Skip to main content
SpringerLink
Log in

Resistance training using a novel robotic walker for over-ground gait rehabilitation: a preliminary study on healthy subjects

  • Original Article
  • Published:
Medical & Biological Engineering & Computing Aims and scope Submit manuscript

Abstract

Strength training is an aspect of gait rehabilitation, which complements balance control and weight-bearing training. However, conventional strength training does not show positive gait outcomes, due to lack of task specificity. Therefore, the aims of this study were to investigate the effects of a resistance force applied at the center of mass (CoM) and to investigate whether this exercise can be used for effective task-specific gait training. Using a novel robotic walker, a consistent resistive force was applied to the CoM of subjects in the posterior direction. Eleven healthy subjects were instructed to walk under five walking conditions with increasing forces, based on each subject’s body weight (BW), at 0, 2.5, 5, 7.5, and 10% BW. Joint kinematics and mean amplitude and frequency of electromyography signals from nine major muscles were measured. The application of resistance resulted in significantly increased flexion angles at ankle, knee, and hip joints. A large amount of motor unit activation with lower firing rates was found at knee and hip joints, indicating that this type of resistance training can improve muscular strength and endurance in a task-specific manner. The long-term effects of the resistance training on neurologically challenged patients will be investigated in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Aagaard P et al (2002) Neural adaptation to resistance training: changes in evoked V-wave and H-reflex responses. J Appl Physiol 92(6):2309–2318

    Article  PubMed  Google Scholar 

  2. Arjunan SP, Kumar DK, Wheeler K, Shimada H, Siddiqi A (2015) Effect of number of motor units and muscle fibre type on surface electromyogram. Med Biol Eng Comput 54(4):575–582

  3. Behrman AL, Harkema SJ (2000) Locomotor training after human spinal cord injury: a series of case studies. Phys Ther 80(7):688–700

    CAS  PubMed  Google Scholar 

  4. Blanchette A, Bouyer LJ (2009) Timing-specific transfer of adapted muscle activity after walking in an elastic force field. J Neurophysiol 102(1):568–577

    Article  PubMed  Google Scholar 

  5. Bovi G et al (2011) A multiple-task gait analysis approach: kinematic, kinetic and EMG reference data for healthy young and adult subjects. Gait Posture 33(1):6–13

    Article  PubMed  Google Scholar 

  6. Brady AO, Straight CR (2014) Muscle capacity and physical function in older women: What are the impacts of resistance training? J Sport Health Sci 3(3):179–188

    Article  Google Scholar 

  7. Campanini I, Merlo A, Damiano B (2013) A method to differentiate the causes of stiff-knee gait in stroke patients. Gait Posture 38(2):165–169

    Article  CAS  PubMed  Google Scholar 

  8. Chang Y-H, Kram R (1999) Metabolic cost of generating horizontal forces during human running. J Appl Physiol 86(5):1657–1662

    CAS  PubMed  Google Scholar 

  9. Chen PH et al (2013) Gait disorders in Parkinson’s disease: assessment and management. Int J Gerontol 7(4):189–193

    Article  Google Scholar 

  10. Dickstein R (2008) Rehabilitation of gait speed after stroke: a critical review of intervention approaches. Neurorehabil Neural Repair 22(6):649–660

    Article  PubMed  Google Scholar 

  11. Ellis RG, Sumner BJ, Kram R (2014) Muscle contributions to propulsion and braking during walking and running: insight from external force perturbations. Gait posture 40(4):594–599

    Article  PubMed  Google Scholar 

  12. Emken JL, Reinkensmeyer DJ (2005) Robot-enhanced motor learning: accelerating internal model formation during locomotion by transient dynamic amplification. IEEE Trans Neural Syst Rehabil Eng 13(1):33–39

    Article  PubMed  Google Scholar 

  13. Eng JJ, Tang PF (2007) Gait training strategies to optimize walking ability in people with stroke: a synthesis of the evidence. Exp Rev Neurother 7(10):1417–1436

    Article  Google Scholar 

  14. Flansbjer UB et al (2008) Progressive resistance training after stroke: effects on muscle strength, muscle tone, gait performance and perceived participation. J Rehabil Med 40(1):42–48

    Article  PubMed  Google Scholar 

  15. Frontera WR et al (2003) Strength training in older women: early and late changes in whole muscle and single cells. Muscle Nerve 28(5):601–608

    Article  PubMed  Google Scholar 

  16. Hass CJ et al (2012) Progressive resistance training improves gait initiation in individuals with Parkinson’s disease. Gait Posture 35(4):669–673

    Article  PubMed  Google Scholar 

  17. Hermens HJ et al (1999) European recommendations for surface electromyography. Roessingh Research and Development, Enschede

    Google Scholar 

  18. Hicks JL, Delp SL, Schwartz MH (2011) Can biomechanical variables predict improvement in crouch gait? Gait Posture 34(2):197–201

    Article  PubMed  PubMed Central  Google Scholar 

  19. Holloszy JO, Booth FW (1976) Biochemical adaptations to endurance exercise in muscle. Annu Rev Physiol 38(1):273–291

    Article  CAS  PubMed  Google Scholar 

  20. Labruyere R, van Hedel HJ (2014) Strength training versus robot-assisted gait training after incomplete spinal cord injury: a randomized pilot study in patients depending on walking assistance. J NeuroEng Rehabil 11(1):4

    Article  PubMed  PubMed Central  Google Scholar 

  21. Lam T, Anderschitz M, Dietz V (2006) Contribution of feedback and feedforward strategies to locomotor adaptations. J Neurophysiol 95(2):766–773

    Article  PubMed  Google Scholar 

  22. Lam T et al (2008) Swing phase resistance enhances flexor muscle activity during treadmill locomotion in incomplete spinal cord injury. Neurorehabil Neural Repair 22(5):438–446

    Article  PubMed  Google Scholar 

  23. Mun KR, et al (2014) Design of a novel robotic over-ground walking device for gait rehabilitation. In: 2014 IEEE 13th international workshop on advanced motion control (AMC), 2014. IEEE

  24. Mun KR, Guo Z, Yu H (2016) Restriction of pelvic lateral and rotational motions alters lower limb kinematics and muscle activation pattern during over-ground walking. Med Biol Eng Comput 30:1–9

    Google Scholar 

  25. O’Connor CM et al (2007) Automatic detection of gait events using kinematic data. Gait Posture 25(3):469–474

    Article  PubMed  Google Scholar 

  26. Olney SJ, Richards C (1996) Hemiparetic gait following stroke. Part I: characteristics. Gait Posture 4(2):136–148

    Article  Google Scholar 

  27. Pagel A, Arieta AH, Riener R, Vallery H (2015) Effects of sensory augmentation on postural control and gait symmetry of transfemoral amputees: a case description. Med Biol Eng Comput 10:1579

    Google Scholar 

  28. Perry J, Slac T, Davids JR (1992) Gait analysis: normal and pathological function. J Pediatric Orthop 12(6):815

    Article  Google Scholar 

  29. Phinyomark A et al (2012) The usefulness of mean and median frequencies in electromyography analysis. INTECH Open Access Publisher, Rijeka

    Book  Google Scholar 

  30. Scandalis TA et al (2001) Resistance training and gait function in patients with Parkinson’s disease. Am J Phys Med Rehabil 80(1):38–43

    Article  CAS  PubMed  Google Scholar 

  31. Scott W, Stevens J, Binder-Macleod SA (2001) Human skeletal muscle fiber type classifications. Phys Ther 81(11):1810–1816

    CAS  PubMed  Google Scholar 

  32. Spanjaard M et al (2007) Gastrocnemius muscle fascicle behavior during stair negotiation in humans. J Appl Physiol 102(4):1618–1623

    Article  CAS  PubMed  Google Scholar 

  33. Sullivan KJ et al (2007) Effects of task-specific locomotor and strength training in adults who were ambulatory after stroke: results of the STEPS randomized clinical trial. Phys Ther 87(12):1580–1602

    Article  PubMed  Google Scholar 

  34. Sutherland DH, Davids JR (1993) Common gait abnormalities of the knee in cerebral palsy. Clin Orthop Relat Res 288:139–147

    Google Scholar 

  35. Topp R et al (1993) The effect of a 12-week dynamic resistance strength training program on gait velocity and balance of older adults. Gerontol 33(4):501–506

    Article  CAS  Google Scholar 

  36. van den Noort JC, Ferrari A, Cutti AG, Becher JG, Harlaar J (2013) Gait analysis in children with cerebral palsy via inertial and magnetic sensors. Med Biol Eng Comput 51(4):377–386

    Article  PubMed  Google Scholar 

  37. Williams G, Kahn M, Randall A (2014) Strength training for walking in neurologic rehabilitation is not task specific: a focused review. Am J Phys Med Rehabil 93(6):511–522

    Article  PubMed  Google Scholar 

  38. Winter DA (1991) Biomechanics and motor control of human gait: normal, elderly and pathological, 2nd edn. Waterloo Biomechanics, Waterloo

  39. Yu H, Spenko M, Dubowsky S (2003) An adaptive shared control system for an intelligent mobility aid for the elderly. Auton Robots 15(1):53–66

    Article  Google Scholar 

Download references

Acknowledgements

This work was support in part by FRC Tier I Grant under the WBS No. R-397-000-218-112, National University of Singapore, and in part by A*STAR under the Grant No. SERC 1512124019, and in part by the BMRC-NMRC Bedside and Bench Grant No. BnB14Nov014, Ministry of Health, Singapore.

Author information

Authors and Affiliations

  1. Image Media Research Center, Korea Institute of Science and Technology, Seoul, 136791, Republic of Korea

    Kyung-Ryoul Mun

  2. Department of Biomedical Engineering, National University of Singapore, 9 Engineering Drive 1, Singapore, 117575, Republic of Singapore

    Brandon Bao Sheng Yeo, Zhao Guo & Haoyong Yu

  3. Department of Biomedical Engineering, Research Institute of Biomedical Engineering, College of Biomedical and Health Science, Konkuk University, Chungju, South Korea

    Soon Cheol Chung

Authors
  1. Kyung-Ryoul Mun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Brandon Bao Sheng Yeo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhao Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Soon Cheol Chung
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Haoyong Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Haoyong Yu.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mun, KR., Yeo, B.B.S., Guo, Z. et al. Resistance training using a novel robotic walker for over-ground gait rehabilitation: a preliminary study on healthy subjects. Med Biol Eng Comput 55, 1873–1881 (2017). https://doi.org/10.1007/s11517-017-1634-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11517-017-1634-x

Keywords

Search

Navigation