Abstract
Body weight support (BWS) promotes better functional outcomes for neurologically challenged patients. Despite the established effectiveness of BWS in gait rehabilitation, the findings on biomechanical effects of BWS training still remain contradictory. Therefore, the aim of this study is to comprehensively investigate the effects of BWS. Using a newly developed robotic walker which can facilitate pelvic motions with an active BWS unit, we compared gait parameters of ten healthy subjects during a 10-m walk with incremental levels of body weight unloading, ranging from 0 to 40 % at 10 % intervals. Significant changes in joint angles and gait temporospatial parameters were observed. In addition, the results of an EMG signal study showed that the intensity of muscle activation was significantly reduced with increasing BWS levels. The reduction was found at the ankle, knee, and hip joints in the sagittal plane as well as at the hip joint in the frontal plane. The results of this study provide an important indication of increased lateral body balance and greater stabilization in sagittal and frontal plane during gait. Our findings provide a better understanding of the biomechanical effects of BWS during gait, which will help guide the gait rehabilitation strategies.
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References
Aaslund MK, Helbostad JL, Moe-Nilssen R (2013) Walking during body-weight-supported treadmill training and acute responses to varying walking speed and body-weight support in ambulatory patients post-stroke. Physiother theory Pract 29(4):278–289
Aaslund MK, Moe-Nilssen R (2008) Treadmill walking with body weight support: effect of treadmill, harness and body weight support systems. Gait Posture 28(2):303–308
Barbeau H, Visintin M (2003) Optimal outcomes obtained with body-weight support combined with treadmill training in stroke subjects. Arch Phys Med Rehabil 84(10):1458–1465
Brouwer B, Parvataneni K, Olney SJ (2009) A comparison of gait biomechanics and metabolic requirements of overground and treadmill walking in people with stroke. Clin Biomech 24(9):729–734
Burgess JK, Weibel GC, Brown DA (2010) Overground walking speed changes when subjected to body weight support conditions for nonimpaired and post stroke individuals. J Neuroeng Rehabil 7(1):1–11
Burnfield JM, Irons SL, Buster TW, Taylor AP, Hildner GA, Shu Y (2014) Comparative analysis of speed’s impact on muscle demands during partial body weight support motor-assisted elliptical training. Gait Posture 39(1):314–320
Celestino ML, Gama GL, Barela AM (2014) Gait characteristics of children with cerebral palsy as they walk with body weight unloading on a treadmill and over the ground. Res Dev Disabil 35(12):3624–3631
Dodd KJ, Morris ME (2003) Lateral pelvic displacement during gait: abnormalities after stroke and changes during the first month of rehabilitation. Arch Phys Med Rehabil 84(8):1200–1205
Donelan JM, Kram R, Kuo AD (2002) Simultaneous positive and negative external mechanical work in human walking. J Biomech 35(1):117–124
Fischer AG, Wolf A (2015) Assessment of the effects of body weight unloading on overground gait biomechanical parameters. Clin Biomech 30(5):454–461
Goldberg SR, Stanhope SJ (2013) Sensitivity of joint moments to changes in walking speed and body-weight-support are interdependent and vary across joints. J Biomech 46(6):1176–1183
Goldie PA, Matyas TA, Evans OM (2001) Gait after stroke: initial deficit and changes in temporal patterns for each gait phase. Arch Phys Med Rehabil 82(8):1057–1065
Hermens HJ, Freriks B, Merletti R, Stegeman D, Blok J, Rau G et al (1999) European recommendations for surface electromyography. Roessingh Res Dev 8(2):13–54
Hesse S, Werner C, Bardeleben A, Barbeau H (2001) Body weight-supported treadmill training after stroke. Curr Atheroscler Rep 3(4):287–294
Hidler JM, Wall AE (2005) Alterations in muscle activation patterns during robotic-assisted walking. Clin Biomech 20(2):184–193
Hsu A-L, Tang P-F, Jan M-H (2003) Analysis of impairments influencing gait velocity and asymmetry of hemiplegic patients after mild to moderate stroke. Arch Phys Med Rehabil 84(8):1185–1193
Kressler J, Nash MS, Burns PA, Field-Fote EC (2013) Metabolic responses to 4 different body weight-supported locomotor training approaches in persons with incomplete spinal cord injury. Arch Phys Med Rehabil 94(8):1436–1442
Kristianslund E, Krosshaug T, van den Bogert AJ (2012) Effect of low pass filtering on joint moments from inverse dynamics: implications for injury prevention. J Biomech 45(4):666–671
Kuo AD, Donelan JM (2010) Dynamic principles of gait and their clinical implications. Phys Ther 90(2):157–174
Kuo AD, Donelan JM, Ruina A (2005) Energetic consequences of walking like an inverted pendulum: step-to-step transitions. Exerc Sport Sci Rev 33(2):88–97
Kurz MJ, Stuberg W, DeJong SL (2011) Body weight supported treadmill training improves the regularity of the stepping kinematics in children with cerebral palsy. Dev Neurorehabil 14(2):87–93
Lewek MD (2011) The influence of body weight support on ankle mechanics during treadmill walking. J Biomech 44(1):128–133
Lyons K, Perry J, Gronley JK, Barnes L, Antonelli D (1983) Timing and relative intensity of hip extensor and abductor muscle action during level and stair ambulation an EMG study. Phys Ther 63(10):1597–1605
Mun K-R, Yu H, Zhu C, Cruz MS (2014) Design of a novel robotic over-ground walking device for gait rehabilitation. In: 2014 IEEE 13th international workshop on paper presented at the advanced motion control (AMC)
O’Connor CM, Thorpe SK, O’Malley MJ, Vaughan CL (2007) Automatic detection of gait events using kinematic data. Gait Posture 25(3):469–474
Parvataneni K, Ploeg L, Olney SJ, Brouwer B (2009) Kinematic, kinetic and metabolic parameters of treadmill versus overground walking in healthy older adults. Clin Biomech 24(1):95–100
Pennycott A, Wyss D, Vallery H, Klamroth-Marganska V, Riener R (2012) Towards more effective robotic gait training for stroke rehabilitation: a review. J Neuroeng Rehabil 9:65
Perry J, Davids JR (1992) Gait analysis: normal and pathological function. J Pediatr Orthop 12(6):815
Peurala SH, Tarkka IM, Pitkänen K, Sivenius J (2005) The effectiveness of body weight-supported gait training and floor walking in patients with chronic stroke. Arch Phys Med Rehabil 86(8):1557–1564
Picelli A, Melotti C, Origano F, Waldner A, Fiaschi A, Santilli V, Smania N (2012) Robot-assisted gait training in patients with parkinson disease a randomized controlled trial. Neurorehabil Neural Repair 26(4):353–361
Rose MH, Løkkegaard A, Sonne-Holm S, Jensen BR (2013) Improved clinical status, quality of life, and walking capacity in Parkinson’s disease after body weight-supported high-intensity locomotor training. Arch Phys Med Rehabil 94(4):687–692
Senthilvelkumar T, Magimairaj H, Fletcher J, Tharion G, George J (2015) Comparison of body weight-supported treadmill training versus body weight-supported overground training in people with incomplete tetraplegia: a pilot randomized trial. Clin Rehabil 29(1):42–49
Threlkeld AJ, Cooper LD, Monger BP, Craven AN, Haupt HG (2003) Temporospatial and kinematic gait alterations during treadmill walking with body weight suspension. Gait Posture 17(3):235–245
Van Hedel H, Tomatis L, Müller R (2006) Modulation of leg muscle activity and gait kinematics by walking speed and bodyweight unloading. Gait Posture 24(1):35–45
Veneman JF, Menger J, van Asseldonk EH, van der Helm FC, van der Kooij H (2008) Fixating the pelvis in the horizontal plane affects gait characteristics. Gait Posture 28(1):157–163. doi:10.1016/j.gaitpost.2007.11.008
Watt JR, Franz JR, Jackson K, Dicharry J, Riley PO, Kerrigan DC (2010) A three-dimensional kinematic and kinetic comparison of overground and treadmill walking in healthy elderly subjects. Clin Biomech 25(5):444–449
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This work was supported by the following grants: NMRC/BnB/0019b/2015 from Ministry of Health of Singapore and FRC Tier 1 under WBS No. R-397-000-218-112 from National University of Singapore.
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Mun, KR., Lim, S.B., Guo, Z. et al. Biomechanical effects of body weight support with a novel robotic walker for over-ground gait rehabilitation. Med Biol Eng Comput 55, 315–326 (2017). https://doi.org/10.1007/s11517-016-1515-8
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DOI: https://doi.org/10.1007/s11517-016-1515-8