Anti-gravity Treadmill Training Research Articles

P.169 - Aerobic anti-gravity exercise in patients with Charcot-Marie-Tooth disease. Types: a pilot study

Charcot-Marie-Tooth (CMT) disease is a hereditary neuropathy associated with impaired walking capacity. Some patients are too weak in the lower extremity muscles to walk at gravity with sufficient intensity or duration to gain benefit. The objective was to investigate the effect of aerobic anti-gravity exercise in weak patients with CMT 1A and X. Five adult patients performed moderate-intensity aerobic anti-gravity exercise 3/week for 10 weeks. There was a significant positive difference in Berg balance scale and postural stability test between test occasions, and walking distance in 6-Minute walk test trended to increase. The study indicates that anti-gravity treadmill training of weak patients with CMT should be pursued in larger CMT cohorts.

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

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.

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

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.

Therapeutic effects of an anti-gravity locomotor training (AlterG) on postural balance and cerebellum structure in children with Cerebral Palsy.

We evaluated the therapeutic effects of anti-gravity locomotor treadmill (AlterG) training on postural stability in children with Cerebral Palsy (CP) and spasticity, particularly in the lower extremity. AlterG can facilitate walking by reducing the weight of CP children by up to 80%; it can also help subjects maintain an appropriate posture during the locomotor AlterG training. Thus, we hypothesized that AlterG training, for a sufficient period of time, has a potential to produce cerebellum neuroplasticity, and consequently result in an effective permanent postural stability. AlterG training was given for 45 minutes, three times a week for two months. Postural balance was evaluated using posturography. The parameters of the Romberg based posturography were extracted to quantify the Center of Balance (CoP). The neuroplasticity of Cerebellum was evaluated using a Diffusion Tensor Imaging (DTI). The evaluations were done pre- and post-training. The Fractional Anisotropy (FA) feature was used for quantifying structural changes in the cerebellum. The results showed that AlterG training resulted in an increase in average FA value of the cerebellum white matter following the training. The results of the posturography evaluations showed a consistent improvement in postural stability. These results were consistent in all subjects. Our findings indicated that the improvement in the posture was accompanied with the enhancement of the cerebellum white matter structure. The clinical implication is that AlterG training can be considered a therapeutic tool for an effective and permanent improvement of postural stability in CP children.

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

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.

Abstract W P141: Anti-Gravity Treadmill Training Leads to Superior Walking Ability Compared to Conventional Physical Therapy in Chronic Community Dwelling Stroke Survivors

The Anti-gravity (AG) treadmill is a new modality, initially used by athletes and astronauts allowing precise unweighting up to 80% of body weight. Patients are enclosed in a cockpit which unweights by filling with air, allowing patients to be safely progressed at higher speed and longer durations than the conventional treadmill. Only a few case studies report outcomes of stroke patients using this system. Methods: We trialled the AG system on 9 (5 men, 4 women) community dwelling, chronic stroke patients between 6/2014 and 8/2014 as part of an outpatient physical therapy (PT) program. 7/9 patients received AG treatment following conventional treadmill training, while 2 began new PT treatments with the AG system. Endurance was measured with the standardized 6 minute walk test before initiation and after completion of AG system treatments. Various other PT and stroke outcomes were measured. Results: 8 ischemic and 1 hemorrhage stroke patients with average age 63 (49-79); average NIHSS of 7.9 (range 3-15) and Modified Rankin Scores of 4 for 5 patients and 3 for 4 were treated an average of 21.4(range 11-86) months post stroke. Patients received an average of 5 sessions (2-8) over an average of 2.8 weeks ((1-4). Blood Pressures monitored pre and post each treatment were stable. No adverse complications or pain occurred. All patients reported subjectively experiencing improvement in gait quality with AG system use. 89% (8/9) patients had improved 6" walk test scores following AG treatments. 7/9 patients had received conventional treadmill training during skilled PT prior to initiation of AG treatments. In the 1 month prior to AG treatment, 3/7 of these patients had worsening of 6" walk scores; 2/7 improved, and 2/7 had no change. Of the 7/9 patients receiving AG treatment following usual treadmill training, 6/7 had improved 6" walk scores (range 2-17%). 6 minute walk scores improved by 81% and 1% in 2 patients initiating AG training without preceding treadmill training. All patients had improved walking duration and speed on AG compared to traditional treadmill. Conclusions: AG treadmill treatment was reported to be positive and led to improved walking and endurance compared to conventional treadmill training in this pilot group of chronic community dwelling stroke patients.

Effects Of Physical Activity With Antigravity Treadmill Training On Physiological Measures In Breast Cancer Patients.

Effects Of Physical Activity With Antigravity Treadmill Training On Physiological Measures In Breast Cancer Patients.

ALTERG: AN INNOVATIVE TECHNOLOGY IN PHYSICAL ACTIVE REHABILITATION OF SPINAL STENOSIS

BackgroundLumbal spinal stenosis causes back pain spreading as far as the legs and thereby constrains the activities of daily living. By walking in a flexed position patients try to extend...

Rehabilitation and Return to Running After Lower Limb Stress Fractures

Lower limb stress fractures are common injuries in runners. In terms of treatment, much of the medical literature has focused primarily on rest and cessation of running, but little has been written about the rehabilitation and functional progression of runners following a lower limb stress fracture. This article reviews the scientific evidence behind common rehabilitation concepts used for runners recovering from these injuries and also discusses sport-specific training modalities such as deep water running and antigravity treadmill training. Overall this article is intended to be a practical resource for clinicians to guide runners in functional rehabilitation and return to running following lower limb stress injury.