessions including baseline slip, training and transfer of training on slippery surface. Both groups experienced two slips, one during baseline and the other during the transfer of training trial. The training group underwent 12 simulated slips using a visual perturbation induced by tilting a virtual reality scene while walking on the treadmill and the control group performed normal walking during the training session. Kinematic and kinetic data were collected during all the sessions. Results demonstrated a reduced incidence of falls in the training group during the transfer of training trial as compared to the control group. The training group was able to transfer reactive control strategies learned during training to the second slip trial. The reactive adjustments included reduced slip distance. Additionally, gait parameters reflective of gait instability (stride length, step width, variability in stride velocity) reduced after walking in the VR environment for 15-20 min. The results indicated a beneficial effect of the virtual reality training in reducing slip severity and recovery kinematics in healthy older adults.

Effects of Perturbation-Based Slip Training using a Virtual Reality Environment on Slip-induced Falls

PubMed Central

Parijat, Prakriti; Lockhart, Thurmon E.; Liu, Jian

2015-01-01

The purpose of the current study was to design and evaluate the effectiveness of virtual reality training in improving recovery reactions and reducing fall frequency in older adults. Twenty-four older adults were recruited and randomly assigned to two groups (virtual reality training and control). Both groups underwent three sessions including baseline slip, training and transfer of training on slippery surface. Both groups experienced two slips, one during baseline and the other during the transfer of training trial. The training group underwent twelve simulated slips using a visual perturbation induced by tilting a virtual reality scene while walking on the treadmill and the control group performed normal walking during the training session. Kinematic and kinetic data were collected during all the sessions. Results demonstrated a reduced incidence of falls in the training group during the transfer of training trial as compared to the control group. The training group was able to transfer reactive control strategies learned during training to the second slip trial. The reactive adjustments included reduced slip distance. Additionally, gait parameters reflective of gait instability (stride length, step width, variability in stride velocity) reduced after walking in the VR environment for 15–20 min. The results indicated a beneficial effect of the virtual reality training in reducing slip severity and recovery kinematics in healthy older adults. PMID:25245221

Long-Term Moderate Exercise Rescues Age-Related Decline in Hippocampal Neuronal Complexity and Memory.

PubMed

Tsai, Sheng-Feng; Ku, Nai-Wen; Wang, Tzu-Feng; Yang, Yan-Hsiang; Shih, Yao-Hsiang; Wu, Shih-Ying; Lee, Chu-Wan; Yu, Megan; Yang, Ting-Ting; Kuo, Yu-Min

2018-05-07

Aging impairs hippocampal neuroplasticity and hippocampus-related learning and memory. In contrast, exercise training is known to improve hippocampal neuronal function. However, whether exercise is capable of restoring memory function in old animals is less clear. Here, we investigated the effects of exercise on the hippocampal neuroplasticity and memory functions during aging. Young (3 months), middle-aged (9-12 months), and old (18 months) mice underwent moderate-intensity treadmill running training for 6 weeks, and their hippocampus-related learning and memory, and the plasticity of their CA1 neurons was evaluated. The memory performance (Morris water maze and novel object recognition tests), and dendritic complexity (branch and length) and spine density of their hippocampal CA1 neurons decreased as their age increased. The induction and maintenance of high-frequency stimulation-induced long-term potentiation in the CA1 area and the expressions of neuroplasticity-related proteins were not affected by age. Treadmill running increased CA1 neuron long-term potentiation and dendritic complexity in all three age groups, and it restored the learning and memory ability in middle-aged and old mice. Furthermore, treadmill running upregulated the hippocampal expressions of brain-derived neurotrophic factor and monocarboxylate transporter-4 in middle-aged mice, glutamine synthetase in old mice, and full-length TrkB in middle-aged and old mice. The hippocampus-related memory function declines from middle age, but long-term moderate-intensity running effectively increased hippocampal neuroplasticity and memory in mice of different ages, even when the memory impairment had progressed to an advanced stage. Thus, long-term, moderate intensity exercise training might be a way of delaying and treating aging-related memory decline. © 2018 S. Karger AG, Basel.

Effects of physical exercise and social isolation on anxiety-related behaviors in two inbred rat strains.

PubMed

Mazur, F G; Oliveira, L F G; Cunha, M P; Rodrigues, A L S; Pértile, R A N; Vendruscolo, L F; Izídio, G S

2017-09-01

We investigated the effects of physical exercise (PE) on locomotor activity and anxiety-like behavior in Lewis (LEW) and Spontaneously Hypertensive Rats (SHR) male rats. Rats received either four weeks of forced training, 5days/week, on a treadmill (experiment 1) or were given 21days of free access to running wheels (experiment 2). We also tested the effects of social isolation (SI) (seven days of isolation - experiment 3) on behavior. In experiment 1, 20% of LEW rats and 63% of SHR rats completed the training protocol. PE significantly increased central and peripheral locomotion in the open field (OF) and entries into the open arms in the elevated plus-maze (EPM) in both strains. In experiment 2, the distance traveled by SHR rats on running wheels was significantly higher compared with LEW rats. PE on running wheels also increased the time spent in the center of the OF in SHR rats only. In experiment 3, SI decreased central and peripheral locomotion in the OF in both strains. In summary, forced PE on a treadmill reduced anxiety-like behavior and increased locomotion in male rats of both strains, whereas voluntary PE on running wheels decreased anxiety-like behavior in SHR rats only. SI decreased locomotion in both strains in the OF. This study suggests that spontaneous activity levels are genotype-dependent and the effects of PE depend on the type of exercise performed. Copyright © 2017 Elsevier B.V. All rights reserved.

Functional Outcome of Neurologic-Controlled HAL-Exoskeletal Neurorehabilitation in Chronic Spinal Cord Injury: A Pilot With One Year Treatment and Variable Treatment Frequency.

PubMed

Jansen, Oliver; Schildhauer, Thomas A; Meindl, Renate C; Tegenthoff, Martin; Schwenkreis, Peter; Sczesny-Kaiser, Matthias; Grasmücke, Dennis; Fisahn, Christian; Aach, Mirko

2017-12-01

Longitudinal prospective study. Whether 1-year HAL-BWSTT of chronic spinal cord injured patients can improve independent ambulated mobility further as a function of training frequency, after an initial 3-month training period. Eight patients with chronic SCI were enrolled. They initially received full standard physical therapy and neurorehabilitation in the acute/subacute posttrauma phase. During this trial, all patients first underwent a daily (5 per week) HAL-BWSTT for 12 weeks. Subsequently, these patients performed a 40-week HAL-BWSTT with a training session frequency of either 1 or 3 to 5 sessions per week. The patients' functional status including HAL-associated treadmill-walking time, -distance, and -speed with additional analysis of gait pattern, and their independent (without wearing the robot suit) functional mobility improvements, were assessed using the 10-Meter-Walk Test (10MWT), Timed-Up-and-Go Test (TUG) and 6-Minute-Walk Test (6MinWT) on admission, at 6 weeks, 12 weeks, and 1 year after enrollment. The data were analyzed separately for the 2 training frequency subgroups after the initial 12-week training period, which was identical in both groups. During the 1-year follow-up, HAL-associated walking parameters and independent functional improvements were maintained in all the patients. This result held irrespective of the training frequency. Long-term 1-year maintenance of HAL-associated treadmill walking parameters and of improved independent walking abilities after initial 12 weeks of daily HAL-BWSTT is possible and depends mainly on the patients' ambulatory status accomplished after initial training period. Subsequent regular weekly training, but not higher frequency training, seems to be sufficient to preserve the improvements accomplished.

Functional Outcome of Neurologic-Controlled HAL-Exoskeletal Neurorehabilitation in Chronic Spinal Cord Injury: A Pilot With One Year Treatment and Variable Treatment Frequency

PubMed Central

Schildhauer, Thomas A.; Meindl, Renate C.; Tegenthoff, Martin; Schwenkreis, Peter; Sczesny-Kaiser, Matthias; Grasmücke, Dennis; Fisahn, Christian; Aach, Mirko

2017-01-01

Study Design: Longitudinal prospective study. Objectives: Whether 1-year HAL-BWSTT of chronic spinal cord injured patients can improve independent ambulated mobility further as a function of training frequency, after an initial 3-month training period. Methods: Eight patients with chronic SCI were enrolled. They initially received full standard physical therapy and neurorehabilitation in the acute/subacute posttrauma phase. During this trial, all patients first underwent a daily (5 per week) HAL-BWSTT for 12 weeks. Subsequently, these patients performed a 40-week HAL-BWSTT with a training session frequency of either 1 or 3 to 5 sessions per week. The patients’ functional status including HAL-associated treadmill-walking time, -distance, and -speed with additional analysis of gait pattern, and their independent (without wearing the robot suit) functional mobility improvements, were assessed using the 10-Meter-Walk Test (10MWT), Timed-Up-and-Go Test (TUG) and 6-Minute-Walk Test (6MinWT) on admission, at 6 weeks, 12 weeks, and 1 year after enrollment. The data were analyzed separately for the 2 training frequency subgroups after the initial 12-week training period, which was identical in both groups. Results: During the 1-year follow-up, HAL-associated walking parameters and independent functional improvements were maintained in all the patients. This result held irrespective of the training frequency. Conclusions: Long-term 1-year maintenance of HAL-associated treadmill walking parameters and of improved independent walking abilities after initial 12 weeks of daily HAL-BWSTT is possible and depends mainly on the patients’ ambulatory status accomplished after initial training period. Subsequent regular weekly training, but not higher frequency training, seems to be sufficient to preserve the improvements accomplished. PMID:29238636

Effects of Dual-Task Management and Resistance Training on Gait Performance in Older Individuals: A Randomized Controlled Trial.

PubMed

Wollesen, Bettina; Mattes, Klaus; Schulz, Sören; Bischoff, Laura L; Seydell, L; Bell, Jeffrey W; von Duvillard, Serge P

2017-01-01

Background: Dual-task (DT) training is a well-accepted modality for fall prevention in older adults. DT training should include task-managing strategies such as task switching or task prioritization to improve gait performance under DT conditions. Methods: We conducted a randomized controlled trial to evaluate a balance and task managing training (BDT group) in gait performance compared to a single task (ST) strength and resistance training and a control group, which received no training. A total of 78 older individuals (72.0 ± 4.9 years) participated in this study. The DT group performed task managing training incorporating balance and coordination tasks while the ST group performed resistance training only. Training consisted of 12 weekly sessions, 60 min each, for 12 weeks. We assessed the effects of ST and BDT training on walking performance under ST and DT conditions in independent living elderly adults. ST and DT walking (visual verbal Stroop task) were measured utilizing a treadmill at self-selected walking speed (mean for all groups: 4.4 ± 1 km h -1 ). Specific gait variables, cognitive performance, and fear of falling were compared between all groups. > Results: Training improved gait performance for step length ( p < 0.001) and gait-line (ST: p < 0.01; DT p < 0.05) in both training groups. The BDT training group showed greater improvements in step length ( p < 0.001) and gait-line ( p < 0.01) during DT walking but did not have changes in cognitive performance. Both interventions reduced fear of falling ( p < 0.05). Conclusion: Implementation of task management strategies into balance and strength training in our population revealed a promising modality to prevent falls in older individuals. Trial registration: German register of clinical trials DRKS00012382.

Inducing hindlimb locomotor recovery in adult rat after complete thoracic spinal cord section using repeated treadmill training with perineal stimulation only

PubMed Central

Alluin, Olivier; Delivet-Mongrain, Hugo

2015-01-01

Although a complete thoracic spinal cord section in various mammals induces paralysis of voluntary movements, the spinal lumbosacral circuitry below the lesion retains its ability to generate hindlimb locomotion. This important capacity may contribute to the overall locomotor recovery after partial spinal cord injury (SCI). In rats, it is usually triggered by pharmacological and/or electrical stimulation of the cord while a robot sustains the animals in an upright posture. In the present study we daily trained a group of adult spinal (T7) rats to walk with the hindlimbs for 10 wk (10 min/day for 5 days/wk), using only perineal stimulation. Kinematic analysis and terminal electromyographic recordings revealed a strong effect of training on the reexpression of hindlimb locomotion. Indeed, trained animals gradually improved their locomotion while untrained animals worsened throughout the post-SCI period. Kinematic parameters such as averaged and instant swing phase velocity, step cycle variability, foot drag duration, off period duration, and relationship between the swing features returned to normal values only in trained animals. The present results clearly demonstrate that treadmill training alone, in a normal horizontal posture, elicited by noninvasive perineal stimulation is sufficient to induce a persistent hindlimb locomotor recovery without the need for more complex strategies. This provides a baseline level that should be clearly surpassed if additional locomotor-enabling procedures are added. Moreover, it has a clinical value since intrinsic spinal reorganization induced by training should contribute to improve locomotor recovery together with afferent feedback and supraspinal modifications in patients with incomplete SCI. PMID:26203108

Glucose transporters and maximal transport are increased in endurance-trained rat soleus

NASA Technical Reports Server (NTRS)

Slentz, C. A.; Gulve, E. A.; Rodnick, K. J.; Henriksen, E. J.; Youn, J. H.; Holloszy, J. O.

1992-01-01

Voluntary wheel running induces an increase in the concentration of the regulatable glucose transporter (GLUT4) in rat plantaris muscle but not in soleus muscle (K. J. Rodnick, J. O. Holloszy, C. E. Mondon, and D. E. James. Diabetes 39: 1425-1429, 1990). Wheel running also causes hypertrophy of the soleus in rats. This study was undertaken to ascertain whether endurance training that induces enzymatic adaptations but no hypertrophy results in an increase in the concentration of GLUT4 protein in rat soleus (slow-twitch red) muscle and, if it does, to determine whether there is a concomitant increase in maximal glucose transport activity. Female rats were trained by treadmill running at 25 m/min up a 15% grade, 90 min/day, 6 days/wk for 3 wk. This training program induced increases of 52% in citrate synthase activity, 66% in hexokinase activity, and 47% in immunoreactive GLUT4 protein concentration in soleus muscles without causing hypertrophy. Glucose transport activity stimulated maximally with insulin plus contractile activity was increased to roughly the same extent (44%) as GLUT4 protein content in soleus muscle by the treadmill exercise training. In a second set of experiments, we examined whether a swim-training program increases glucose transport activity in the soleus in the presence of a maximally effective concentration of insulin. The swimming program induced a 44% increase in immunoreactive GLUT4 protein concentration. Glucose transport activity maximally stimulated with insulin was 62% greater in soleus muscle of the swimmers than in untrained controls. Training did not alter the basal rate of 2-deoxyglucose uptake.(ABSTRACT TRUNCATED AT 250 WORDS).

Improved Training Method for Rapid Rehabilitation of Amputees

DTIC Science & Technology

2013-03-01

crowded environments, stairs , ramps, and hills. The key factor that limits the ability of amputees to achieve maximum functional capabilities is falls...Method for evoking a trip response using a treadmill based perturbation during locomotion”, has been submitted to the Journal of Biomechanics o

Effects of repetitive transcranial magnetic stimulation and trans-spinal direct current stimulation associated with treadmill exercise in spinal cord and cortical excitability of healthy subjects: A triple-blind, randomized and sham-controlled study

PubMed Central

Albuquerque, Plínio Luna; Campêlo, Mayara; Mendonça, Thyciane; Fontes, Luís Augusto Mendes; Brito, Rodrigo de Mattos

2018-01-01

Repetitive transcranial magnetic stimulation (rTMS) over motor cortex and trans-spinal direct current stimulation (tsDCS) modulate corticospinal circuits in healthy and injured subjects. However, their associated effects with physical exercise is still not defined. This study aimed to investigate the effect of three different settings of rTMS and tsDCS combined with treadmill exercise on spinal cord and cortical excitability of healthy subjects. We performed a triple blind, randomized, sham-controlled crossover study with 12 healthy volunteers who underwent single sessions of rTMS (1Hz, 20Hz and Sham) and tsDCS (anodal, cathodal and Sham) associated with 20 minutes of treadmill walking. Cortical excitability was assessed by motor evoked potential (MEP) and spinal cord excitability by the Hoffmann reflex (Hr), nociceptive flexion reflex (NFR) and homosynaptic depression (HD). All measures were assessed before, immediately, 30 and 60 minutes after the experimental procedures. Our results demonstrated that anodal tsDCS/treadmill exercise reduced MEP’s amplitude and NFR’s area compared to sham condition, conversely, cathodal tsDCS/treadmill exercise increased NFR’s area. High-frequency rTMS increased MEP’s amplitude and NFR’s area compared to sham condition. Anodal tsDCS/treadmill exercise and 20Hz rTMS/treadmill exercise reduced Hr amplitude up to 30 minutes after stimulation offset and no changes were observed in HD measures. We demonstrated that tsDCS and rTMS combined with treadmill exercise modulated cortical and spinal cord excitability through different mechanisms. tsDCS modulated spinal reflexes in a polarity-dependent way acting at local spinal circuits while rTMS probably promoted changes in the presynaptic inhibition of spinal motoneurons. In addition, the association of two neuromodulatory techniques induced long-lasting changes. PMID:29596524

Effects of repetitive transcranial magnetic stimulation and trans-spinal direct current stimulation associated with treadmill exercise in spinal cord and cortical excitability of healthy subjects: A triple-blind, randomized and sham-controlled study.

PubMed

Albuquerque, Plínio Luna; Campêlo, Mayara; Mendonça, Thyciane; Fontes, Luís Augusto Mendes; Brito, Rodrigo de Mattos; Monte-Silva, Katia

2018-01-01

Repetitive transcranial magnetic stimulation (rTMS) over motor cortex and trans-spinal direct current stimulation (tsDCS) modulate corticospinal circuits in healthy and injured subjects. However, their associated effects with physical exercise is still not defined. This study aimed to investigate the effect of three different settings of rTMS and tsDCS combined with treadmill exercise on spinal cord and cortical excitability of healthy subjects. We performed a triple blind, randomized, sham-controlled crossover study with 12 healthy volunteers who underwent single sessions of rTMS (1Hz, 20Hz and Sham) and tsDCS (anodal, cathodal and Sham) associated with 20 minutes of treadmill walking. Cortical excitability was assessed by motor evoked potential (MEP) and spinal cord excitability by the Hoffmann reflex (Hr), nociceptive flexion reflex (NFR) and homosynaptic depression (HD). All measures were assessed before, immediately, 30 and 60 minutes after the experimental procedures. Our results demonstrated that anodal tsDCS/treadmill exercise reduced MEP's amplitude and NFR's area compared to sham condition, conversely, cathodal tsDCS/treadmill exercise increased NFR's area. High-frequency rTMS increased MEP's amplitude and NFR's area compared to sham condition. Anodal tsDCS/treadmill exercise and 20Hz rTMS/treadmill exercise reduced Hr amplitude up to 30 minutes after stimulation offset and no changes were observed in HD measures. We demonstrated that tsDCS and rTMS combined with treadmill exercise modulated cortical and spinal cord excitability through different mechanisms. tsDCS modulated spinal reflexes in a polarity-dependent way acting at local spinal circuits while rTMS probably promoted changes in the presynaptic inhibition of spinal motoneurons. In addition, the association of two neuromodulatory techniques induced long-lasting changes.

Decreases in Maximal Oxygen Uptake Among Army Reserve Officers’ Training Corps Cadets Following Three Months Without Mandatory Physical Training

PubMed Central

LIGUORI, GARY; KREBSBACH, KASSIE; SCHUNA, JOHN

2012-01-01

During the academic year, Army ROTC cadets are required to participate in mandatory physical training; however, during summer months training is not required. The purpose of this study was to determine if there is a change in cadet VO2max after the summer when training is not mandatory. Participants completed a graded exercise treadmill test to determine their VO2max in late spring of 2010 and again in early fall of 2010. Results indicated that over a three-month break from mandatory physical training, a significant decrease in VO2max was seen for both genders in ROTC cadets. PMID:27182392

Effects of treadmill inclination on electromyographic activity and hind limb kinematics in healthy hounds at a walk.

PubMed

Lauer, Susanne K; Hillman, Robert B; Li, Li; Hosgood, Giselle L

2009-05-01

To evaluate the effect of treadmill incline on muscle activity and joint range of motion (ROM) in hind limbs of dogs. 8 purpose-bred healthy adult hounds. Activities of the hamstring (semimembranosus, semitendinosus, and biceps femoris muscles), gluteal (superficial, middle, and deep gluteal muscles), and quadriceps (femoris, vastus lateralis, vastus intermedius, and vastus medialis muscles) muscle groups and hip and stifle joint ROM were measured with surface electrogoniometric and myographic sensors in hounds walking on a treadmill at 0.54 m/s at inclines of 5%, 0%, and -5% in random order. Mean electromyographic activities and mean ROMs at each inclination were compared for swing and stance phases. Treadmill inclination did not affect duration of the stance and swing phases or the whole stride. When treadmill inclination was increased from -5% to 5%, hip joint ROM increased and the degree of stifle joint extension decreased significantly. In the beginning of the stance phase, activity of the hamstring muscle group was significantly increased when walking at a 5% incline versus a 5% decline. In the end of the stance phase, that activity was significantly increased when walking at a 5% incline versus at a 5% decline or on a flat surface. Activity of the gluteal and quadriceps muscle groups was not affected when treadmill inclination changed. Treadmill inclination affected joint kinematics only slightly. Walking on a treadmill at a 5% incline had more potential to strengthen the hamstring muscle group than walking on a treadmill with a flat or declined surface.

Electromechanical gait training with functional electrical stimulation: case studies in spinal cord injury.

PubMed

Hesse, S; Werner, C; Bardeleben, A

2004-06-01

Single case studies. To describe the technique of intensive locomotor training on an electromechanical gait trainer (GT) combined with functional electrical stimulation (FES). Neurological Rehabilitation Clinic, Berlin, Germany. Four spinal cord-injured (SCI) patients, one tetraparetic, two paraparetic, and one patient with an incomplete cauda syndrome, more than 3 months postinjury, who were unable to walk at all, or with two therapists. They received 25 min of locomotor training on the GT plus FES daily for 5 weeks in addition to the regular therapy. The patients tolerated the programme well, and therapists rated the programme less strenuous compared to manually assisted treadmill training. Gait ability improved in all four patients; three patients could walk independently on the floor with the help of technical aids, and one required the help of one therapist after therapy; gait speed and endurance more than doubled, and the gastrocnemius activity increased in the patients with a central paresis. This combined technique allows intensive locomotor therapy in SCI subjects with reduced effort from the therapists. The patients' improved walking ability confirmed the potential of locomotor therapy in SCI subjects.

Enhancing Functional Performance using Sensorimotor Adaptability Training Programs

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Mulavara, A. P.; Peters, B. T.; Brady, R.; Audas, C.; Ruttley, T. M.; Cohen, H. S.

2009-01-01

During the acute phase of adaptation to novel gravitational environments, sensorimotor disturbances have the potential to disrupt the ability of astronauts to perform functional tasks. The goal of this project is to develop a sensorimotor adaptability (SA) training program designed to facilitate recovery of functional capabilities when astronauts transition to different gravitational environments. The project conducted a series of studies that investigated the efficacy of treadmill training combined with a variety of sensory challenges designed to increase adaptability including alterations in visual flow, body loading, and support surface stability.

Implementation of exercise training programs in a hemodialysis unit: effects on physical performance.

PubMed

Bulckaen, Massimo; Capitanini, Alessandro; Lange, Sara; Caciula, Andrea; Giuntoli, Franco; Cupisti, Adamasco

2011-01-01

Exercise training is beneficial for hemodialysis patients, but it should be tailored to individual abilities and willingness to participate. This study evaluated the effects of different 6-month programs of physical activity in 18 patients of a single hemodialysis unit. Before and after a 12-month control period (T0), and following 3 (T3) and 6 (T6) months of training, the patients underwent the 6-minute walk test (6MWT) and constant treadmill test at 3 km/hour speed and 10% grade; spontaneous physical activity was assessed by pedometers. All patients trained for coordination, flexibility and muscular strengthening for 30 minutes within the first 2 hours of hemodialysis sessions: 9 patients underwent home exercise walking training (advised walking group [AWG]); the other 9 patients underwent the advised home training program plus an additional supervised gym training session, twice weekly (supervised walking group [SWG]). In both AWG and SWG, no changes occurred during the control period (232 ± 204 m and 248 ± 187 m at T0). In contrast, endurance performance at treadmill increased at T3 and T6 in the AWG (377 ± 272 m and 615 ± 413 m; p<0.01) and in the SWG (424 ± 272 m and 890 ± 364 m; p<0.001). No unwanted side effects occurred. This study shows that physical exercise programs can safely increase physical performance in hemodialysis patients. The training program should be continued for at least 6 months to increase muscle strength and endurance. Intradialytic exercise and home-based, pedometer-based regimens may be a useful and easy approach, whereas supervised programs can give additional benefits in motivated, selected patients.

A spectrum of exercise training reduces soluble Aβ in a dose-dependent manner in a mouse model of Alzheimer's disease.

PubMed

Moore, Kaitlin M; Girens, Renee E; Larson, Sara K; Jones, Maria R; Restivo, Jessica L; Holtzman, David M; Cirrito, John R; Yuede, Carla M; Zimmerman, Scott D; Timson, Benjamin F

2016-01-01

Physical activity has long been hypothesized to influence the risk and pathology of Alzheimer's disease. However, the amount of physical activity necessary for these benefits is unclear. We examined the effects of three months of low and high intensity exercise training on soluble Aβ40 and Aβ42 levels in extracellular enriched fractions from the cortex and hippocampus of young Tg2576 mice. Low (LOW) and high (HI) intensity exercise training animals ran at speeds of 15m/min on a level treadmill and 32 m/min at a 10% grade, respectively for 60 min per day, five days per week, from three to six months of age. Sedentary mice (SED) were placed on a level, non-moving, treadmill for the same duration. Soleus muscle citrate synthase activity increased by 39% in the LOW group relative to SED, and by 71% in the HI group relative to LOW, indicating an exercise training effect in these mice. Soluble Aβ40 concentrations decreased significantly in an exercise training dose-dependent manner in the cortex. In the hippocampus, concentrations were decreased significantly in the HI group relative to LOW and SED. Soluble Aβ42 levels also decreased significantly in an exercise training dose-dependent manner in both the cortex and hippocampus. Five proteins involved in Aβ clearance (neprilysin, IDE, MMP9, LRP1 and HSP70) were elevated by exercise training with its intensity playing a role in each case. Our data demonstrate that exercise training reduces extracellular soluble Aβ in the brains of Tg2576 mice in a dose-dependent manner through an up-regulation of Aβ clearance. Copyright © 2015 Elsevier Inc. All rights reserved.

Moderate Treadmill Exercise Protects Synaptic Plasticity of the Dentate Gyrus and Related Signaling Cascade in a Rat Model of Alzheimer's Disease.

PubMed

Dao, An T; Zagaar, Munder A; Alkadhi, Karim A

2015-12-01

The dentate gyrus (DG) of the hippocampus is known to be more resistant to the effects of various external factors than other hippocampal areas. This study investigated the neuroprotective effects of moderate treadmill exercise on early-phase long-term potentiation (E-LTP) and its molecular signaling pathways in the DG of amyloid β rat model of sporadic Alzheimer's disease (AD). Animals were preconditioned to run on treadmill for 4 weeks and concurrently received ICV infusion of Aβ₁₋₄₂ peptides (250 pmol/day) during the third and fourth weeks of exercise training. We utilized in vivo electrophysiological recordings to assess the effect of exercise and/or AD pathology on basal synaptic transmission and E-LTP magnitude of the perforant pathway synapses in urethane-anesthetized rats. Immunoblotting analysis was used to quantify changes in the levels of learning and memory-related key signaling molecules. The AD-impaired basal synaptic transmission and suppression of E-LTP in the DG were prevented by prior moderate treadmill exercise. In addition, exercise normalized the basal levels of memory and E-LTP-related signaling molecules including Ca(2+)/calmodulin-dependent protein kinase II (CaMKII), calcineurin (PP2B), and brain-derived neurotrophic factor (BDNF). Exercise also prevented the reduction of phosphorylated CaMKII and aberrant increase of PP2B seen after E-LTP induction in amyloid-infused rats. Our data suggests that by restoring the balance of kinase-phosphatase, 4 weeks of moderate treadmill exercise prevents DG synaptic deficits and deleterious alterations in signaling pathways associated with AD.

Effects of manipulating the duration and intensity of aerobic training sessions on the physical performance of rats.

PubMed

Teixeira-Coelho, Francisco; Fonseca, Cletiana Gonçalves; Barbosa, Nicolas Henrique Santos; Vaz, Filipe Ferreira; Cordeiro, Letícia Maria de Souza; Coimbra, Cândido Celso; Pires, Washington; Soares, Danusa Dias; Wanner, Samuel Penna

2017-01-01

This study investigated the effects of manipulating the load components of aerobic training sessions on the physical performance of rats. To achieve this purpose, adult male Wistar rats were divided into four groups: an untrained control (CON) group and training groups with a predominant overload in intensity (INT) or duration (DUR) or alternating and similar overloads in intensity and duration (ID). Prior to, during, and after 8 weeks of the control or training protocols, the performance of the rats (evaluated by their workload) was determined during fatiguing, incremental-speed treadmill running. Two additional incremental running tests were performed prior to and at the end of the protocols to measure the peak rate of oxygen consumption (VO2peak). As expected, the rats in the trained groups exhibited increased performance, whereas the untrained rats showed stable performance throughout the 8 weeks. Notably, the performance gain exhibited by the DUR rats reached a plateau after the 4th week. This plateau was not present in the INT or ID rats, which exhibited increased performance at the end of training protocol compared with the DUR rats. None of the training protocols changed the VO2peak values; however, these values were attained at faster speeds, which indicated increased running economy. In conclusion, our findings demonstrate that the training protocols improved the physical performance of rats, likely resulting from enhanced running economy. Furthermore, compared with overload in duration, overload in the intensity of training sessions was more effective at inducing performance improvements across the 8 weeks of the study.

Effects of manipulating the duration and intensity of aerobic training sessions on the physical performance of rats

PubMed Central

Teixeira-Coelho, Francisco; Fonseca, Cletiana Gonçalves; Barbosa, Nicolas Henrique Santos; Vaz, Filipe Ferreira; Cordeiro, Letícia Maria de Souza; Coimbra, Cândido Celso; Pires, Washington; Soares, Danusa Dias

2017-01-01

This study investigated the effects of manipulating the load components of aerobic training sessions on the physical performance of rats. To achieve this purpose, adult male Wistar rats were divided into four groups: an untrained control (CON) group and training groups with a predominant overload in intensity (INT) or duration (DUR) or alternating and similar overloads in intensity and duration (ID). Prior to, during, and after 8 weeks of the control or training protocols, the performance of the rats (evaluated by their workload) was determined during fatiguing, incremental-speed treadmill running. Two additional incremental running tests were performed prior to and at the end of the protocols to measure the peak rate of oxygen consumption (VO2peak). As expected, the rats in the trained groups exhibited increased performance, whereas the untrained rats showed stable performance throughout the 8 weeks. Notably, the performance gain exhibited by the DUR rats reached a plateau after the 4th week. This plateau was not present in the INT or ID rats, which exhibited increased performance at the end of training protocol compared with the DUR rats. None of the training protocols changed the VO2peak values; however, these values were attained at faster speeds, which indicated increased running economy. In conclusion, our findings demonstrate that the training protocols improved the physical performance of rats, likely resulting from enhanced running economy. Furthermore, compared with overload in duration, overload in the intensity of training sessions was more effective at inducing performance improvements across the 8 weeks of the study. PMID:28841706

Dairy Attenuates Weight Gain to a Similar Extent as Exercise in Rats Fed a High-Fat, High-Sugar Diet.

PubMed

Trottier, Sarah K; MacPherson, Rebecca E K; Knuth, Carly M; Townsend, Logan K; Peppler, Willem T; Mikhaeil, John S; Leveille, Cam F; LeBlanc, Paul J; Shearer, Jane; Reimer, Raylene A; Wright, David C

2017-10-01

To compare the individual and combined effects of dairy and endurance exercise training in reducing weight gain and adiposity in a rodent model of diet-induced obesity. An 8-week feeding intervention of a high-fat, high-sugar diet was used to induce obesity in male Sprague-Dawley rats. Rats were then assigned to one of four groups for 6 weeks: (1) casein sedentary (casein-S), (2) casein exercise (casein-E), (3) dairy sedentary (dairy-S), and (4) dairy exercise (dairy-E). Rats were exercise trained by treadmill running 5 d/wk. Dairy-E prevented weight gain to a greater extent than either dairy or exercise alone. Adipose tissue and liver mass were reduced to a similar extent in dairy-S, casein-E, and dairy-E groups. Differences in weight gain were not explained by food intake or total energy expenditure. The total amount of lipid excreted was greater in the dairy-S compared to casein-S and dairy-E groups. This study provides evidence that dairy limits weight gain to a similar extent as exercise training and the combined effects are greater than either intervention alone. While exercise training reduces weight gain through increases in energy expenditure, dairy appears to increase lipid excretion in the feces. © 2017 The Obesity Society.

Unmatched speed perceptions between overground and treadmill manual wheelchair propulsion in long-term manual wheelchair users.

PubMed

Chénier, Félix; Champagne, Audrey; Desroches, Guillaume; Gagnon, Dany H

2018-03-01

Manual wheelchair (MWC) propulsion is increasingly assessed on a motorized treadmill (TM), which is often considered more ecologically valid than stationary rollers. However, no clear consensus on the similarities between overground (OG) and TM propulsion has yet been reached. Furthermore, no study has investigated the participants' perceptions of propelling a MWC on a TM compared to OG. The present study aims to assess the perception of speed when propelling on a TM vs OG, and to relate this perception to measured spatiotemporal variables, kinetics and work. In this repeated-measures study, the propulsion's spatiotemporal variables, kinetics, and work of nineteen experienced wheelchair users with a spinal cord injury were compared between three conditions: 1) OG at a self-selected speed, 2) on a TM at a self-selected speed perceived as being similar to the OG speed (TM perceived ), and 3) on a TM at the same speed as OG (TM matched ). Each variable was compared between conditions using an analysis of variance for repeated measures. All participants selected a lower speed for TM perceived than OG, with a difference of -0.6 m/s (-44%). This adaptation may be due to a combination of two factors: 1) the absence of speed information, and 2) the feeling of urgency to grab the wheels during the recovery phase. The power output, work per cycle, and work per minute were also much lower on TM perceived than OG. However, in contrast to other work on MWC propulsion on a TM, the kinetic variables assessed were all similar between the OG and TM matched conditions. Training on a TM should be performed at a speed that matches the OG speed and not at a self-selected speed on the TM, which would reduce the power output and work and therefore reduce the efficiency of the training. Copyright © 2018 Elsevier B.V. All rights reserved.

Everyday multitasking habits: University students seamlessly text and walk on a split-belt treadmill.

PubMed

Hinton, Dorelle Clare; Cheng, Yeu-Yao; Paquette, Caroline

2018-01-01

With increasing numbers of adults owning a cell phone, walking while texting has become common in daily life. Previous research has shown that walking is not entirely automated and when challenged with a secondary task, normal walking patterns are disrupted. This study investigated the effects of texting on the walking patterns of healthy young adults while walking on a split-belt treadmill. Following full adaptation to the split-belt treadmill, thirteen healthy adults (23±3years) walked on a tied-belt and split-belt treadmill, both with and without a simultaneous texting task. Inertial-based movement monitors recorded spatiotemporal components of gait and stability. Measures of spatial and temporal gait symmetry were calculated to compare gait patterns between treadmill (tied-belt and split-belt) and between texting (absent or present) conditions. Typing speed and accuracy were recorded to monitor texting performance. Similar to previous research, the split-belt treadmill caused an alteration to both spatial and temporal aspects of gait, but not to time spent in dual support or stability. However, all participants successfully maintained balance while walking and were able to perform the texting task with no significant change to accuracy or speed on either treadmill. From this paradigm it is evident that when university students are challenged to text while walking on either a tied-belt or split-belt treadmill, without any other distraction, their gait is minimally affected and they are able to maintain texting performance. Copyright © 2017 Elsevier B.V. All rights reserved.

Endurance performance and nocturnal HRV indices.

PubMed

Nummela, A; Hynynen, E; Kaikkonen, P; Rusko, H

2010-03-01

The effects of endurance training on endurance performance characteristics and cardiac autonomic modulation during night sleep were investigated. Twenty-four sedentary subjects trained over four weeks two hours per week at an average running intensity of 76+/-4% of their heart rate reserve. The R to R ECG-intervals were recorded and heart rate variability indices including high frequency power (HFP) were calculated for the nights following the training days every week. The subjects were divided into responders and non-responders according to the improvements in the maximal velocity of the incremental treadmill test (v(max)). The responders improved their v(max) by 10.9+/-46 % (p < 0.001) while no changes were observed in the non-responders (1.6+/-3.0%), although there were no differences in any training load variables between the groups. In the responders nocturnal HFP was significantly higher during the fourth training week compared to the first training week (p=0.036). Furthermore, a significant correlation was observed between the change in v(max) and the change in nocturnal HFP (r=0.482, p=0.042). It was concluded that after similar training, an increase in cardiac vagal modulation was related to improved v(max) in the sedentary subjects. Georg Thieme Verlag KG Stuttgart.New York.

Comparison of a robotic-assisted gait training program with a program of functional gait training for children with cerebral palsy: design and methods of a two group randomized controlled cross-over trial.

PubMed

Hilderley, Alicia J; Fehlings, Darcy; Lee, Gloria W; Wright, F Virginia

2016-01-01

Enhancement of functional ambulation is a key goal of rehabilitation for children with cerebral palsy (CP) who experience gross motor impairment. Physiotherapy (PT) approaches often involve overground and treadmill-based gait training to promote motor learning, typically as free walking or with body-weight support. Robotic-assisted gait training (RAGT), using a device such as the Lokomat ® Pro, may permit longer training duration, faster and more variable gait speeds, and support walking pattern guidance more than overground/treadmill training to further capitalize on motor learning principles. Single group pre-/post-test studies have demonstrated an association between RAGT and moderate to large improvements in gross motor skills, gait velocity and endurance. A single published randomized controlled trial (RCT) comparing RAGT to a PT-only intervention showed no difference in gait kinematics. However, gross motor function and walking endurance were not evaluated and conclusions were limited by a large PT group drop-out rate. In this two-group cross-over RCT, children are randomly allocated to the RAGT or PT arm (each with twice weekly sessions for eight weeks), with cross-over to the other intervention arm following a six-week break. Both interventions are grounded in motor learning principles with incorporation of individualized mobility-based goals. Sessions are fully operationalized through manualized, menu-based protocols and post-session documentation to enhance internal and external validity. Assessments occur pre/post each intervention arm (four time points total) by an independent assessor. The co-primary outcomes are gross motor functional ability (Gross Motor Function Measure (GMFM-66) and 6-minute walk test), with secondary outcome measures assessing: (a) individualized goals; (b) gait variables and daily walking amounts; and (c) functional abilities, participation and quality of life. Investigators and statisticians are blinded to study group allocation in the analyses, and assessors are blinded to treatment group. The primary analysis will be the pre- to post-test differences (change scores) of the GMFM-66 and 6MWT between RAGT and PT groups. This study is the first RCT comparing RAGT to an active gait-related PT intervention in paediatric CP that addresses gait-related gross motor, participation and individualized outcomes, and as such, is expected to provide comprehensive information as to the potential role of RAGT in clinical practice. Trial registration ClinicalTrials.gov NCT02196298.

Effects of high-intensity interval training and moderate-intensity continuous training on glycaemic control and skeletal muscle mitochondrial function in db/db mice.

PubMed

Chavanelle, Vivien; Boisseau, Nathalie; Otero, Yolanda F; Combaret, Lydie; Dardevet, Dominique; Montaurier, Christophe; Delcros, Geoffrey; Peltier, Sébastien L; Sirvent, Pascal

2017-03-16

Physical activity is known as an effective strategy for prevention and treatment of Type 2 Diabetes. The aim of this work was to compare the effects of a traditional Moderate Intensity Continuous Training (MICT) with a High Intensity Interval Training (HIIT) on glucose metabolism and mitochondrial function in diabetic mice. Diabetic db/db male mice (N = 25) aged 6 weeks were subdivided into MICT, HIIT or control (CON) group. Animals in the training groups ran on a treadmill 5 days/week during 10 weeks. MICT group ran for 80 min (0° slope) at 50-60% of maximal speed (Vmax) reached during an incremental test. HIIT group ran thirteen times 4 minutes (20° slope) at 85-90% of Vmax separated by 2-min-rest periods. HIIT lowered fasting glycaemia and HbA1c compared with CON group (p < 0.05). In all mitochondrial function markers assessed, no differences were noted between the three groups except for total amount of electron transport chain proteins, slightly increased in the HIIT group vs CON. Western blot analysis revealed a significant increase of muscle Glut4 content (about 2 fold) and higher insulin-stimulated Akt phosphorylation ratios in HIIT group. HIIT seems to improve glucose metabolism more efficiently than MICT in diabetic mice by mechanisms independent of mitochondrial adaptations.

Robot-assisted walking training for individuals with Parkinson’s disease: a pilot randomized controlled trial

PubMed Central

2013-01-01

Background Over the last years, the introduction of robotic technologies into Parkinson’s disease rehabilitation settings has progressed from concept to reality. However, the benefit of robotic training remains elusive. This pilot randomized controlled observer trial is aimed at investigating the feasibility, the effectiveness and the efficacy of new end-effector robot training in people with mild Parkinson’s disease. Methods Design. Pilot randomized controlled trial. Setting. Robot assisted gait training (EG) compared to treadmill training (CG). Participants. Twenty cognitively intact participants with mild Parkinson’s disease and gait disturbance. Interventions. The EG underwent a rehabilitation programme of robot assisted walking for 40 minutes, 5 times a week for 4 weeks. The CG received a treadmill training programme for 40 minutes, 5 times a week for 4 weeks. Main outcome measures. The outcome measure of efficacy was recorded by gait analysis laboratory. The assessments were performed at the beginning (T0) and at the end of the treatment (T1). The main outcome was the change in velocity. The feasibility of the intervention was assessed by recording exercise adherence and acceptability by specific test. Results Robot training was feasible, acceptable, safe, and the participants completed 100% of the prescribed training sessions. A statistically significant improvement in gait index was found in favour of the EG (T0 versus T1). In particular, the statistical analysis of primary outcome (gait speed) using the Friedman test showed statistically significant improvements for the EG (p = 0,0195). The statistical analysis performed by Friedman test of Step length left (p = 0,0195) and right (p = 0,0195) and Stride length left (p = 0,0078) and right (p = 0,0195) showed a significant statistical gain. No statistically significant improvements on the CG were found. Conclusions Robot training is a feasible and safe form of rehabilitative exercise for cognitively intact people with mild PD. This original approach can contribute to increase a short time lower limb motor recovery in idiopathic PD patients. The focus on the gait recovery is a further characteristic that makes this research relevant to clinical practice. On the whole, the simplicity of treatment, the lack of side effects, and the positive results from patients support the recommendation to extend the use of this treatment. Further investigation regarding the long-time effectiveness of robot training is warranted. Trial registration ClinicalTrials.gov NCT01668407 PMID:23706025

Gait Parameter Adjustments for Walking on a Treadmill at Preferred, Slower, and Faster Speeds in Older Adults with Down Syndrome

PubMed Central

Smith, Beth A.; Kubo, Masayoshi; Ulrich, Beverly D.

2012-01-01

The combined effects of ligamentous laxity, hypotonia, and decrements associated with aging lead to stability-enhancing foot placement adaptations during routine overground walking at a younger age in adults with Down syndrome (DS) compared to their peers with typical development (TD). Our purpose here was to examine real-time adaptations in older adults with DS by testing their responses to walking on a treadmill at their preferred speed and at speeds slower and faster than preferred. We found that older adults with DS were able to adapt their gait to slower and faster than preferred treadmill speeds; however, they maintained their stability-enhancing foot placements at all speeds compared to their peers with TD. All adults adapted their gait patterns similarly in response to faster and slower than preferred treadmill-walking speeds. They increased stride frequency and stride length, maintained step width, and decreased percent stance as treadmill speed increased. Older adults with DS, however, adjusted their stride frequencies significantly less than their peers with TD. Our results show that older adults with DS have the capacity to adapt their gait parameters in response to different walking speeds while also supporting the need for intervention to increase gait stability. PMID:22693497

Power output measurement during treadmill cycling.

PubMed

Coleman, D A; Wiles, J D; Davison, R C R; Smith, M F; Swaine, I L

2007-06-01

The study aim was to consider the use of a motorised treadmill as a cycling ergometry system by assessing predicted and recorded power output values during treadmill cycling. Fourteen male cyclists completed repeated cycling trials on a motorised treadmill whilst riding their own bicycle fitted with a mobile ergometer. The speed, gradient and loading via an external pulley system were recorded during 20-s constant speed trials and used to estimate power output with an assumption about the contribution of rolling resistance. These values were then compared with mobile ergometer measurements. To assess the reliability of measured power output values, four repeated trials were conducted on each cyclist. During level cycling, the recorded power output was 257.2 +/- 99.3 W compared to the predicted power output of 258.2 +/- 99.9 W (p > 0.05). For graded cycling, there was no significant difference between measured and predicted power output, 268.8 +/- 109.8 W vs. 270.1 +/- 111.7 W, p > 0.05, SEE 1.2 %. The coefficient of variation for mobile ergometer power output measurements during repeated trials ranged from 1.5 % (95 % CI 1.2 - 2.0 %) to 1.8 % (95 % CI 1.5 - 2.4 %). These results indicate that treadmill cycling can be used as an ergometry system to assess power output in cyclists with acceptable accuracy.

Does Nordic walking improves the postural control and gait parameters of women between the age 65 and 74: a randomized trial

PubMed Central

Kocur, Piotr; Wiernicka, Marzena; Wilski, Maciej; Kaminska, Ewa; Furmaniuk, Lech; Maslowska, Marta Flis; Lewandowski, Jacek

2015-01-01

[Purpose] To assess the effect of 12-weeks Nordic walking training on gait parameters and some elements of postural control. [Subjects and Methods] Sixty-seven women aged 65 to 74 years were enrolled in this study. The subjects were divided into a Nordic Walking group (12 weeks of Nordic walking training, 3 times a week for 75 minutes) and a control group. In both study groups, a set of functional tests were conducted at the beginning and at the end of the study: the Forward Reach Test (FRT) and the Upward Reach Test (URT) on a stabilometric platform, and the analysis of gait parameters on a treadmill. [Results] The NW group showed improvements in: the range of reach in the FRT test and the URT test in compared to the control group. The length of the gait cycle and gait cycle frequency also showed changes in the NW group compared to the control group. [Conclusion] A 12-week NW training program had a positive impact on selected gait parameters and may improve the postural control of women aged over 65 according to the results selected functional tests. PMID:26834341

Does Nordic walking improves the postural control and gait parameters of women between the age 65 and 74: a randomized trial.

PubMed

Kocur, Piotr; Wiernicka, Marzena; Wilski, Maciej; Kaminska, Ewa; Furmaniuk, Lech; Maslowska, Marta Flis; Lewandowski, Jacek

2015-12-01

[Purpose] To assess the effect of 12-weeks Nordic walking training on gait parameters and some elements of postural control. [Subjects and Methods] Sixty-seven women aged 65 to 74 years were enrolled in this study. The subjects were divided into a Nordic Walking group (12 weeks of Nordic walking training, 3 times a week for 75 minutes) and a control group. In both study groups, a set of functional tests were conducted at the beginning and at the end of the study: the Forward Reach Test (FRT) and the Upward Reach Test (URT) on a stabilometric platform, and the analysis of gait parameters on a treadmill. [Results] The NW group showed improvements in: the range of reach in the FRT test and the URT test in compared to the control group. The length of the gait cycle and gait cycle frequency also showed changes in the NW group compared to the control group. [Conclusion] A 12-week NW training program had a positive impact on selected gait parameters and may improve the postural control of women aged over 65 according to the results selected functional tests.

Effects of Visual Feedback Distortion on Gait Adaptation: Comparison of Implicit Visual Distortion Versus Conscious Modulation on Retention of Motor Learning.

PubMed

Kim, Seung-Jae; Ogilvie, Mitchell; Shimabukuro, Nathan; Stewart, Trevor; Shin, Joon-Ho

2015-09-01

Visual feedback can be used during gait rehabilitation to improve the efficacy of training. We presented a paradigm called visual feedback distortion; the visual representation of step length was manipulated during treadmill walking. Our prior work demonstrated that an implicit distortion of visual feedback of step length entails an unintentional adaptive process in the subjects' spatial gait pattern. Here, we investigated whether the implicit visual feedback distortion, versus conscious correction, promotes efficient locomotor adaptation that relates to greater retention of a task. Thirteen healthy subjects were studied under two conditions: (1) we implicitly distorted the visual representation of their gait symmetry over 14 min, and (2) with help of visual feedback, subjects were told to walk on the treadmill with the intent of attaining the gait asymmetry observed during the first implicit trial. After adaptation, the visual feedback was removed while subjects continued walking normally. Over this 6-min period, retention of preserved asymmetric pattern was assessed. We found that there was a greater retention rate during the implicit distortion trial than that of the visually guided conscious modulation trial. This study highlights the important role of implicit learning in the context of gait rehabilitation by demonstrating that training with implicit visual feedback distortion may produce longer lasting effects. This suggests that using visual feedback distortion could improve the effectiveness of treadmill rehabilitation processes by influencing the retention of motor skills.

Force properties of skinned cardiac muscle following increasing volumes of aerobic exercise in rats.

PubMed

Boldt, Kevin Rudi; Rios, Jaqueline Lourdes; Joumaa, Venus; Herzog, Walter

2018-05-03

The positive effects of chronic endurance exercise training on health and performance have been well documented. These positive effects have been evaluated primarily at the structural level, and work has begun to evaluate mechanical adaptations of the myocardium. However, it remains poorly understood how the volume of exercise training affects cardiac adaptation. In order to gain some understanding, we subjected three-month-old Sprague-Dawley rats (N=23) to treadmill running for eleven weeks at one of three exercise volumes (moderate, high, and extra high). Following training, hearts were excised and mechanical testing was completed on skinned trabecular fiber bundles. Performance on a maximal fitness test was dose-dependent upon training volume, where greater levels of training led to greater performance. No differences were observed between animals from any group for active stress production. Heart mass and passive stress increases in a dose-dependent manner for animals in the control, moderate, and high duration groups. However, hearts from animals in the extra high duration group presented with inhibited responses for heart mass and passive stress, despite performing greatest on a graded treadmill fitness test. These results suggest that heart mass and passive stress adapt in a dose-dependent manner, until exercise becomes excessive and adaptation is inhibited. Our findings are in agreement with the beneficial role exercise has in cardiac adaptation. However, excessive exercise comes with risks of maladaptation which must be weighed against the desire to increase performance.

Early postnatal motor experience shapes the motor properties of C57BL/6J adult mice.

PubMed

Serradj, Nadjet; Picquet, Florence; Jamon, Marc

2013-11-01

This study aimed to evaluate the long-term consequences of early motor training on the muscle phenotype and motor output of middle-aged C57BL/6J mice. Neonatal mice were subjected to a variety of motor training procedures, for 3 weeks during the period of acquisition of locomotion. These procedures are widely used for motor training in adults; they include enriched environment, forced treadmill, chronic centrifugation, and hindlimb suspension. At 9 months, the mice reared in the enriched environment showed a slower type of fibre in slow muscles and a faster type in fast muscles, improved performance in motor tests, and a modified gait and body posture while walking. The proportion of fibres in the postural muscles of centrifuged mice did not change, but these mice showed improved resistance to fatigue. The suspended mice showed increased persistence of immature hybrid fibres in the tibialis, with a slower shift in the load-bearing soleus, without any behavioural changes. The forced treadmill was very stressful for the mice, but had limited effects on motor output, although a slower profile was observed in the tibialis. These results support the hypothesis that motor experience during a critical period of motor development shapes muscle phenotype and motor output. The different impacts of the various training procedures suggest that motor performance in adults can be optimized by appropriate training during a defined period of motor development. © 2013 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Trunk motion visual feedback during walking improves dynamic balance in older adults: Assessor blinded randomized controlled trial.

PubMed

Anson, Eric; Ma, Lei; Meetam, Tippawan; Thompson, Elizabeth; Rathore, Roshita; Dean, Victoria; Jeka, John

2018-05-01

Virtual reality and augmented feedback have become more prevalent as training methods to improve balance. Few reports exist on the benefits of providing trunk motion visual feedback (VFB) during treadmill walking, and most of those reports only describe within session changes. To determine whether trunk motion VFB treadmill walking would improve over-ground balance for older adults with self-reported balance problems. 40 adults (75.8 years (SD 6.5)) with self-reported balance difficulties or a history of falling were randomized to a control or experimental group. Everyone walked on a treadmill at a comfortable speed 3×/week for 4 weeks in 2 min bouts separated by a seated rest. The control group was instructed to look at a stationary bulls-eye target while the experimental group also saw a moving cursor superimposed on the stationary bulls-eye that represented VFB of their walking trunk motion. The experimental group was instructed to keep the cursor in the center of the bulls-eye. Somatosensory (monofilaments and joint position testing) and vestibular function (canal specific clinical head impulses) was evaluated prior to intervention. Balance and mobility were tested before and after the intervention using Berg Balance Test, BESTest, mini-BESTest, and Six Minute Walk. There were no significant differences between groups before the intervention. The experimental group significantly improved on the BESTest (p = 0.031) and the mini-BEST (p = 0.019). The control group did not improve significantly on any measure. Individuals with more profound sensory impairments had a larger improvement on dynamic balance subtests of the BESTest. Older adults with self-reported balance problems improve their dynamic balance after training using trunk motion VFB treadmill walking. Individuals with worse sensory function may benefit more from trunk motion VFB during walking than individuals with intact sensory function. Copyright © 2018 Elsevier B.V. All rights reserved.

Exercise training versus T3 and T4 hormones treatment: The differential benefits of thyroid hormones on the parasympathetic drive of infarcted rats.

PubMed

Teixeira, Rayane Brinck; Zimmer, Alexsandra; de Castro, Alexandre Luz; Carraro, Cristina Campos; Casali, Karina Rabello; Dias, Ingrid Gonçalves Machuca; Godoy, Alessandra Eifler Guerra; Litvin, Isnard Elman; Belló-Klein, Adriane; da Rosa Araujo, Alex Sander

2018-03-01

This study aimed to investigate whether beneficial effects of thyroid hormones are comparable to those provided by the aerobic exercise training, to verify its applicability as a therapeutic alternative to reverse the pathological cardiac remodeling post-infarction. Male rats were divided into SHAM-operated (SHAM), myocardial infarction (MI), MI subjected to exercise training (MIE), and MI who received T3 and T4 treatment (MIH) (n = 8/group). MI, MIE and MIH groups underwent an infarction surgery while SHAM was SHAM-operated. One-week post-surgery, MIE and MIH groups started the exercise training protocol (moderate intensity on treadmill), or the T3 (1.2 μg/100 g/day) and T4 (4.8 μg/100 g/day) hormones treatment by gavage, respectively, meanwhile SHAM and MI had no intervention for 9 weeks. The groups were accompanied until 74 days after surgery, when all animals were anesthetized, left ventricle echocardiography and femoral catheterization were performed, followed by euthanasia and left ventricle collection for morphological, oxidative stress, and intracellular kinases expression analysis. Thyroid hormones treatment was more effective in cardiac dilation and infarction area reduction, while exercise training provided more protection against fibrosis. Thyroid hormones treatment increased the lipoperoxidation and decreased GSHPx activity as compared to MI group, increased the t-Akt2 expression as compared to SHAM group, and increased the vascular parasympathetic drive. Thyroid hormones treatment provided differential benefits on the LV function and autonomic modulation as compared to the exercise training. Nevertheless, the redox unbalance induced by thyroid hormones highlights the importance of more studies targeting the ideal duration of this treatment. Copyright © 2018 Elsevier Inc. All rights reserved.

Water depth effects on impact loading, kinematic and physiological variables during water treadmill running.

PubMed

Macdermid, Paul W; Wharton, Josh; Schill, Carina; Fink, Philip W

2017-07-01

The purpose of this study was to compare impact loading, kinematic and physiological responses to three different immersion depths (mid-shin, mid-thigh, and xiphoid process) while running at the same speed on a water based treadmill. Participants (N=8) ran on a water treadmill at three depths for 3min. Tri-axial accelerometers were used to identify running dynamics plus measures associated with impact loading rates, while heart rate data were logged to indicate physiological demand. Participants had greater peak impact accelerations (p<0.01), greater impact loading rates (p<0.0001), greater stride frequency (p<0.05), shorter stride length (p<0.01), and greater rate of acceleration development at toe-off (p<0.0001) for the mid-shin and mid-thigh compared to running immersed to the xiphoid process. Physiological effort determined by heart rate was also significantly less (p<0.0001) when running immersed to the xiphoid process. Water immersed treadmill running above the waistline alters kinematics of gait, reduces variables associated with impact, while decreasing physiological demand compared to depths below the waistline. Copyright © 2017 Elsevier B.V. All rights reserved.

Physical Performance in Elite Male and Female Team Handball Players.

PubMed

Wagner, Herbert; Fuchs, Patrick; Fusco, Andrea; Fuchs, Philip; Bell, W Jeffrey; Duvillard, Serge P

2018-06-12

Biological differences between men and women are well known; however, literature-addressing knowledge about the influence of sex to specific and general performance in team handball is almost nonexistent. Consequently, the aim of the study was to assess and compare specific and general physical performance in male and female elite team handball players, to determine if the differences are consequential for general compared to specific physical performance characteristics and the relationship between general and specific physical performance. Twelve male and ten female elite team handball players performed a game based performance test, upper- und lower-body strength and power tests, a sprinting test, and an incremental treadmill-running test. Significant differences (P<.05) between male and female players were found for peak oxygen uptake and total running time during the treadmill test, 30m sprinting time, leg extension strength, trunk and shoulder rotation torque, counter movement jump height as well as offense and defense time, ball velocity and jump height in the game based performance test. An interaction (sex × test) was found for time and oxygen uptake and except shoulder rotation torque and ball velocity in females, we found only a low relationship between specific and general physical performance. The results of the study revealed that male players are heavier, taller, faster, stronger, jump higher and have a better aerobic performance. However, female players performed relatively better in the team handball specific tests compared to the general tests. Our findings also suggest that female players should focus more on strength training.

Aerobic exercise training promotes additional cardiac benefits better than resistance exercise training in postmenopausal rats with diabetes.

PubMed

Quinteiro, Hugo; Buzin, Morgana; Conti, Filipe Fernandes; Dias, Danielle da Silva; Figueroa, Diego; Llesuy, Susana; Irigoyen, Maria-Cláudia; Sanches, Iris Callado; De Angelis, Kátia

2015-05-01

The aim of this study was to evaluate the effects of aerobic exercise training or resistance exercise training on cardiac morphometric, functional, and oxidative stress parameters in rats with ovarian hormone deprivation and diabetes. Female Wistar rats (200-220 g) were divided into a sham-operated group (euglycemic sham-operated sedentary [ES]; n = 8) and three ovariectomized (bilateral removal of ovaries) and diabetic (streptozotocin 50 mg/kg IV) groups as follows: diabetic ovariectomized sedentary (DOS; n = 8), diabetic ovariectomized undergoing aerobic exercise training (DOTA; n = 8), and diabetic ovariectomized undergoing resistance exercise training (DOTR; n = 8). After 8 weeks of resistance (ladder) or aerobic (treadmill) exercise training, left ventricle function and morphometry were evaluated by echocardiography, whereas oxidative stress was evaluated at the left ventricle. The DOS group presented with increased left ventricle cavity in diastole and relative wall thickness (RWT), and these changes were attenuated in both DOTA and DOTR groups. Systolic and diastolic function was impaired in the DOS group compared with the ES group, and only the DOTA group was able to reverse this dysfunction. Lipoperoxidation and glutathione redox balance were improved in both trained groups compared with the DOS group. Glutathione peroxidase and superoxide dismutase were higher in the DOTA group than in the other studied groups. Correlations were observed between lipoperoxidation and left ventricle cavity in diastole (r = 0.55), between redox balance and RWT (r = 0.62), and between lipoperoxidation and RWT (r = -0.60). Aerobic exercise training and resistance exercise training promote attenuation of cardiac morphometric dysfunction associated with a reduction in oxidative stress in an experimental model of diabetes and menopause. However, only dynamic aerobic exercise training is able to attenuate systolic and diastolic dysfunction under this condition.

Calcineurin-NFAT Signaling and Neurotrophins Control Transformation of Myosin Heavy Chain Isoforms in Rat Soleus Muscle in Response to Aerobic Treadmill Training.

PubMed

Liu, Wenfeng; Chen, Gan; Li, Fanling; Tang, Changfa; Yin, Dazhong

2014-12-01

This study elucidated the role of CaN-NFAT signaling and neurotrophins on the transformation of myosin heavy chain isoforms in the rat soleus muscle fiber following aerobic exercise training. To do so, we examined the content and distribution of myosin heavy chain (MyHC) isoforms in the rat soleus muscle fiber, the activity of CaN and expression of NFATc1 in these fibers, and changes in the expression of nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF) and neutrophin-3 (NT-3) in the soleus and striatum following high-and medium-intensity aerobic treadmill training. Specific pathogen-free 2 month old male Sprague-Dawley (SD) rats were randomly divided into three groups: Control group (Con, n = 8), moderate-intensity aerobic exercise group (M-Ex, n = 8) and high-intensity aerobic exercise group (H-Ex, n = 8). We used ATPase staining to identify the muscle fiber type I and II, SDS-PAGE to separate and analyze the isoforms MyHCI, MyHCIIA, MyHCIIB and MyHCIIx, and performed western blots to determine the expression of NFATc1, NGF, BDNF and NT-3. CaN activity was measured using a colorimetric assay. In the soleus muscle, 8 weeks of moderate-intensity exercise can induce transformation of MyHC IIA and MyHC IIB to MyHC IIX and MyHC I (p < 0.01), while high-intensity treadmill exercise can induce transform MyHC IIx to MyHC IIB, MyHC IIA and MyHC I (p < 0.01). In comparison to the control group, CaN activity and NFATcl protein level were significantly increased in both the M-Ex and H-Ex groups (p < 0.05, p < 0.01), with a more pronounced upregulation in the M-Ex group (p < 0.05). Eight weeks of moderate- and high-intensity aerobic exercise induced the expression of NGF, BDNF and NT-3 in the soleus muscle and the striatum (p < 0.01), with the most significant increase in the H-Ex group (p < 0.01). In the rat soleus muscle, (1) CaN-NFATcl signaling contributes to the conversion of MyHC I isoform in response to moderate-intensity exercise; (2) Neurotrophins NGF, BDNF and NT-3 might play a role in the conversion of MyHC II isoform in response to high-intensity treadmill exercise. Key pointsEight weeks of moderate-intensity treadmill training induces the transformation MyHC IIA and MyHC IIB to MyHC IIX and MyHC I in the soleus muscles, while high-intensity exercise leads to transformation of MyHC IIX to MyHC IIA, MyHC IIB and MyHC I.MyHC I conversion in response to moderate-intensity aerobic exercise is mediated by calcineurin-NFATcl signaling.Eight weeks of moderate- and high-ntensity aerobic exercise induces the expression of NGF, BDNF and NT-3 in expression noted in rats subjected to high-intensity training. NGF and NT-3 expression in the striatum is lower than in the soleus muscle, while BDNF levels are similar. Neurotrophins may be involved in mediating MyHC II conversion in response to high-intensity aerobic exercise.

Low-Intensity Wheelchair Training in Inactive People with Long-Term Spinal Cord Injury: A Randomized Controlled Trial on Propulsion Technique.

PubMed

van der Scheer, Jan W; de Groot, Sonja; Vegter, Riemer J K; Hartog, Johanneke; Tepper, Marga; Slootman, Hans; Veeger, DirkJan H E J; van der Woude, Lucas H V

2015-11-01

The objective of this study was to investigate the effects of a low-intensity wheelchair training on propulsion technique in inactive people with long-term spinal cord injury. Participants in this multicenter nonblinded randomized controlled trial were inactive manual wheelchair users with spinal cord injury for at least 10 yrs (N = 29), allocated to exercise (n = 14) or no exercise. The 16-wk training consisted of wheelchair treadmill propulsion at 30%-40% heart rate reserve or equivalent in rate of perceived exertion, twice a week, 30 mins per session. Propulsion technique was assessed at baseline as well as after 8, 16, and 42 wks during two submaximal treadmill-exercise blocks using a measurement wheel attached to a participant's own wheelchair. Changes over time between the groups were analyzed using Mann-Whitney U tests on difference scores (P < 0.05/3). Data of 16 participants could be analyzed (exercise: n = 8). Significant differences between the exercise and control groups were only found in peak force after 8 wks (respective medians, -20 N vs. 1 N; P = 0.01; r(u) = 0.78). Significant training effects on propulsion technique were not found in this group. Perhaps, substantial effects require a higher intensity or frequency. Investigating whether more effective and feasible interventions exist might help reduce the population's risk of upper-body joint damage during daily wheelchair propulsion.

Exercise training utilizing body weight-supported treadmill walking with a young adult with cerebral palsy who was non-ambulatory.

PubMed

DiBiasio, Paula A; Lewis, Cynthia L

2012-11-01

The purpose of this case report is to determine the effects of exercise training using body weight-supported treadmill walking (BWSTW) with an 18-year-old male diagnosed with Cerebral palsy (CP) who was non-ambulatory and not receiving physical therapy. Outcome measures included the Pediatric Quality of Life Inventory (PedsQL), the Pediatric Evaluation of Disability Inventory (PEDI), heart rate (HR), rate of perceived exertion, 3-minute walk test and physiological cost index (PCI). BWSTW sessions took place twice a week for 6 weeks with a reduction of approximately 40% of the patient's weight. Over-ground 3-minute walk test distance and PCI were essentially unchanged. BWSTW exercise time increased by 67% with a 43% increase in speed while average working HR decreased by 8%. BWSTW PCI decreased by 26%. PedsQL parent report improved in all domains. PedsQL self-report demonstrated a mild decrease. PEDI showed improvements in self-care and mobility. Exercise utilizing BWSTW resulted in a positive training effect for this young adult with CP who was non-ambulatory. Developing effective and efficient protocols for exercise training utilizing BWSTW may aid in the use of this form of exercise and further quantify outcomes. Ensuring that young adults with CP have safe and feasible options to exercise and be physically active on a regular basis is an important role of a physical therapist.

Effects of a short burst of gait training with body weight-supported treadmill training for a person with chronic stroke: a single-subject study.

PubMed

Combs, Stephanie A; Miller, Ellen Winchell

2011-04-01

The purpose of this study was to investigate the effects of a short-burst dose of intense gait training with body weight-supported treadmill training (BWSTT) on walking speed, endurance, and quality of life of a participant with chronic stroke. A single-subject experimental (A-B-A-A) design with immediate and 3-month retention phases was used. The participant was a 66-year-old woman, 1 year after left cerebrovascular accident. Repeated baseline walking performance was established during 2 weeks of testing using the comfortable 10-meter walk test (CWT) and the 6-minute walk test (6MWT). The Stroke Impact Scale (SIS) was measured one time during baseline. Baseline testing was followed by ten 30-minute sessions of BWSTT over a 2-week duration. Retention testing was conducted immediately and 3 months following the intervention. Statistically significant improvements from baseline with the CWT and the 6MWT were achieved and maintained by the participant across all subsequent measurement phases. Improvements considered to be clinically meaningful changes in the SIS domains of strength and mobility achieved immediately after the intervention were not maintained at 3-month retention testing. For the participant in this study, the short-burst dosage of BWSTT provided a feasible and effective means for improving goal-oriented functional walking ability.

How to gain evidence in neurorehabilitation: a personal view.

PubMed

Luft, Andreas R

2012-12-01

Neurorehabilitation is an emerging field driven by developments in neuroscience and biomedical engineering. Most patients that require neurorehabilitation have had a stroke, but other diseases of the brain, spinal cord, or nerves can also be alleviated. Modern therapies in neurorehabilitation focus on reducing impairment and improving function in daily life. As compared with acute care medicine, the clinical evidence for most neurorehabilitative treatments (modern or conventional) is sparse. Clinical trials support constraint-induced movement therapy for the arm and aerobic treadmill training for walking, both high-intensity interventions requiring therapist time (i.e., cost) and patient motivation. Promising approaches for the future include robotic training, telerehabilitation at the patient’s home, and supportive therapies that promote motivation and compliance. It is argued that a better understanding of the neuroscience of recovery together with results from small-scale and well-focused clinical experiments are necessary to design optimal interventions for specific target groups of patients.

Differential coronary resistance microvessel remodeling between type 1 and type 2 diabetic mice: impact of exercise training.

PubMed

Trask, Aaron J; Delbin, Maria A; Katz, Paige S; Zanesco, Angelina; Lucchesi, Pamela A

2012-01-01

The goals of the present study were to compare coronary resistance microvessel (CRM) remodeling between type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) mice, and to determine the impact of aerobic exercise training on CRM remodeling in diabetes. Eight week old male mice were divided into T1DM: control sedentary (Control-SD), T1DM sedentary (T1DM-SD) induced by streptozotocin, and T1DM exercise trained (T1DM-TR); T2DM: control sedentary (Db/db-SD), T2DM sedentary (db/db-SD), and T2DM trained (db/db-TR). Aerobic exercise training (TR) was performed on a mouse treadmill for 8weeks. CRMs were isolated and mounted on a pressure myograph to measure and record vascular remodeling and mechanics. CRM diameters, wall thickness, stress-strain, incremental modulus remained unchanged in T1DM-SD mice compared to control, and exercise training showed no effect. In contrast, CRMs isolated from db/db-SD mice exhibited decreased luminal diameter with thicker microvascular walls, which significantly increased the wall:lumen ratio (Db/db-SD: 5.8±0.3 vs. db/db-SD: 8.9±0.7, p<0.001). Compared to db/db-SD mice, coronary arterioles isolated from db/db-TR mice had similar internal diameter and wall thickness, while wall:lumen ratio (6.8±0.2, p<0.05) and growth index (db/db-SD: 16.2 vs. db/db-TR: 4.3, % over Db/db) were reduced. These data show that CRMs undergo adverse inward hypertrophic remodeling only in T2DM, but not T1DM, and that aerobic exercise training can partially mitigate this process. Copyright © 2012 Elsevier Inc. All rights reserved.

Moderate Aerobic Training Improves Cardiorespiratory Parameters in Elastase-Induced Emphysema

PubMed Central

Henriques, Isabela; Lopes-Pacheco, Miquéias; Padilha, Gisele A.; Marques, Patrícia S.; Magalhães, Raquel F.; Antunes, Mariana A.; Morales, Marcelo M.; Rocha, Nazareth N.; Silva, Pedro L.; Xisto, Débora G.; Rocco, Patricia R. M.

2016-01-01

Aim: We investigated the therapeutic effects of aerobic training on lung mechanics, inflammation, morphometry and biological markers associated with inflammation, and endothelial cell damage, as well as cardiac function in a model of elastase-induced emphysema. Methods: Eighty-four BALB/c mice were randomly allocated to receive saline (control, C) or 0.1 IU porcine pancreatic elastase (emphysema, ELA) intratracheally once weekly for 4 weeks. After the end of administration period, once cardiorespiratory impairment associated with emphysema was confirmed, each group was further randomized into sedentary (S) and trained (T) subgroups. Trained mice ran on a motorized treadmill, at moderate intensity, 30 min/day, 3 times/week for 4 weeks. Results: Four weeks after the first instillation, ELA animals, compared to C, showed: (1) reduced static lung elastance (Est,L) and levels of vascular endothelial growth factor (VEGF) in lung tissue, (2) increased elastic and collagen fiber content, dynamic elastance (E, in vitro), alveolar hyperinflation, and levels of interleukin-1β and tumor necrosis factor (TNF)-α, and (3) increased right ventricular diastolic area (RVA). Four weeks after aerobic training, ELA-T group, compared to ELA-S, was associated with reduced lung hyperinflation, elastic and collagen fiber content, TNF-α levels, and RVA, as well as increased Est,L, E, and levels of VEGF. Conclusion: Four weeks of regular and moderate intensity aerobic training modulated lung inflammation and remodeling, thus improving pulmonary function, and reduced RVA and pulmonary arterial hypertension in this animal model of elastase-induced emphysema. PMID:27536247

Using robot-applied resistance to augment body-weight-supported treadmill training in an individual with incomplete spinal cord injury.

PubMed

Lam, Tania; Pauhl, Katherine; Krassioukov, Andrei; Eng, Janice J

2011-01-01

The efficacy of task-specific gait training for people with spinal cord injury (SCI) is premised on evidence that the provision of gait-related afferent feedback is key for the recovery of stepping movements. Recent findings have shown that sensory feedback from flexor muscle afferents can facilitate flexor muscle activity during the swing phase of walking. This case report was undertaken to determine the feasibility of using robot-applied forces to resist leg movements during body-weight-supported treadmill training (BWSTT) and to measure its effect on gait and other health-related outcomes. The patient described in this case report was a 43-year-old man with a T11 incomplete chronic SCI. He underwent 36 sessions of BWSTT using a robotic gait orthosis to provide forces that resist hip and knee flexion. Tolerance to the training program was monitored using the Borg CR10 scale and heart rate and blood pressure changes during each training session. Outcome measures (ie, 10-Meter Walk Test, Six-Minute Walk Test, modified Emory Functional Ambulation Profile [mEFAP], Activities-specific Balance Confidence Scale, and Canadian Occupational Performance Measure) were completed and kinematic parameters of gait, lower-extremity muscle strength (force-generating capacity), lower-limb girth, and tolerance to orthostatic stress were measured before and after the training program. The patient could tolerate the training. Overground walking speed, endurance, and performance on all subtasks of the mEFAP improved and were accompanied by increased lower-limb joint flexion and toe clearance during gait. The patient's ambulatory self-confidence and self-perceived performance in walking also improved. These findings suggest that this new approach to BWSTT is a feasible and potentially effective therapy for improving skilled overground walking performance.

Mucosal immunity and upper respiratory tract symptoms in recreational endurance runners.

PubMed

Ihalainen, Johanna K; Schumann, Moritz; Häkkinen, Keijo; Mero, Antti A

2016-01-01

The present study investigated the effects of a 12-week endurance-training intervention on salivary proteins and upper respiratory tract symptoms (URS) in 25 young men. Saliva samples of 25 recreational male endurance runners (age 34.6 years, body mass index = 23.8 kg·m(-2), peak aerobic capacity = 47.2 mL·kg(-1)·min(-1)) were collected before (PRE) and after (POST) the training intervention, in a fasting state, as well as both before and after a maximal incremental treadmill run. The training consisted of both continuous and interval training sessions, 4-6 times per week based on the polarized training approach. Participants filled in Wisconsin Upper Respiratory Symptom Survey-21 and were retrospectively divided into 2 groups according to whether they reported URS (URS group, n = 13) or not (HEALTHY group, n = 12). Basal salivary immunoglobulin A (sa-sIgA) levels were significantly higher (+70%, p < 0.05) in the HEALTHY group both at PRE and POST whereas no significant differences were observed in salivary immunoglobulin M, salivary immunoglobulin G, lysozyme, or salivary α-amylase activity (sAA). Sa-sIgA concentration at PRE significantly correlated with the number of sick-days (R = -0.755, p < 0.001) in all subjects. The incremental treadmill run acutely increased sAA significantly (p < 0.05) at PRE (200%) and POST (166%) in the HEALTHY group but not in the URS group. This study demonstrated that subjects, who experienced URS during the 12 weeks of progressive endurance training intervention, had significantly lower basal sa-sIgA levels both before and after the experimental endurance training period. In addition to sa-sIgA, acute sAA response to exercise might be a possible determinant of susceptibility to URS in endurance runners.

Electrical Stimulation During Gait Promotes Increase of Muscle Cross-sectional Area in Quadriplegics: A Preliminary Study

PubMed Central

Cliquet, Alberto; Rondina, Jane Maryan; Cendes, Fernando

2008-01-01

Increases in muscular cross-sectional area (CSA) occur in quadriplegics after training, but the effects of neuromuscular electrical stimulation (NMES) along with training are unknown. Thus, we addressed two questions: (1) Does NMES during treadmill gait training increase the quadriceps CSA in complete quadriplegics?; and (2) Is treadmill gait training alone enough to observe an increase in CSA? Fifteen quadriplegics were divided into gait (n = 8) and control (n = 7) groups. The gait group performed training with NMES for 6 months twice a week for 20 minutes each time. After 6 months of traditional therapy, the control group received the same gait training protocol but without NMES for an additional 6 months. Axial images of the thigh were acquired at the beginning of the study, at 6 months (for both groups), and at 12 months for the control group to determine the average quadriceps CSA. After 6 months, there was an increase of CSA in the gait group (from 49.8 ± 9.4 cm2 to 57.3 ± 10.3 cm2), but not in the control group (from 43.6 ± 7.6 cm2 to 41.8 ± 8.4 cm2). After another 6 months of gait without NMES in the control group, the CSA did not change (from 41.8 ± 8.4 cm2 to 41.7 ± 7.9 cm2). The increase in quadriceps CSA after gait training in patients with chronic complete quadriplegia appears associated with NMES. PMID:18791775

Locomotor Adaptation Improves Balance Control, Multitasking Ability and Reduces the Metabolic Cost of Postural Instability

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Peters, B. T.; Mulavara, A. P.; Brady, R. A.; Batson, C. D.; Miller, C. A.; Ploutz-Snyder, R. J.; Guined, J. R.; Buxton, R. E.; Cohen, H. S.

2011-01-01

During exploration-class missions, sensorimotor disturbances may lead to disruption in the ability to ambulate and perform functional tasks during the initial introduction to a novel gravitational environment following a landing on a planetary surface. The overall goal of our current project is to develop a sensorimotor adaptability training program to facilitate rapid adaptation to these environments. We have developed a unique training system comprised of a treadmill placed on a motion-base facing a virtual visual scene. It provides an unstable walking surface combined with incongruent visual flow designed to enhance sensorimotor adaptability. Greater metabolic cost incurred during balance instability means more physical work is required during adaptation to new environments possibly affecting crewmembers? ability to perform mission critical tasks during early surface operations on planetary expeditions. The goal of this study was to characterize adaptation to a discordant sensory challenge across a number of performance modalities including locomotor stability, multi-tasking ability and metabolic cost. METHODS: Subjects (n=15) walked (4.0 km/h) on a treadmill for an 8 -minute baseline walking period followed by 20-minutes of walking (4.0 km/h) with support surface motion (0.3 Hz, sinusoidal lateral motion, peak amplitude 25.4 cm) provided by the treadmill/motion-base system. Stride frequency and auditory reaction time were collected as measures of locomotor stability and multi-tasking ability, respectively. Metabolic data (VO2) were collected via a portable metabolic gas analysis system. RESULTS: At the onset of lateral support surface motion, subj ects walking on our treadmill showed an increase in stride frequency and auditory reaction time indicating initial balance and multi-tasking disturbances. During the 20-minute adaptation period, balance control and multi-tasking performance improved. Similarly, throughout the 20-minute adaptation period, VO2 gradually decreased following an initial increase after the onset of support surface motion. DISCUSSION: Resu lts confirmed that walking in discordant conditions not only compromises locomotor stability and the ability to multi-task, but comes at a quantifiable metabolic cost. Importantly, like locomotor stability and multi-tasking ability, metabolic expenditure while walking in discordant sensory conditions improved during adaptation. This confirms that sensorimotor adaptability training can benefit multiple performance parameters central to the successful completion of critical mission tasks.

Different motor tasks impact differently on cognitive performance of older persons during dual task tests.

PubMed

Simoni, David; Rubbieri, Gaia; Baccini, Marco; Rinaldi, Lucio; Becheri, Dimitri; Forconi, Tatiana; Mossello, Enrico; Zanieri, Samanta; Marchionni, Niccolò; Di Bari, Mauro

2013-07-01

Dual task paradigm states that the introduction of a second task during a cognitive or motor performance results in a decreased performance in either task. Treadmill walk, often used in clinical applications of dual task testing, has never been compared to overground walk, to ascertain its susceptibility to interference from a second task. We compared the effects of overground and treadmill gait on dual task performance. Gait kinematic parameters and cognitive performance were obtained in 29 healthy older adults (mean age 75 years, 14 females) when they were walking freely on a sensorized carpet or during treadmill walking with an optoelectronic system, in single task or dual task conditions, using alternate repetition of letters as a cognitive verbal task. During overground walking, speed, cadence, step length stride length, and double support time (all with P value<0.001) and cognitive performance (number of correct words, P<0.001) decreased substantially from single to dual task testing. When subjects walked at a fixed speed on the treadmill, cadence decreased significantly (P=0.005), whereas cognitive performance remained unaffected. Both motor and cognitive performances decline during dual task testing with overground walking. Conversely, cognitive performance remains unaffected in dual task testing on the treadmill. In the light of current dual task paradigm, these findings may have relevant implication for our understanding of motor control, as they suggest that treadmill walk does not involve brain areas susceptible to interference from the introduction of a cognitive task. Copyright © 2013 Elsevier Ltd. All rights reserved.

Utilization of an Anti-Gravity Treadmill in a Physical Activity Program with Female Breast Cancer Survivors: A Pilot Study

PubMed Central

FAIRMAN, CIARAN M.; KENDALL, KRISTINA L.; HARRIS, BRANDONN S.; CRANDALL, KENNETH J.; MCMILLAN, JIM

2016-01-01

Breast Cancer survivors can experience a myriad of physical and psychological benefits as a result of regular exercise. This study aimed to build on previous research using lower impact exercise programs by using an antigravity (Alter-G®) treadmill to administer cardiovascular training. The purpose of this study was to determine the effectiveness a physical activity program, including an Alter-G® treadmill, for improving physiological and psychosocial measures in female breast cancer survivors. A 14-week intervention using an AB-AB study design was employed. Six female breast cancer survivors were recruited to participate in the study. Participants attended three 60-minute sessions per week, consisting of a combination of muscular strength/endurance, and cardiovascular endurance exercises. Consistent with current literature and guidelines, exercise interventions were individualized and tailored to suit individuals. Data was collected and analyzed in 2013. Visual inspection of results found improvements in cardiovascular endurance and measures of body composition. Quality of life was maintained and in some cases, improved. Finally, no adverse effects were reported from the participants, and adherence to the program for those who completed the study was 97%. The results of this study suggest that the use of a physical activity program in combination with an Alter-G® treadmill may provide practical and meaningful improvements in measures of cardiovascular endurance and body composition. PMID:27293508

Utilization of an Anti-Gravity Treadmill in a Physical Activity Program with Female Breast Cancer Survivors: A Pilot Study.

PubMed

Fairman, Ciaran M; Kendall, Kristina L; Harris, Brandonn S; Crandall, Kenneth J; McMillan, Jim

Breast Cancer survivors can experience a myriad of physical and psychological benefits as a result of regular exercise. This study aimed to build on previous research using lower impact exercise programs by using an antigravity (Alter-G ® ) treadmill to administer cardiovascular training. The purpose of this study was to determine the effectiveness a physical activity program, including an Alter-G ® treadmill, for improving physiological and psychosocial measures in female breast cancer survivors. A 14-week intervention using an AB-AB study design was employed. Six female breast cancer survivors were recruited to participate in the study. Participants attended three 60-minute sessions per week, consisting of a combination of muscular strength/endurance, and cardiovascular endurance exercises. Consistent with current literature and guidelines, exercise interventions were individualized and tailored to suit individuals. Data was collected and analyzed in 2013. Visual inspection of results found improvements in cardiovascular endurance and measures of body composition. Quality of life was maintained and in some cases, improved. Finally, no adverse effects were reported from the participants, and adherence to the program for those who completed the study was 97%. The results of this study suggest that the use of a physical activity program in combination with an Alter-G ® treadmill may provide practical and meaningful improvements in measures of cardiovascular endurance and body composition.

Effects of mild running on substantia nigra during early neurodegeneration.

PubMed

Almeida, Michael F; Silva, Carolliny M; Chaves, Rodrigo S; Lima, Nathan C R; Almeida, Renato S; Melo, Karla P; Demasi, Marilene; Fernandes, Tiago; Oliveira, Edilamar M; Netto, Luis E S; Cardoso, Sandra M; Ferrari, Merari F R

2018-06-01

Moderate physical exercise acts at molecular and behavioural levels, such as interfering in neuroplasticity, cell death, neurogenesis, cognition and motor functions. Therefore, the aim of this study is to analyse the cellular effects of moderate treadmill running upon substantia nigra during early neurodegeneration. Aged male Lewis rats (9-month-old) were exposed to rotenone 1mg/kg/day (8 weeks) and 6 weeks of moderate treadmill running, beginning 4 weeks after rotenone exposure. Substantia nigra was extracted and submitted to proteasome and antioxidant enzymes activities, hydrogen peroxide levels and Western blot to evaluate tyrosine hydroxylase (TH), alpha-synuclein, Tom-20, PINK1, TrkB, SLP1, CRMP-2, Rab-27b, LC3II and Beclin-1 level. It was demonstrated that moderate treadmill running, practiced during early neurodegeneration, prevented the increase of alpha-synuclein and maintained the levels of TH unaltered in substantia nigra of aged rats. Physical exercise also stimulated autophagy and prevented impairment of mitophagy, but decreased proteasome activity in rotenone-exposed aged rats. Physical activity also prevented H 2 O 2 increase during early neurodegeneration, although the involved mechanism remains to be elucidated. TrkB levels and its anterograde trafficking seem not to be influenced by moderate treadmill running. In conclusion, moderate physical training could prevent early neurodegeneration in substantia nigra through the improvement of autophagy and mitophagy.

The Robinson Protocol: a treadmill anaerobic performance test.

PubMed

Robinson, Ellyn M; Graham, Louise B; Headley, Samuel A

2004-08-01

The current investigation was designed to further examine the reliability of the Robinson protocol, which is a run-to-exhaustion treadmill test. Robinson (10) originally examined this protocol with 5 subjects. The significance of the initial exploratory study was the impetus for expanding the study to examine the reliability of the protocol with a larger sample. Fifteen male subjects participated in 3 trial runs on the treadmill. The first trial was a modified McConnell (7) test to determine the aerobic capacity of each subject. The second and third trials were identical Robinson protocols (10). The first trial run mean, in seconds (262.04 +/- 74.50), was not significantly different from the second trial run mean (257.30 +/- 72.65), p = 0.526 (2 tailed). As expected, trial 1 and trial 2 were highly correlated (intraclass) (r = 0.927, p < 0.001). These results provide additional support for the hypothesis that the Robinson protocol with a greater subject pool is a reliable protocol that can be used in research studies interested in examining various physiological interventions or anaerobic training.

Motion Controlled Gait Enhancing Mobile Shoe for Rehabilitation

PubMed Central

Handzic, Ismet; Vasudevan, Erin V.; Reed, Kyle B.

2011-01-01

Walking on a split-belt treadmill, which has two belts that can be run at different speeds, has been shown to improve walking patterns post-stroke. However, these improvements are only temporarily retained once individuals transition to walking over ground. We hypothesize that longer-lasting effects would be observed if the training occurred during natural walking over ground, as opposed to on a treadmill. In order to study such long-term effects, we have developed a mobile and portable device which can simulate the same gait altering movements experienced on a split-belt treadmill. The new motion controlled gait enhancing mobile shoe improves upon the previous version’s drawbacks. This version of the GEMS has motion that is continuous, smooth, and regulated with on-board electronics. A vital component of this new design is the Archimedean spiral wheel shape that redirects the wearer’s downward force into a horizontal backward motion. The design is passive and does not utilize any motors. Its motion is regulated only by a small magnetic particle brake. Further experimentation is needed to evaluate the long-term after-effects. PMID:22275620

Exercise for haemophilia.

PubMed

Strike, Karen; Mulder, Kathy; Michael, Rojer

2016-12-19

Haemophilia is a bleeding disorder associated with haemorrhaging into joints and muscles. Exercise is often used to aid recovery after bleeds, and to improve joint function in the presence of arthropathy. Our objective was to systematically review the available evidence on the safety and effectiveness of exercise for people with haemophilia. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register and electronic databases PubMed, OVID-Embase, and CINAHL. We hand searched abstracts from congresses of the World Federation of Hemophilia and the European Hematology Association, trial registries and the reference lists of relevant articles.Date of the last search of the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register: 14 December 2016. Randomized or quasi-randomized controlled studies comparing any exercise intervention considered relevant in haemophilia management including supervised, unsupervised, aquatic, strengthening, aerobic or cardiovascular, stretching, proprioceptive and balance training exercise programs in males of any age with haemophilia A or B of any severity (those with co-morbidities were not excluded). Two authors reviewed the identified abstracts to determine their eligibility. For studies meeting the inclusion criteria, full articles were obtained. The two authors extracted data and assessed the risk of bias. Any disagreements were resolved by discussion. The authors contacted study investigators to obtain any missing data. Eight studies were included, which represented 233 males with all severities of haemophilia A and B, ranging in age from eight years to 49 years. Study duration ranged from four to 12 weeks. Exercise interventions varied greatly and included resistance exercises, isometric exercises, bicycle ergometry, treadmill walking and hydrotherapy; therefore, comparison between studies was difficult.None of the studies measured or reported adverse effects from the interventions. None of the studies reported outcomes regarding bleed frequency, quality of life or aerobic activity. Overall risk of bias across all studies was assessed as unclear.Very few studies provided sufficient information for comparison. None of the studies reported data that favoured the control group. One study reported that six weeks of resistance training improved joint health status (Colorado score) compared to controls. The addition of pulsed electromagnetic fields also improved ankle scores compared to exercises alone, but this was not seen in the elbows or knees.Two studies reported statistically significant improvements in pain intensity after exercise interventions compared to controls. Hydrotherapy exercises produced significant decreases in pain compared to controls and land-based exercise groups.Two studies found improvement in joint motion in the exercise group compared to controls. One study compared land- and water-based exercises; there was no difference in the range of motion between the two groups; however, the water-based exercise group did show improvement over the control group.One study, comparing joint traction and proprioceptive neuromuscular facilitation for the elbow to a control group, showed no differences in biceps girth or strength after 12 weeks of intervention.Some studies reported comparisons between interventions. In one study, treadmill training significantly improved balance in children compared to bicycle ergometry. Another study added partial weight bearing exercises to quadriceps exercises and showed improved walking tolerance.Four studies evaluated quadriceps or hamstring strength (or both). The addition of bicycle ergometry and exercises with weights was more effective than static exercises and treadmill walking for strengthening knee flexors and extensors. Partial weight-bearing exercises through range were more effective than static and short arc exercises for improving knee extensor strength. The addition of treadmill walking to ultrasound, stretching and strengthening exercises showed increased peak torque of knee flexors and extensors and decrease in knee effusion.The results should be interpreted with caution due to the quality of evidence (GRADE) as outlined in the summary of findings tables, which demonstrates that all but one of the outcomes assessed were rated as low or very low due to the small sample sizes and potential bias. These results must be considered with caution. There is a lack of confidence in the results due to the small number of included studies and the inability to pool the results due to the heterogeneity of outcome measures. Most exercise interventions produced improvement in one or more of the measured outcomes including pain, range of motion, strength and walking tolerance. Hydrotherapy may be more effective than land exercises for pain relief in adults. Functional exercises such as treadmill walking and partial weight bearing exercises seem to be more effective than static or short arc exercises for improving muscle strength. These findings are consistent with the many non-controlled intervention reports in the haemophilia literature. No adverse effects were reported as a result of any of the interventions. However, some groups used prophylactic factor prior to exercise and other groups studied only subjects with moderate haemophilia. Therefore, the safety of these techniques for persons with severe haemophilia remains unclear.

Effect of added mass on treadmill performance and pulmonary function.

PubMed

Walker, Rachel E; Swain, David P; Ringleb, Stacie I; Colberg, Sheri R

2015-04-01

Military personnel engage in strenuous physical activity and load carriage. This study evaluated the role of body mass and of added mass on aerobic performance (uphill treadmill exercise) and pulmonary function. Performance on a traditional unloaded run test (4.8 km) was compared with performance on loaded tasks. Subjects performed an outdoor 4.8-km run and 4 maximal treadmill tests wearing loads of 0, 10, 20, and 30 kg. Subjects' pulmonary function (forced expired volume in 1 second [FEV1], forced vital capacity [FVC], and maximal voluntary ventilation [MVV]) was tested with each load, and peak values of heart rate, oxygen consumption ((Equation is included in full-text article.)), ventilation (VE), and respiratory exchange ratio (RER) were measured during each treadmill test. Performance on the 4.8-km run was correlated with treadmill performance, measured as time to exhaustion (TTE), with the strength of the correlation decreasing with load (r = 0.87 for 0 kg to 0.76 for 30 kg). Body mass was not correlated with TTE, other than among men with the 30-kg load (r = 0.48). During treadmill exercise, all peak responses other than RER decreased with load. Pulmonary function measures (FEV1, FVC, and MVV) decreased with load. Body mass was poorly correlated with treadmill performance, but added mass decreased performance. The decreased performance may be in part because of decreased pulmonary function. Unloaded 4.8-km run performance was correlated to unloaded uphill treadmill performance, but less so as load increased. Therefore, traditional run tests may not be an effective means of evaluating aerobic performance for military field operations.

Ankle Training With a Robotic Device Improves Hemiparetic Gait After a Stroke

PubMed Central

Forrester, Larry W.; Roy, Anindo; Krebs, Hermano Igo; Macko, Richard F.

2013-01-01

Background Task-oriented therapies such as treadmill exercise can improve gait velocity after stroke, but slow velocities and abnormal gait patterns often persist, suggesting a need for additional strategies to improve walking. Objectives To determine the effects of a 6-week visually guided, impedance controlled, ankle robotics intervention on paretic ankle motor control and gait function in chronic stroke. Methods This was a single-arm pilot study with a convenience sample of 8 stroke survivors with chronic hemiparetic gait, trained and tested in a laboratory. Subjects trained in dorsiflexion–plantarflexion by playing video games with the robot during three 1-hour training sessions weekly, totaling 560 repetitions per session. Assessments included paretic ankle ranges of motion, strength, motor control, and overground gait function. Results Improved paretic ankle motor control was seen as increased target success, along with faster and smoother movements. Walking velocity also increased significantly, whereas durations of paretic single support increased and double support decreased. Conclusions Robotic feedback training improved paretic ankle motor control with improvements in floor walking. Increased walking speeds were comparable with reports from other task-oriented, locomotor training approaches used in stroke, suggesting that a focus on ankle motor control may provide a valuable adjunct to locomotor therapies. PMID:21115945

Prolonged ingestion of prehydrolyzed whey protein induces little or no change in digestive enzymes, but decreases glutaminase activity in exercising rats.

PubMed

Nery-Diez, Ana Cláudia C; Carvalho, Iara R; Amaya-Farfán, Jaime; Abecia-Soria, Maria Inés; Miyasaka, Célio K; Ferreira, Clécio da S

2010-08-01

Because consumption of whey protein hydrolysates is on the increase, the possibility that prolonged ingestion of whey protein hydrolysates affect the digestive system of mammals has prompted us to evaluate the enzymatic activities of pepsin, leucine-aminopeptidase, chymotrypsin, trypsin, and glutaminase in male Wistar rats fed diets containing either a commercial whey isolate or a whey protein hydrolysate with medium degree of hydrolysis and to compare the results with those produced by physical training (sedentary, sedentary-exhausted, trained, and trained-exhausted) in the treadmill for 4 weeks. The enzymatic activities were determined by classical procedures in all groups. No effect due to the form of the whey protein in the diet was seen in the activities of pepsin, trypsin, chymotrypsin, and leucine-aminopeptidase. Training tended to increase the activity of glutaminase, but exhaustion promoted a decrease in the trained animals, and consumption of the hydrolysate decreased it even further. The results are consistent with the conclusion that chronic consumption of a whey protein hydrolysate brings little or no modification of the proteolytic digestive system and that the lowering of glutaminase activity may be associated with an antistress effect, counteracting the effect induced by training in the rat.

Doping dose of salbutamol and exercise training: impact on the skeleton of ovariectomized rats.

PubMed

Bonnet, N; Laroche, N; Beaupied, H; Vico, L; Dolleans, E; Benhamou, C L; Courteix, D

2007-08-01

Previous studies in healthy rats have demonstrated a deleterious bone impact of beta-agonist treatment. The purpose of this study was to examine the trabecular and cortical effects of beta(2)-agonists at doping dose on treadmill exercising rats with estrogen deficiency. Adult female rats were ovariectomized (OVX; n = 44) or sham operated (n = 12). Then, OVX rats received a subcutaneous injection of salbutamol (SAB) or vehicle with (EXE) or without treadmill exercise for 10 wk. Bone mineral density (BMD) was analyzed by densitometry. Microcomputed tomography and histomorphometric analysis were performed to study trabecular bone structure and bone cell activities. After 10 wk, SAB rats presented a much more marked decrease of BMD and trabecular parameters. Exercise did not change the high level of bone resorption in OVX EXE SAB compared with OVX SAB group (both on COOH-terminal collagen cross-links and osteoclast number). These results confirm the deleterious effect of beta(2)-agonists on bone quantity (femoral BMD gain: OVX EXE, +6.8%, vs. OVX EXE SAB, -1.8%; P < 0.01) and quality (-8.0% of femoral trabecular thickness in OVX EXE SAB vs. OVX EXE), indicating that SAB suppresses the effect of EXE in OVX rats. Furthermore, we notice that the slight beneficial effect of exercise was mainly localized in the tibia. These findings indicate the presence of a bone alteration threshold below which there is no more alteration in structural bone quantity and quality. The negative effects of SAB on bone observed in this study in trained rats may indicate potential complications in doping female athletes with exercise-induced amenorrhea.

Exercise stress test

MedlinePlus

Exercise ECG; ECG - exercise treadmill; EKG - exercise treadmill; Stress ECG; Exercise electrocardiography; Stress test - exercise treadmill; CAD - treadmill; Coronary artery disease - treadmill; Chest pain - treadmill; Angina - treadmill; ...

Maximum walking speeds obtained using treadmill and overground robot system in persons with post-stroke hemiplegia

PubMed Central

2012-01-01

Background Previous studies demonstrated that stroke survivors have a limited capacity to increase their walking speeds beyond their self-selected maximum walking speed (SMWS). The purpose of this study was to determine the capacity of stroke survivors to reach faster speeds than their SMWS while walking on a treadmill belt or while being pushed by a robotic system (i.e. “push mode”). Methods Eighteen chronic stroke survivors with hemiplegia were involved in the study. We calculated their self-selected comfortable walking speed (SCWS) and SMWS overground using a 5-meter walk test (5-MWT). Then, they were exposed to walking at increased speeds, on a treadmill and while in “push mode” in an overground robotic device, the KineAssist, until they were tested at a speed that they could not sustain without losing balance. We recorded the time and number of steps during each trial and calculated gait speed, average cadence and average step length. Results Maximum walking speed in the “push mode” was 13% higher than the maximum walking speed on the treadmill and both were higher (“push mode”: 61%; treadmill: 40%) than the maximum walking speed overground. Subjects achieved these faster speeds by initially increasing both step length and cadence and, once individuals stopped increasing their step length, by only increasing cadence. Conclusions With post-stroke hemiplegia, individuals are able to walk at faster speeds than their SMWS overground, when provided with a safe environment that provides external forces that requires them to attempt dynamic stability maintenance at higher gait speeds. Therefore, this study suggests the possibility that, given the appropriate conditions, people post-stroke can be trained at higher speeds than previously attempted. PMID:23057500

Maternal low-protein diet-induced delayed reflex ontogeny is attenuated by moderate physical training during gestation in rats.

PubMed

Falcão-Tebas, Filippe; Bento-Santos, Adriano; Fidalgo, Marco Antônio; de Almeida, Marcelus Brito; dos Santos, José Antônio; Lopes de Souza, Sandra; Manhães-de-Castro, Raul; Leandro, Carol Góis

2012-02-01

We evaluated the effects of moderate- to low-intensity physical training during gestation on reflex ontogeny in neonate rats whose mothers were undernourished. Virgin female Wistar rats were divided into four groups as follows: untrained (NT, n 7); trained (T, n 7); untrained with a low-protein diet (NT+LP, n 7); trained with a low-protein diet (T+LP, n 4). Trained rats were subjected to a protocol of moderate physical training on a treadmill over a period of 4 weeks (5 d/week and 60 min/d, at 65 % of VO₂max). After confirming the pregnancy, the intensity and duration of the exercise were reduced. Low-protein groups were provided with an 8 % casein diet, and controls were provided with a 17 % casein diet. Their respective offspring were evaluated (during the 10th-17th days of postnatal life) in terms of physical feature maturation, somatic growth and reflex ontogeny. Pups born to mothers provided with the low-protein diet during gestation and lactation showed delayed physical feature and reflex maturation and a deficit in somatic growth when compared with controls. However, most of these deficiencies were attenuated in pups of undernourished mothers undergoing training. In conclusion, physical training during gestation attenuates the effects of perinatal undernutrition on some patterns of maturation in the central nervous system during development.

A robot and control algorithm that can synchronously assist in naturalistic motion during body-weight-supported gait training following neurologic injury.

PubMed

Aoyagi, Daisuke; Ichinose, Wade E; Harkema, Susan J; Reinkensmeyer, David J; Bobrow, James E

2007-09-01

Locomotor training using body weight support on a treadmill and manual assistance is a promising rehabilitation technique following neurological injuries, such as spinal cord injury (SCI) and stroke. Previous robots that automate this technique impose constraints on naturalistic walking due to their kinematic structure, and are typically operated in a stiff mode, limiting the ability of the patient or human trainer to influence the stepping pattern. We developed a pneumatic gait training robot that allows for a full range of natural motion of the legs and pelvis during treadmill walking, and provides compliant assistance. However, we observed an unexpected consequence of the device's compliance: unimpaired and SCI individuals invariably began walking out-of-phase with the device. Thus, the robot perturbed rather than assisted stepping. To address this problem, we developed a novel algorithm that synchronizes the device in real-time to the actual motion of the individual by sensing the state error and adjusting the replay timing to reduce this error. This paper describes data from experiments with individuals with SCI that demonstrate the effectiveness of the synchronization algorithm, and the potential of the device for relieving the trainers of strenuous work while maintaining naturalistic stepping.

Effect of resistance training regimens on treadmill running and neuromuscular performance in recreational endurance runners.

PubMed

Mikkola, Jussi; Vesterinen, Ville; Taipale, Ritva; Capostagno, Benoit; Häkkinen, Keijo; Nummela, Ari

2011-10-01

The purpose of this study was to assess the effects of heavy resistance, explosive resistance, and muscle endurance training on neuromuscular, endurance, and high-intensity running performance in recreational endurance runners. Twenty-seven male runners were divided into one of three groups: heavy resistance, explosive resistance or muscle endurance training. After 6 weeks of preparatory training, the groups underwent an 8-week resistance training programme as a supplement to endurance training. Before and after the 8-week training period, maximal strength (one-repetition maximum), electromyographic activity of the leg extensors, countermovement jump height, maximal speed in the maximal anaerobic running test, maximal endurance performance, maximal oxygen uptake ([V·]O(₂max)), and running economy were assessed. Maximal strength improved in the heavy (P = 0.034, effect size ES = 0.38) and explosive resistance training groups (P = 0.003, ES = 0.67) with increases in leg muscle activation (heavy: P = 0.032, ES = 0.38; explosive: P = 0.002, ES = 0.77). Only the heavy resistance training group improved maximal running speed in the maximal anaerobic running test (P = 0.012, ES = 0.52) and jump height (P = 0.006, ES = 0.59). Maximal endurance running performance was improved in all groups (heavy: P = 0.005, ES = 0.56; explosive: P = 0.034, ES = 0.39; muscle endurance: P = 0.001, ES = 0.94), with small though not statistically significant improvements in [V·]O(₂max) (heavy: ES = 0.08; explosive: ES = 0.29; muscle endurance: ES = 0.65) and running economy (ES in all groups < 0.08). All three modes of strength training used concurrently with endurance training were effective in improving treadmill running endurance performance. However, both heavy and explosive strength training were beneficial in improving neuromuscular characteristics, and heavy resistance training in particular contributed to improvements in high-intensity running characteristics. Thus, endurance runners should include heavy resistance training in their training programmes to enhance endurance performance, such as improving sprinting ability at the end of a race.

Changes in Soleus H-Reflex Modulation after Treadmill Training in Children with Cerebral Palsy

ERIC Educational Resources Information Center

Hodapp, Maike; Vry, Julia; Mall, Volker; Faist, Michael

2009-01-01

In healthy children, short latency leg muscle reflexes are profoundly modulated throughout the step cycle in a functionally meaningful way and contribute to the electromyographic (EMG) pattern observed during gait. With maturation of the corticospinal tract, the reflex amplitudes are depressed via supraspinal inhibitory mechanisms. In the soleus…

The Effects of Exercise on Expression of CYP19 and StAR mRNA in Steroid-Induced Polycystic Ovaries of Female Rats.

PubMed

Aghaie, Fatemeh; Khazali, Homayoun; Hedayati, Mehdi; Akbarnejad, Ali

2018-01-01

Polycystic ovarian syndrome (PCOS) is the most frequent female endocrine disorder that affects 5-10% of women. PCOS is characterized by hyperandrogenism, oligo-/anovulation, and polycystic ovaries. The aim of the present research is to evaluate the expression of steroidogenic acute regulatory protein (StAR) and aromatase (CYP19) mRNA in the ovaries of an estradiol valerate (EV)-induced PCOS rat model, and the effect of treadmill and running wheel (voluntary) exercise on these parameters. In this experimental study, we divided adult female Wistar rats that weighed approximately 220 ± 20 g initially into control (n=10) and PCOS (n=30). Subsequently, PCOS group were divided to PCOS, PCOS with treadmill exercise (P-ExT), and PCOS with running wheel exercise (P-ExR) groups (n=10 per group). The expressions of StAR and CYP19 mRNA in the ovaries were determined by quantitative real-time reverse transcriptase polymerase chain reaction (qRT-PCR). Data were analyzed by one-way ANOVA using SPSS software, version 16. The data were assessed at α=0.05. There was significantly lower mRNA expression of CYP19 in the EV-induced PCOS, running wheel and treadmill exercise rats compared to the control group (P<0.001). Treadmill exercise (P=0.972) and running wheel exercise (P=0.839) had no significant effects on CYP19 mRNA expression compared to the PCOS group. mRNA expression of StAR in the ovaries of the PCOS group indicated an increasing trend compared to the control group, however this was not statistically significant (P=0.810). We observed that 8 weeks of running wheel and treadmill exercises could not statistically decrease StAR mRNA expression compared to the PCOS group (P=0.632). EV-induced PCOS in rats decreased CYP19 mRNA expression, but had no effect on StAR mRNA expression. We demonstrated that running wheel and moderate treadmill exercise could not modify CYP19 and StAR mRNA expressions. Copyright© by Royan Institute. All rights reserved.

VO2 attained during treadmill running: the influence of a specialist (400-m or 800-m) event.

PubMed

James, David V B; Sandals, Leigh E; Draper, Stephen B; Maldonado-Martin, Sara; Wood, Dan M

2007-06-01

Previously it has been observed that, in well-trained 800-m athletes, VO2max is not attained during middle-distance running events on a treadmill, even when a race-type pacing strategy is adopted. Therefore, the authors investigated whether specialization in a particular running distance (400-m or 800-m) influences the VO2 attained during running on a treadmill. Six 400-m and six 800-m running specialists participated in the study.A 400-m trial and a progressive test to determine VO2max were completed in a counterbalanced order. Oxygen uptakes attained during the 400-m trial were compared to examine the influence of specialist event. A VO2 plateau was observed in all participants for the progressive test, demonstrating the attainment of VO2max. The VO2max values were 56.2 +/- 4.7 and 69.3 +/- 4.5 mL x kg-1 x min-1 for the 400-m- and 800-m-event specialists, respectively (P = .0003). Durations for the 400-m trial were 55.1 +/- 4.2 s and 55.8 +/- 2.3 s for the 400-m- and 800-m-event specialists, respectively. The VO2 responses achieved were 93.1% +/- 2.0% and 85.7% +/- 3.0% VO2max for the 400-m- and 800-m-event specialists, respectively (P = .001). These results demonstrate that specialist running events do appear to influence the percentage of VO2max achieved in the 400-m trial, with the 800-m specialists attaining a lower percentage of VO2max than the 400-m specialists. The 400-m specialists appear to compensate for a lower VO2max by attaining a higher percentage VO2max during a 400-m trial.

A marching-walking hybrid induces step length adaptation and transfers to natural walking

PubMed Central

Long, Andrew W.; Finley, James M.

2015-01-01

Walking is highly adaptable to new demands and environments. We have previously studied adaptation of locomotor patterns via a split-belt treadmill, where subjects learn to walk with one foot moving faster than the other. Subjects learn to adapt their walking pattern by changing the location (spatial) and time (temporal) of foot placement. Here we asked whether we can induce adaptation of a specific walking pattern when one limb does not “walk” but instead marches in place (i.e., marching-walking hybrid). The marching leg's movement is limited during the stance phase, and thus certain sensory signals important for walking may be reduced. We hypothesized that this would produce a spatial-temporal strategy different from that of normal split-belt adaptation. Healthy subjects performed two experiments to determine whether they could adapt their spatial-temporal pattern of step lengths during the marching-walking hybrid and whether the learning transfers to over ground walking. Results showed that the hybrid group did adapt their step lengths, but the time course of adaptation and deadaption was slower than that for the split-belt group. We also observed that the hybrid group utilized a mostly spatial strategy whereas the split-belt group utilized both spatial and temporal strategies. Surprisingly, we found no significant difference between the hybrid and split-belt groups in over ground transfer. Moreover, the hybrid group retained more of the learned pattern when they returned to the treadmill. These findings suggest that physical rehabilitation with this marching-walking paradigm on conventional treadmills may produce changes in symmetry comparable to what is observed during split-belt training. PMID:25867742

A marching-walking hybrid induces step length adaptation and transfers to natural walking.

PubMed

Long, Andrew W; Finley, James M; Bastian, Amy J

2015-06-01

Walking is highly adaptable to new demands and environments. We have previously studied adaptation of locomotor patterns via a split-belt treadmill, where subjects learn to walk with one foot moving faster than the other. Subjects learn to adapt their walking pattern by changing the location (spatial) and time (temporal) of foot placement. Here we asked whether we can induce adaptation of a specific walking pattern when one limb does not "walk" but instead marches in place (i.e., marching-walking hybrid). The marching leg's movement is limited during the stance phase, and thus certain sensory signals important for walking may be reduced. We hypothesized that this would produce a spatial-temporal strategy different from that of normal split-belt adaptation. Healthy subjects performed two experiments to determine whether they could adapt their spatial-temporal pattern of step lengths during the marching-walking hybrid and whether the learning transfers to over ground walking. Results showed that the hybrid group did adapt their step lengths, but the time course of adaptation and deadaption was slower than that for the split-belt group. We also observed that the hybrid group utilized a mostly spatial strategy whereas the split-belt group utilized both spatial and temporal strategies. Surprisingly, we found no significant difference between the hybrid and split-belt groups in over ground transfer. Moreover, the hybrid group retained more of the learned pattern when they returned to the treadmill. These findings suggest that physical rehabilitation with this marching-walking paradigm on conventional treadmills may produce changes in symmetry comparable to what is observed during split-belt training. Copyright © 2015 the American Physiological Society.

Physiological differences between cycling and running: lessons from triathletes.

PubMed

Millet, Gregoire P; Vleck, V E; Bentley, D J

2009-01-01

The purpose of this review was to provide a synopsis of the literature concerning the physiological differences between cycling and running. By comparing physiological variables such as maximal oxygen consumption (V O(2max)), anaerobic threshold (AT), heart rate, economy or delta efficiency measured in cycling and running in triathletes, runners or cyclists, this review aims to identify the effects of exercise modality on the underlying mechanisms (ventilatory responses, blood flow, muscle oxidative capacity, peripheral innervation and neuromuscular fatigue) of adaptation. The majority of studies indicate that runners achieve a higher V O(2max) on treadmill whereas cyclists can achieve a V O(2max) value in cycle ergometry similar to that in treadmill running. Hence, V O(2max) is specific to the exercise modality. In addition, the muscles adapt specifically to a given exercise task over a period of time, resulting in an improvement in submaximal physiological variables such as the ventilatory threshold, in some cases without a change in V O(2max). However, this effect is probably larger in cycling than in running. At the same time, skill influencing motor unit recruitment patterns is an important influence on the anaerobic threshold in cycling. Furthermore, it is likely that there is more physiological training transfer from running to cycling than vice versa. In triathletes, there is generally no difference in V O(2max) measured in cycle ergometry and treadmill running. The data concerning the anaerobic threshold in cycling and running in triathletes are conflicting. This is likely to be due to a combination of actual training load and prior training history in each discipline. The mechanisms surrounding the differences in the AT together with V O(2max) in cycling and running are not largely understood but are probably due to the relative adaptation of cardiac output influencing V O(2max) and also the recruitment of muscle mass in combination with the oxidative capacity of this mass influencing the AT. Several other physiological differences between cycling and running are addressed: heart rate is different between the two activities both for maximal and submaximal intensities. The delta efficiency is higher in running. Ventilation is more impaired in cycling than in running. It has also been shown that pedalling cadence affects the metabolic responses during cycling but also during a subsequent running bout. However, the optimal cadence is still debated. Central fatigue and decrease in maximal strength are more important after prolonged exercise in running than in cycling.

Performance on a work-simulating firefighter test versus approved laboratory tests for firefighters and applicants.

PubMed

von Heimburg, Erna; Medbø, Jon Ingulf; Sandsund, Mariann; Reinertsen, Randi Eidsmo

2013-01-01

Firefighters must meet minimum physical demands. The Norwegian Labour Inspection Authority (NLIA) has approved a standardised treadmill walking test and 3 simple strength tests for smoke divers. The results of the Trondheim test were compared with those of the NLIA tests taking into account possible effects of age, experience level and gender. Four groups of participants took part in the tests: 19 young experienced firefighters, 24 senior male firefighters and inexperienced applicants, 12 male and 8 female. Oxygen uptake (VO2) at exhaustion rose linearly by the duration of the treadmill test. Time spent on the Trondheim test was closely related to performance time and peak VO2 on the treadmill test. Senior experienced firefighters did not perform better than equally fit young applicants. However, female applicants performed poorer on the Trondheim test than on the treadmill test. Performance on the Trondheim test was not closely related to muscle strength beyond a minimum. CONCLUSION. Firefighters completing the Trondheim test in under 19 min fit the requirements of the NLIA treadmill test. The Trondheim test can be used as an alternative to the NLIA tests for testing aerobic fitness but not for muscular strength. Women's result of the Trondheim test were poorer than the results of the NLIA treadmill test, probably because of their lower body mass.

Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke: a randomized, controlled trial.

PubMed

Macko, Richard F; Ivey, Frederick M; Forrester, Larry W; Hanley, Daniel; Sorkin, John D; Katzel, Leslie I; Silver, Kenneth H; Goldberg, Andrew P

2005-10-01

Physical inactivity propagates disability after stroke through physical deconditioning and learned nonuse. We investigated whether treadmill aerobic training (T-AEX) is more effective than conventional rehabilitation to improve ambulatory function and cardiovascular fitness in patients with chronic stroke. Sixty-one adults with chronic hemiparetic gait after ischemic stroke (>6 months) were randomized to 6 months (3x/week) progressive T-AEX or a reference rehabilitation program of stretching plus low-intensity walking (R-CONTROL). Peak exercise capacity (Vo2 peak), o2 consumption during submaximal effort walking (economy of gait), timed walks, Walking Impairment Questionnaire (WIQ), and Rivermead Mobility Index (RMI) were measured before and after 3 and 6 months of training. Twenty-five patients completed T-AEX and 20 completed R-CONTROL. Only T-AEX increased cardiovascular fitness (17% versus 3%, delta% T-AEX versus R-CONTROL, P<0.005). Group-by-time analyses revealed T-AEX improved ambulatory performance on 6-minute walks (30% versus 11%, P<0.02) and mobility function indexed by WIQ distance scores (56% versus 12%, P<0.05). In the T-AEX group, increasing training velocity predicted improved Vo2 peak (r=0.43, P<0.05), but not walking function. In contrast, increasing training session duration predicted improved 6-minute walk (r=0.41, P<0.05), but not fitness gains. T-AEX improves both functional mobility and cardiovascular fitness in patients with chronic stroke and is more effective than reference rehabilitation common to conventional care. Specific characteristics of training may determine the nature of exercise-mediated adaptations.

A 4-week neuromuscular training program and gait patterns at the ankle joint.

PubMed

Coughlan, Garrett; Caulfield, Brian

2007-01-01

Previous research into the rehabilitation of ankle sprains has primarily focused on outcome measures that do not replicate functional activities, thus making it difficult to extrapolate the results relative to the weight-bearing conditions under which most ankle sprains occur. To measure the effects of a training program on gait during walking and running in an active athletic population. Matched-pairs, controlled trial. University motion analysis laboratory. Ten subjects from an athletic population (7 healthy, 3 with functional ankle instability: age = 25.8 +/- 3.9 years, height = 177.6 +/- 6.1 cm, mass = 66.8 +/- 7.4 kg) and 10 controls matched for age, sex, activity, and ankle instability (7 healthy, 3 with functional ankle instability: age = 27.4 +/- 5.8 years, height = 178.7 +/- 10.8 cm, mass = 71.6 +/- 10.0 kg). A 4-week neuromuscular training program undertaken by the treatment group. We measured ankle position and velocity in the frontal (x) and sagittal (y) planes in all subjects during treadmill walking and running for the periods 100 milliseconds before heel strike, at heel strike, and 100 milliseconds after heel strike. A 4-week neuromuscular training program resulted in no significant changes in ankle position or velocity during treadmill walking and running. The mechanisms by which neuromuscular training improves function in normal subjects and those with functional ankle instability do not appear to result in measurable changes in gait kinematics. Our findings raise issues regarding methods of ankle sprain rehabilitation and the measurement of their effectiveness in improving functional activities. Further research in a larger population with functional ankle instability is necessary.

Kinematic variability, fractal dynamics and local dynamic stability of treadmill walking

PubMed Central

2011-01-01

Background Motorized treadmills are widely used in research or in clinical therapy. Small kinematics, kinetics and energetics changes induced by Treadmill Walking (TW) as compared to Overground Walking (OW) have been reported in literature. The purpose of the present study was to characterize the differences between OW and TW in terms of stride-to-stride variability. Classical (Standard Deviation, SD) and non-linear (fractal dynamics, local dynamic stability) methods were used. In addition, the correlations between the different variability indexes were analyzed. Methods Twenty healthy subjects performed 10 min TW and OW in a random sequence. A triaxial accelerometer recorded trunk accelerations. Kinematic variability was computed as the average SD (MeanSD) of acceleration patterns among standardized strides. Fractal dynamics (scaling exponent α) was assessed by Detrended Fluctuation Analysis (DFA) of stride intervals. Short-term and long-term dynamic stability were estimated by computing the maximal Lyapunov exponents of acceleration signals. Results TW did not modify kinematic gait variability as compared to OW (multivariate T2, p = 0.87). Conversely, TW significantly modified fractal dynamics (t-test, p = 0.01), and both short and long term local dynamic stability (T2 p = 0.0002). No relationship was observed between variability indexes with the exception of significant negative correlation between MeanSD and dynamic stability in TW (3 × 6 canonical correlation, r = 0.94). Conclusions Treadmill induced a less correlated pattern in the stride intervals and increased gait stability, but did not modify kinematic variability in healthy subjects. This could be due to changes in perceptual information induced by treadmill walking that would affect locomotor control of the gait and hence specifically alter non-linear dependencies among consecutive strides. Consequently, the type of walking (i.e. treadmill or overground) is important to consider in each protocol design. PMID:21345241

Gait analysis following treadmill training with body weight support versus conventional physical therapy: a prospective randomized controlled single blind study.

PubMed

Lucareli, P R; Lima, M O; Lima, F P S; de Almeida, J G; Brech, G C; D'Andréa Greve, J M

2011-09-01

Single-blind randomized, controlled clinical study. To evaluate, using kinematic gait analysis, the results obtained from gait training on a treadmill with body weight support versus those obtained with conventional gait training and physiotherapy. Thirty patients with sequelae from traumatic incomplete spinal cord injuries at least 12 months earlier; patients were able to walk and were classified according to motor function as ASIA (American Spinal Injury Association) impairment scale C or D. Patients were divided randomly into two groups of 15 patients by the drawing of opaque envelopes: group A (weight support) and group B (conventional). After an initial assessment, both groups underwent 30 sessions of gait training. Sessions occurred twice a week, lasted for 30 min each and continued for four months. All of the patients were evaluated by a single blinded examiner using movement analysis to measure angular and linear kinematic gait parameters. Six patients (three from group A and three from group B) were excluded because they attended fewer than 85% of the training sessions. There were no statistically significant differences in intra-group comparisons among the spatial-temporal variables in group B. In group A, the following significant differences in the studied spatial-temporal variables were observed: increases in velocity, distance, cadence, step length, swing phase and gait cycle duration, in addition to a reduction in stance phase. There were also no significant differences in intra-group comparisons among the angular variables in group B. However, group A achieved significant improvements in maximum hip extension and plantar flexion during stance. Gait training with body weight support was more effective than conventional physiotherapy for improving the spatial-temporal and kinematic gait parameters among patients with incomplete spinal cord injuries.

Selectively bred rat model system for low and high response to exercise training

PubMed Central

Pollott, Geoffrey E.; Britton, Steven L.

2013-01-01

We initiated a large-scale bidirectional selection experiment in a genetically heterogeneous rat population (N/NIH stock, n = 152) to develop lines of low response trainers (LRT) and high response trainers (HRT) as a contrasting animal model system. Maximal treadmill running distance [meters (m)] was tested before (DIST1) and after (DIST2) standardized aerobic treadmill training over an 8 wk period (3 exercise sessions per week). Response to training was calculated as the change in exercise capacity (ΔDIST = DIST2 − DIST1). A within-family selection and rotational breeding paradigm between 10 families was practiced for both selected lines. For the founder population, exercise training produced a 140 ± 15 m gain in exercise capacity with interindividual variation ranging from −339 to +627 m. After 15 generations of selection (n = 3,114 rats), HRT rats improved 223 ± 20 m as a result of exercise training while exercise capacity declined −65 ± 15 m in LRT rats given the same absolute training environment. The narrow-sense heritability (h2) for ΔDIST was 0.10 ± 0.02. The LRT and HRT lines did not differ significantly for body weight or intrinsic (i.e., DIST1) exercise capacity. Using pedigree records the inbreeding coefficient increased at a rate of 1.7% per generation for HRT and 1.6% per generation for LRT, ∼30% slower than expected from random mating. Animal models developed from heterogeneous stock and enriched via selection, as presented here, often generate extreme values for traits of interest and may prove more useful than current models for uncovering genetic underpinnings. PMID:23715262

Effect of Moderate Versus High-Intensity Interval Exercise Training on Heart Rate Variability Parameters in Inactive Latin-American Adults: A Randomised Clinical Trial.

PubMed

Ramírez-Vélez, Robinson; Tordecilla-Sanders, Alejandra; Téllez-T, Luis Andrés; Camelo-Prieto, Diana; Hernández-Quiñonez, Paula Andrea; Correa-Bautista, Jorge Enrique; Garcia-Hermoso, Antonio; Ramírez-Campillo, Rodrigo; Izquierdo, Mikel

2017-02-01

We investigated the effect of moderate versus high-intensity interval exercise training on the HRV indices in physically inactive adults. Twenty inactive adults were randomly allocated to receive either moderate intensity training (MCT group) or high-intensity interval training (HIT group). The MCT group performed aerobic training at an intensity of 55-75%, which consisted of walking on a treadmill at 60-80% of the maximum heart rate (HRmax) until the expenditure of 300 kcal. The HIT group ran on a treadmill for 4 minutes at 85-95% peak HRmax and had a recovery of 4 minutes at 65% peak HRmax until the expenditure of 300 kcal. Supine resting HRV indices (time domain: SDNN, standard deviation of normal-to-normal intervals; rMSSD, Root mean square successive difference of RR intervals and frequency domain: HFLn, high-frequency spectral power; LF, low-frequency spectral power and HF/LF ratio) were measured at baseline and 12 weeks thereafter. The SDNN changes were 3.4 (8.9) ms in the MCT group and 29.1 (7.6) ms in the HIT group (difference between groups 32.6 [95% CI, 24.9 to 40.4 (P = 0.01)]. The LF/HFLn ratio change 0.19 (0.03) ms in the MCT group and 0.13 (0.01) ms in the HIT group (P between groups = 0.016). No significant group differences were observed for the rMSSD, HF and LF parameters. In inactive adults, this study showed that a 12-week HIT training program could increase short-term HRV, mostly in vagally mediated indices such as SDNN and HF/LFLn ratio power.

Task-oriented aerobic exercise in chronic hemiparetic stroke: training protocols and treatment effects.

PubMed

Macko, R F; Ivey, F M; Forrester, L W

2005-01-01

Stroke is the leading cause of disability in older Americans. Each year 750,000 Americans suffer a stroke, two thirds of whom are left with neurological deficits that persistently impair function. Principal among them is hemiparetic gait that limits mobility and increases fall risk, promoting a sedentary lifestyle. These events propagate disability by physical deconditioning and "learned non-use," with further functional declines accelerated by the sarcopenia and fitness decrements of advancing age. Conventional rehabilitation care typically provides little or no structured therapeutic exercise beyond the subacute stroke recovery period, based on natural history studies showing little or no further functional motor recovery beyond 6 months after stroke. Emerging evidence suggests that new models of task-oriented exercise have the potential to improve motor function even years after stroke. This article presents treadmill as a task-oriented training paradigm to optimize locomotor relearning while eliciting cardiovascular conditioning in chronic stroke patients. Protocols for exercise testing and longitudinal aerobic training progression are presented that provide fundamental formulas that safely approach the complex task of customizing aerobic training to gait deficit severity in the high CVD risk stroke population. The beneficial effects of 6 months task-oriented treadmill exercise on cardiovascular-metabolic fitness, energy cost of hemiparetic gait, ADL mobility task performance, and leg strength are discussed with respect to the central and peripheral neuromuscular adaptations targeted by the training. Collectively, these findings constitute one initial experience in a much broader neuroscience and exercise rehabilitation development of task-oriented training paradigms that offer a multisystems approach to improving both neurological and cardiovascular health outcomes in the chronic stroke population.

Supplemental intermittent-day heat training and the lactate threshold.

PubMed

Gollan, Stuart; Chalmers, Samuel; Alderton, Stephen; Norton, Kevin

2017-04-01

Heat acclimation over consecutive days has been shown to improve aerobic-based performance. Recently, it has been suggested that heat training can improve performance in a temperate environment. However, due to the multifactorial training demands of athletes, consecutive-day heat training may not be suitable. The current study aimed to investigate the effect of brief (8×30min) intermittent (every 3-4 days) supplemental heat training on the second lactate threshold point (LT 2 ) in temperate and hot conditions. 21 participants undertook eight intermittent-day mixed-intensity treadmill exercise training sessions in hot (30°C; 50% relative humidity [RH]) or temperate (18°C; 30% RH) conditions. A pre- and post-incremental exercise test occurred in temperate (18°C; 30% RH) and hot conditions (30°C; 50% RH) to determine the change in LT 2 . The heat training protocol did not improve LT 2 in temperate (Effect Size [ES]±90 confidence interval=0.10±0.16) or hot (ES=0.26±0.26) conditions. The primary finding was that although the intervention group had a change greater than the SWC, no statistically significant improvements were observed following an intermittent eight day supplemental heat training protocol comparable to a control group training only in temperate conditions. This is likely due to the brief length of each heat training session and/or the long duration between each heat exposure. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparison of single bout effects of bicycle training versus locomotor training on paired reflex depression of the soleus H-reflex after motor incomplete spinal cord injury.

PubMed

Phadke, Chetan P; Flynn, Sheryl M; Thompson, Floyd J; Behrman, Andrea L; Trimble, Mark H; Kukulka, Carl G

2009-07-01

To examine paired reflex depression changes post 20-minute bout each of 2 training environments: stationary bicycle ergometer training (bicycle training) and treadmill with body weight support and manual assistance (locomotor training). Pretest-posttest repeated-measures. Locomotor laboratory. Motor incomplete SCI (n=12; mean, 44+/-16y); noninjured subjects (n=11; mean, 30.8+/-8.3y). All subjects received each type of training on 2 separate days. Paired reflex depression at different interstimulus intervals (10 s, 1 s, 500 ms, 200 ms, and 100 ms) was measured before and after both types of training. (1) Depression was significantly less post-SCI compared with noninjured subjects at all interstimulus intervals and (2) post-SCI at 100-millisecond interstimulus interval: reflex depression significantly increased postbicycle training in all SCI subjects and in the chronic and spastic subgroups (P<.05). Phase-dependent regulation of reflex excitability, essential to normal locomotion, coordinated by pre- and postsynaptic inhibitory processes (convergent action of descending and segmental inputs onto spinal circuits) is impaired post-SCI. Paired reflex depression provides a quantitative assay of inhibitory processes contributing to phase-dependent changes in reflex excitability. Because bicycle training normalized reflex depression, we propose that bicycling may have a potential role in walking rehabilitation, and future studies should examine the long-term effects on subclinical measures of reflex activity and its relationship to functional outcomes.

Metabolomic Response of Skeletal Muscle to Aerobic Exercise Training in Insulin Resistant Type 1 Diabetic Rats.

PubMed

Dotzert, Michelle S; Murray, Michael R; McDonald, Matthew W; Olver, T Dylan; Velenosi, Thomas J; Hennop, Anzel; Noble, Earl G; Urquhart, Brad L; Melling, C W James

2016-05-20

The etiology of insulin resistance in Type 1 Diabetes (T1D) is unknown, however it affects approximately 20% of T1D patients. Intramyocellular lipids (IMCL) have been identified as a mechanism of insulin resistance. We examined skeletal muscle of T1D rats to determine if alterations in lipid metabolism were evident and whether aerobic exercise training improves IMCL and insulin resistance. To do so, 48 male Sprague-Dawley rats were divided into control (C), sedentary diabetes (D) and diabetes exercise (DX) groups. Following multiple low-dose Streptozotocin (STZ) injections (20 mg/kg), glycemia (9-15 mM) was maintained using insulin treatment. DX were treadmill trained at high intensity (~75% V02max; 5days/week) for 10 weeks. The results demonstrate that D exhibited insulin resistance compared with C and DX, indicated by decreased glucose infusion rate during a hyperinsulinemic-euglycemic clamp (p < 0.05). There were no differences between C and DX, suggesting that exercise improved insulin resistance (p < 0.05). Metabolomics analysis revealed a significant shift in lipid metabolism whereby notable fatty acid metabolites (arachidonic acid, palmitic acid and several polyunsaturated fatty acids) were significantly elevated in D compared to C and DX. Based on the intermediates observed, insulin resistance in T1D is characterized by an insulin-desensitizing intramyocellular fatty acid metabolite profile that is ameliorated with exercise training.

Retraining walking adaptability following incomplete spinal cord injury.

PubMed

Fox, Emily J; Tester, Nicole J; Butera, Katie A; Howland, Dena R; Spiess, Martina R; Castro-Chapman, Paula L; Behrman, Andrea L

2017-01-01

Functional walking requires the ability to modify one's gait pattern to environmental demands and task goals-gait adaptability. Following incomplete spinal cord injury (ISCI), gait rehabilitation such as locomotor training (Basic-LT) emphasizes intense, repetitive stepping practice. Rehabilitation approaches focusing on practice of gait adaptability tasks have not been established for individuals with ISCIs but may promote recovery of higher level walking skills. The primary purpose of this case series was to describe and determine the feasibility of administering a gait adaptability retraining approach-Adapt-LT-by comparing the dose and intensity of Adapt-LT to Basic-LT. Three individuals with ISCIs (>1 year, AIS C or D) completed three weeks each (15 sessions) of Basic-LT and Adapt-LT. Interventions included practice on a treadmill with body weight support and practice overground (≥30 mins total). Adapt-LT focused on speed changes, obstacle negotiation, and backward walking. Training parameters (step counts, speeds, perceived exertion) were compared and outcomes assessed pre and post interventions. Based on completion of the protocol and similarities in training parameters in the two interventions, it was feasible to administer Adapt-LT with a similar dosage and intensity as Basic-LT. Additionally, the participants demonstrated gains in walking function and balance following each training type. Rehabilitation that includes stepping practice with adaptability tasks is feasible for individuals with ISCIs. Further investigation is needed to determine the efficacy of Adapt-LT.

Knockout of p21-activated kinase-1 attenuates exercise-induced cardiac remodelling through altered calcineurin signalling

PubMed Central

Davis, Robert T.; Simon, Jillian N.; Utter, Megan; Mungai, Paul; Alvarez, Manuel G.; Chowdhury, Shamim A.K.; Heydemann, Ahlke; Ke, Yunbo; Wolska, Beata M.; Solaro, R. John

2015-01-01

Aims Despite its known cardiovascular benefits, the intracellular signalling mechanisms underlying physiological cardiac growth remain poorly understood. Therefore, the purpose of this study was to investigate a novel role of p21-activated kinase-1 (Pak1) in the regulation of exercise-induced cardiac hypertrophy. Methods and results Wild-type (WT) and Pak1 KO mice were subjected to 6 weeks of treadmill endurance exercise training (ex-training). Cardiac function was assessed via echocardiography, in situ haemodynamics, and the pCa–force relations in skinned fibre preparations at baseline and at the end of the training regimen. Post-translational modifications to the sarcomeric proteins and expression levels of calcium-regulating proteins were also assessed following ex-training. Heart weight/tibia length and echocardiography data revealed that there was marked hypertrophy following ex-training in the WT mice, which was not evident in the KO mice. Additionally, following ex-training, WT mice demonstrated an increase in cardiac contractility, myofilament calcium sensitivity, and phosphorylation of cardiac myosin-binding protein C, cardiac TnT, and tropomyosin compared with KO mice. With ex-training in WT mice, there were also increased protein levels of calcineurin and increased phosphorylation of phospholamban. Conclusions Our data suggest that Pak1 is essential for adaptive physiological cardiac remodelling and support previous evidence that demonstrates Pak1 signalling is important for cardiac growth and survival. PMID:26464331

Robot-assisted gait training in patients with Parkinson disease: a randomized controlled trial.

PubMed

Picelli, Alessandro; Melotti, Camilla; Origano, Francesca; Waldner, Andreas; Fiaschi, Antonio; Santilli, Valter; Smania, Nicola

2012-05-01

. Gait impairment is a common cause of disability in Parkinson disease (PD). Electromechanical devices to assist stepping have been suggested as a potential intervention. . To evaluate whether a rehabilitation program of robot-assisted gait training (RAGT) is more effective than conventional physiotherapy to improve walking. . A total of 41 patients with PD were randomly assigned to 45-minute treatment sessions (12 in all), 3 days a week, for 4 consecutive weeks of either robotic stepper training (RST; n = 21) using the Gait Trainer or physiotherapy (PT; n = 20) with active joint mobilization and a modest amount of conventional gait training. Participants were evaluated before, immediately after, and 1 month after treatment. Primary outcomes were 10-m walking speed and distance walked in 6 minutes. . Baseline measures revealed no statistical differences between groups, but the PT group walked 0.12 m/s slower; 5 patients withdrew. A statistically significant improvement was found in favor of the RST group (walking speed 1.22 ± 0.19 m/s [P = .035]; distance 366.06 ± 78.54 m [P < .001]) compared with the PT group (0.98 ± 0.32 m/s; 280.11 ± 106.61 m). The RAGT mean speed increased by 0.13 m/s, which is probably not clinically important. Improvements were maintained 1 month later. . RAGT may improve aspects of walking ability in patients with PD. Future trials should compare robotic assistive training with treadmill or equal amounts of overground walking practice.

Functional and psychosocial effects of either a traditional dancing or a formal exercising training program in patients with chronic heart failure: a comparative randomized controlled study.

PubMed

Kaltsatou, Antonia C H; Kouidi, Evangelia I; Anifanti, Maria A; Douka, Stella I; Deligiannis, Asterios P

2014-02-01

To compare the effects of traditional dancing with formal exercise training in terms of functional and cardiovascular benefits and motivation in patients with chronic heart failure. Randomized controlled trial. Sports Medicine Laboratory. Fifty-one Greek male patients aged 67.1±5.5 years with chronic heart failure of New York Heart Association (NYHA) class II-III, participated in an eight-month study. They were randomly assigned to either training with Greek traditional dances (group A, n=18), formal exercise training (group B, n=16) or a sedentary control group (group C, n=17). At entry and the end of the study all patients underwent cardiopulmonary exercise testing, functional ability assessment and quality of life evaluations. The Intrinsic Motivation Inventory was also used to assess participants' subjective experience. After training group A showed increased peak oxygen consumption by 33.8% (19.5 vs. 26.1 ml/kg/min, p<0.05) and B by 32.3% (19.5 vs. 25.8 ml/kg/min, p<0.05), maximal treadmill tolerance by 48.5% (p<0.05) and by 46.4% (p<0.05), and a decreased Slope of expired minute ventilation for carbon dioxide output (VE/VCO2) slope by 18% (p<0.05) and 19.5% (p<0.05), respectively. Trained patients revealed significant improvement in the quality of life indices. Intrinsic Motivation Inventory was increased only in group A by 26.2% (3.08 vs. 3.87, p<0.05). Exercise training in chronic heart failure patients with Greek traditional dances led to functional and cardiovascular benefits similar to formal exercise training and to a higher level of motivation.

Task-Specific and Functional Effects of Speed-Focused Elliptical or Motor-Assisted Cycle Training in Children With Bilateral Cerebral Palsy: Randomized Clinical Trial.

PubMed

Damiano, Diane L; Stanley, Christopher J; Ohlrich, Laurie; Alter, Katharine E

2017-08-01

Locomotor training using treadmills or robotic devices is commonly utilized to improve gait in cerebral palsy (CP); however, effects are inconsistent and fail to exceed those of equally intense alternatives. Possible limitations of existing devices include fixed nonvariable rhythm and too much limb or body weight assistance. To quantify and compare effectiveness of a motor-assisted cycle and a novel alternative, an elliptical, in CP to improve interlimb reciprocal coordination through intensive speed-focused leg training. A total of 27 children with bilateral CP, 5 to 17 years old, were randomized to 12 weeks of 20 minutes, 5 days per week home-based training (elliptical = 14; cycle = 13) at a minimum of 40 revolutions per minute, with resistance added when speed target was achieved. Primary outcomes were self-selected and fastest voluntary cadence on the devices and gait speed. Secondary outcomes included knee muscle strength, and selective control and functional mobility measures. Cadence on trained but not nontrained devices increased, demonstrating task specificity of training and increased exercise capability. Mean gait speed did not increase in either group, nor did parent-reported functional mobility. Knee extensor strength increased in both. An interaction between group and time was seen in selective control with scores slightly increasing for the elliptical and decreasing for the cycle, possibly related to tighter limb coupling with cycling. Task-specific effects were similarly positive across groups, but no transfer was seen to gait or function. Training dose was low (≤20 hours) compared with intensive upper-limb training recommendations and may be insufficient to produce appreciable clinical change.

Inflight Treadmill Exercise Can Serve as Multi-Disciplinary Countermeasure System

NASA Technical Reports Server (NTRS)

Bloomberg, J. J.; Batson, C. D.; Buxton, R. E.; Feiveson, A. H.; Kofman, I. S.; Laurie, S.; Lee, S. M. C.; Miller, C. A.; Mulavara, A. P.; Peters, B. T.;

Treadmill walking in water induces greater respiratory muscle fatigue than treadmill walking on land in healthy young men.

PubMed

Yamashina, Yoshihiro; Yokoyama, Hisayo; Naghavi, Nooshin; Hirasawa, Yoshikazu; Takeda, Ryosuke; Ota, Akemi; Imai, Daiki; Miyagawa, Toshiaki; Okazaki, Kazunobu

2016-05-01

The purpose of the present study was to investigate the effect of walking in water on respiratory muscle fatigue compared with that of walking on land at the same exercise intensity. Ten healthy males participated in 40-min treadmill walking trials on land and in water at an intensity of 60% of peak oxygen consumption. Respiratory function and respiratory muscle strength were evaluated before and after walking trials. Inspiratory muscle strength and forced expiratory volume in 1 s were significantly decreased immediately after walking in water, and expiratory muscle strength was significantly decreased immediately and 5 min after walking in water compared with the baseline. The decreases of inspiratory and expiratory muscle strength were significantly greater compared with that after walking on land. In conclusion, greater inspiratory and expiratory muscle fatigue was induced by walking in water than by walking on land at the same exercise intensity in healthy young men.

Age-related effect of aerobic exercise training on antioxidant and oxidative markers in the liver challenged by doxorubicin in rats.

PubMed

Ahmadian, Mehdi; Dabidi Roshan, Valiollah; Leicht, Anthony S

2018-05-16

The aims of the current study were to investigate the oxidant and antioxidant status of liver tissue challenged by doxorubicin and to examine the possible protective effects of aerobic exercise on doxorubicin-induced oxidative stress. Seventy-two rats were divided into three age groups (Young, Adult, and Elderly) with three treatment subgroups consisting of eight rats per age group: doxorubicin, aerobic exercise + doxorubicin, and aerobic exercise + saline. The experimental groups performed regular treadmill running for 3 weeks. Doxorubicin was administered by i.p. injection at a dosage of 20 mg kg -1 while the aerobic exercise + saline group received saline of a comparable volume. Heat shock protein 70, malondialdehyde, glutathione peroxidase, and protein carbonyl were determined from the liver homogenates following the intervention period. Treatment with doxorubicin induced hepatotoxicity in all groups with lower values of oxidative stress in young compared with the older groups. The inclusion of aerobic exercise training significantly increased heat shock protein 70 and antioxidant enzyme levels (glutathione peroxidase) whereas it decreased oxidative stress biomarkers (malondialdehyde and protein carbonyl) for all age groups. These results suggest that aerobic exercise training may be a potential, non-drug strategy to modulate doxorubicin-induced hepatotoxicity through its positive impact on antioxidant levels and oxidative stress biomarkers.

Effect of speed endurance and strength training on performance, running economy and muscular adaptations in endurance-trained runners.

PubMed

Vorup, Jacob; Tybirk, Jonas; Gunnarsson, Thomas P; Ravnholt, Tanja; Dalsgaard, Sarah; Bangsbo, Jens

2016-07-01

To investigate the effects of combined strength and speed endurance (SE) training along with a reduced training volume on performance, running economy and muscular adaptations in endurance-trained runners. Sixteen male endurance runners (VO2-max: ~60 ml kg(-1) min(-1)) were randomly assigned to either a combined strength and SE training (CSS; n = 9) or a control (CON; n = 7) group. For 8 weeks, CSS replaced their normal moderate-intensity training (~63 km week(-1)) with SE (2 × week(-1)) and strength training (2 × week(-1)) as well as aerobic high (1 × week(-1)) and moderate (1 × week(-1)) intensity training with a reduction in total volume of ~58 %, whereas CON continued their training (~45 km week(-1)). In CSS, 400-m and Yo-Yo intermittent recovery test performance was improved by 5 % (P < 0.01) and 19 % (P < 0.001), respectively, during the intervention period. Maximal aerobic speed was 0.6 km h(-1) higher (P < 0.05), and maximal activity of lactate dehydrogenase subunits 1 and 2 was 17 % (P < 0.05) higher after compared to before the intervention period. Time to exhaustion and peak blood lactate during an incremental treadmill test was 9 % (P < 0.05) and 32 % (P < 0.01), respectively, higher and expression of Na(+)-K(+) pump β1 subunit was 15 % higher (P < 0.05) after compared to before the intervention period. 10-K performance, maximum oxygen uptake and running economy were unchanged. In CON, no changes were observed. Adding strength and speed endurance training, along with a reduced training volume, can improve short-term exercise capacity and induce muscular adaptations related to anaerobic capacity in endurance-trained runners.

Adaptive gait responses to awareness of an impending slip during treadmill walking.

PubMed

Yang, Feng; Kim, JaeEun; Munoz, Jose

2016-10-01

The awareness of potential slip risk has been shown to cause protective changes to human gait during overground walking. It remains unknown if such adaptations to walking pattern also exist when ambulating on a treadmill. This study sought to determine whether and to what extent individuals, when being aware of a potential slip risk during treadmill walking, could adjust their gait pattern to improve their dynamic stability against backward balance loss in response to the impending slip hazard. Fifty-four healthy young subjects (age: 23.9±4.7years) participated in this study. Subjects' gait pattern was measured under two conditions: walking on a treadmill without (or normal walking) and with (or aware walking) the awareness of the potential slip perturbation. During both walking conditions, subjects' full body kinematics were gathered by using a motion capture system. Spatial gait parameters and the dynamic gait stability against backward balance were compared between the two walking conditions. The results revealed that subjects proactively adopted a "cautious gait" during aware walking compared with the normal walking. The cautious gait, which was achieved by taking a shorter step and a more flatfoot landing, positioned the body center of mass closer to the base of support, improving participants' dynamic stability and increasing their resistance against a possible slip-related fall. The finding from this study could provide insights into the dynamic stability control when individuals anticipate potential slip risk during treadmill walking. Copyright © 2016 Elsevier B.V. All rights reserved.

A comparison of VO2max and metabolic variables between treadmill running and treadmill skating.

PubMed

Koepp, Kriston K; Janot, Jeffrey M

2008-03-01

The purpose of this study was to determine differences in VO2max and metabolic variables between treadmill running and treadmill skating. This study also examined VO2max responses during a continuous skating treadmill protocol and a discontinuous skating treadmill protocol. Sixteen male high school hockey players, who had a mean age of 16 +/- 1 years and were of an above-average fitness level, participated in this study. All subjects completed 4 exercise trials: a 1-hour skating treadmill familiarization trial, a treadmill running trial, and 2 randomized skating treadmill trials. Minute ventilation (VE), oxygen consumption VO2), carbon dioxide production VCO2), respiratory exchange ratio (RER), and heart rate were averaged every 15 seconds up to VO2max for each exercise test. The results showed that there was a significant difference (P < 0.05) for VO2max (mL.kg.min) and maximal VCO2 (L.min) between the running treadmill protocol and discontinuous skating treadmill protocol. There was also a significant difference for maximal RER between the discontinuous and continuous skating treadmill protocol and between the discontinuous skating treadmill protocol and running treadmill protocol. In conclusion, the running treadmill elicited a greater VO2max (mL.kg.min) than the skating treadmill did, but when it comes to specificity of ice skating, the skating treadmill may be ideal. Also, there was no significant difference between the discontinuous and continuous skating treadmill protocols. Therefore, a continuous protocol is possible on the skating treadmill without compromising correct skating position and physiologic responses. However, the continuous skating treadmill protocol should undergo validation before other scientists, coaches, and strength and conditioning professionals can apply it correctly.

In-shoe plantar pressure distribution and lower extremity muscle activity patterns of backward compared to forward running on a treadmill.

PubMed

Sterzing, Thorsten; Frommhold, Clivia; Rosenbaum, Dieter

2016-05-01

Backward locomotion in humans occurs during leisure, rehabilitation, and competitive sports. Little is known about its general biomechanical characteristics and how it affects lower extremity loading as well as muscle coordination. Thus, the purpose of this research was to analyze in-shoe plantar pressure patterns and lower extremity muscle activity patterns for backward compared to forward running. On a treadmill, nineteen runners performed forward running at their individually preferred speed, followed by backward running at 70% of their self-selected forward speed. In-shoe plantar pressures of nine foot regions and muscular activity of nine lower extremity muscles were recorded simultaneously over a one-minute interval. Backward and forward running variables were averaged over the accumulated steps and compared with Wilcoxon-signed rank tests (p<.05). For backward compared to forward running, in-shoe plantar pressure distribution showed a load increase under metatarsal heads I and II, as well as under the medial midfoot. This was indicated by higher maximum forces and peak pressures, and by longer contact times. Muscle activity showed significantly higher mean amplitudes during backward running in the semitendinosus, rectus femoris, vastus lateralis, and gluteus medius during stance, and in the rectus femoris during swing phase, while significantly lower mean amplitudes were observed in the tibialis anterior during swing phase. Observations indicate plantar foot loading and muscle activity characteristics that are specific for the running direction. Thus, backward running may be used on purpose for certain rehabilitation tasks, aiming to strengthen respective lower extremity muscles. Furthermore, the findings are relevant for sport specific backward locomotion training. Finally, results provide an initial baseline for innovative athletic footwear development aiming to increase comfort and performance during backward running. Copyright © 2016 Elsevier B.V. All rights reserved.

Effect of Combined Exercise Versus Aerobic-Only Training on Skeletal Muscle Lipid Metabolism in a Rodent Model of Type1 Diabetes.

PubMed

Dotzert, Michelle S; McDonald, Matthew W; Murray, Michael R; Nickels, J Zachary; Noble, Earl G; Melling, C W James

2017-12-04

Abnormal skeletal muscle lipid metabolism is associated with insulin resistance in people with type 1 diabetes. Although lipid metabolism is restored with aerobic exercise training, the risk for postexercise hypoglycemia is increased with this modality. Integrating resistance and aerobic exercise is associated with reduced hypoglycemic risk; however, the effects of this exercise modality on lipid metabolism and insulin resistance remain unknown. We compared the effects of combined (aerobic + resistance) versus aerobic exercise training on oxidative capacity and muscle lipid metabolism in a rat model of type 1 diabetes. Male Sprague-Dawley rats were divided into 4 groups: sedentary control (C), sedentary control + diabetes (CD), diabetes + high-intensity aerobic exercise (DAE) and diabetes + combined aerobic and resistance exercise (DARE). Following diabetes induction (20 mg/kg streptozotocin over five days), DAE rats ran for 12 weeks (5 days/week for 1 hour) on a motorized treadmill (27 m/min at a 6-degree grade), and DARE rats alternated daily between running and incremental weighted ladder climbing. After training, DAE showed reduced muscle CD36 protein content and lipid content compared to CD (p≤0.05). DAE rats also had significantly increased citrate synthase (CS) activity compared to CD (p≤0.05). DARE rats showed reduced CD36 protein content compared to CD and increased CS activity compared to CD and DAE rats (p≤0.05). DARE rats demonstrated increased skeletal muscle lipid staining, elevated lipin-1 protein content and insulin sensitivity (p≤0.05). Integration of aerobic and resistance exercise may exert a synergistic effect, producing adaptations characteristic of the "athlete's paradox," including increased capacity to store and oxidize lipids. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Cardiovascular rehabilitation soon after stroke using feedback-controlled robotics-assisted treadmill exercise: study protocol of a randomised controlled pilot trial.

PubMed

Stoller, Oliver; de Bruin, Eling D; Schuster-Amft, Corina; Schindelholz, Matthias; de Bie, Rob A; Hunt, Kenneth J

2013-09-22

After experiencing a stroke, most individuals also suffer from cardiac disease, are immobile and thus have low endurance for exercise. Aerobic capacity is seriously reduced in these individuals and does not reach reasonable levels after conventional rehabilitation programmes. Cardiovascular exercise is beneficial for improvement of aerobic capacity in mild to moderate stroke. However, less is known about its impact on aerobic capacity, motor recovery, and quality-of-life in severely impaired individuals. The aim of this pilot study is to explore the clinical efficacy and feasibility of cardiovascular exercise with regard to aerobic capacity, motor recovery, and quality-of-life using feedback-controlled robotics-assisted treadmill exercise in non-ambulatory individuals soon after experiencing a stroke. This will be a single-centred single blind, randomised control trial with a pre-post intervention design. Subjects will be recruited early after their first stroke (≤20 weeks) at a neurological rehabilitation clinic and will be randomly allocated to an inpatient cardiovascular exercise programme that uses feedback-controlled robotics-assisted treadmill exercise (experimental) or to conventional robotics-assisted treadmill exercise (control). Intervention duration depends on the duration of each subject's inpatient rehabilitation period. Aerobic capacity, as the primary outcome measure, will be assessed using feedback-controlled robotics-assisted treadmill-based cardiopulmonary exercise testing. Secondary outcome measures will include gait speed, walking endurance, standing function, and quality-of-life. Outcome assessment will be conducted at baseline, after each 4-week intervention period, and before clinical discharge. Ethical approval has been obtained. Whether cardiovascular exercise in non-ambulatory individuals early after stroke has an impact on aerobic capacity, motor recovery, and quality-of-life is not yet known. Feedback-controlled robotics-assisted treadmill exercise is a relatively recent intervention method and might be used to train and evaluate aerobic capacity in this population. The present pilot trial is expected to provide new insights into the implementation of early cardiovascular exercise for individuals with severe motor impairment. The findings of this study may guide future research to explore the effects of early cardiovascular activation after severe neurological events. This trial is registered with the Clinical Trials.gov Registry (NCT01679600).