Kinematic and muscle demand similarities between motor-assisted elliptical training and walking: Implications for pediatric gait rehabilitation.
Many children with physical disabilities and special health care needs experience barriers to accessing effective therapeutic technologies to improve walking and fitness in healthcare and community environments. The expense of many robotic and exoskeleton technologies hinders widespread use in most clinics, school settings, and fitness facilities. A motor-assisted elliptical trainer that is being used to address walking and fitness deficits in adults was modified to enable children as young as three years of age to access the technology (Pedi-ICARE). We compared children's kinematic and muscle activation patterns during walking and training on the Pedi-ICARE. Eighteen children walked (self-selected comfortable speed), Pedi-ICARE trained with motor-assistance at self-selected comfortable speed (AAC), and trained while over-riding motor-assistance (AAC+). Coefficient of multiple correlations (CMCs) compared lower extremity kinematic profiles during AAC and AAC+ to gait. Repeated measures ANOVAs identified muscle demand differences across conditions. CMCs revealed strong similarities at the hip and knee between each motor-assisted elliptical condition and gait. Ankle CMCs were only moderate. Muscle demands were generally lowest during AAC. Over-riding the motor increased hip and knee muscle demands. The similarity of motion patterns between Pedi-ICARE conditions and walking suggest the device could be used to promote task-specific training to improve walking. The capacity to manipulate muscle demands using different motor-assistance conditions highlights Pedi-ICARE's versatility in addressing a wide range of children's abilities.
Movement and Neurosciences Center, Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, 5401 South Street, Lincoln, NE, 68506-2150, United States. Electronic address: jburnfield@madonna.org.
Judith M
JM
Burnfield
Movement and Neurosciences Center, Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, 5401 South Street, Lincoln, NE, 68506-2150, United States. Electronic address: gcesar@madonna.org.
Guilherme M
GM
Cesar
Movement and Neurosciences Center, Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, 5401 South Street, Lincoln, NE, 68506-2150, United States. Electronic address: tbuster@madonna.org.
Thad W
TW
Buster
Movement and Neurosciences Center, Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, 5401 South Street, Lincoln, NE, 68506-2150, United States. Electronic address: sirons@madonna.org.
Sonya L
SL
Irons
Department of Mechanical and Materials Engineering, University of Nebraska-Lincoln, W 316 NH, Lincoln, NE, 68588-0526, United States. Electronic address: cnelson5@unl.edu.
Carl A
CA
Nelson
D001696:Biomechanical Phenomena; D002648:Child; D002675:Child, Preschool; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D035002:Lower Extremity / Q000502:physiology*; D008297:Male; D018482:Muscle, Skeletal / Q000502:physiology*; D016059:Range of Motion, Articular; D016138:Walking
Child; Elliptical; Gait; Kinematics; Muscle demand