Lower Body Positive Pressure Treadmill Research Articles

Fat Oxidation During Ambulation On A Normal And Lower Body Positive Pressure Treadmill

Fat Oxidation During Ambulation On A Normal And Lower Body Positive Pressure Treadmill

The effect of lower-body positive-pressure treadmill training in early rehabilitation for patients with lower extremity fractures

The effect of lower-body positive-pressure treadmill training in early rehabilitation for patients with lower extremity fractures

Investigation Of Biomechanical Accommodation During Submaximal Running On A Lower-body Positive Pressure Treadmill (LBPPT).

Investigation Of Biomechanical Accommodation During Submaximal Running On A Lower-body Positive Pressure Treadmill (LBPPT).

How about running on Mars? Influence of sensorimotor coherence on running and spatial perception in simulated reduced gravity.

Motor control, including locomotion, strongly depends on the gravitational field. Recent developments such as lower-body positive pressure treadmills (LBPPT) have enabled studies on Earth about the effects of reduced body weight (BW) on walking and running, up to 60% BW. The present experiment was set up to further investigate adaptations to a more naturalistic simulated hypogravity, mimicking a Martian environment with additional visual information during running sessions on LBPPT. Twenty-nine participants performed three sessions of four successive five-min runs at preferred speed, alternating Earth- or simulated Mars-like gravity (100% vs. 38% BW). They were displayed visual scenes using a virtual reality headset to assess the effects of coherent visual flow while running. Running performance was characterized by normal ground reaction force and pelvic accelerations. The perceived upright and vection (visually-induced self-motion sensation)in dynamic visual environments were also investigated at the end of the different sessions. We found that BW reduction induced biomechanical adaptations independently of the visual context. Active peak force and stance time decreased, while flight time increased. Strong inter-individual differences in braking and push-off times appeared at 38% BW, which were not systematically observed in our previous studies at 80% and 60% BW. Additionally, the importance given to dynamic visual cues in the perceived upright diminished at 38% BW, suggesting an increased reliance on the egocentric body axis as a reference for verticality when the visual context is fully coherent with the previous locomotor activity. Also, while vection was found to decrease in case of a coherent visuomotor coupling at 100% BW (i.e., post-exposure influence), it remained unaffected by the visual context at 38% BW. Overall, our findings suggested that locomotor and perceptual adaptations were not similarly impacted, depending on the -simulated- gravity condition and visual context.

Neuromuscular adjustments to unweighted running: the increase in hamstring activity is sensitive to trait anxiety.

Introduction: Originally developed for astronauts, lower body positive pressure treadmills (LBPPTs) are increasingly being used in sports and clinical settings because they allow for unweighted running. However, the neuromuscular adjustments to unweighted running remain understudied. They would be limited for certain lower limb muscles and interindividually variable. This study investigated whether this might be related to familiarization and/or trait anxiety. Methods: Forty healthy male runners were divided into two equal groups with contrasting levels of trait anxiety (high, ANX+, n = 20 vs. low, ANX-, n = 20). They completed two 9-min runs on a LBPPT. Each included three consecutive 3-min conditions performed at 100%, 60% (unweighted running), and 100% body weight. Normal ground reaction force and electromyographic activity of 11 ipsilateral lower limb muscles were analyzed for the last 30s of each condition in both runs. Results: Unweighted running showed muscle- and stretch-shortening cycle phase-dependent neuromuscular adjustments that were repeatable across both runs. Importantly, hamstring (BF, biceps femoris; STSM, semitendinosus/semimembranosus) muscle activity increased during the braking (BF: +44 ± 18%, p < 0.001) and push-off (BF: +49 ± 12% and STSM: +123 ± 14%, p < 0.001 for both) phases, and even more so for ANX+ than for ANX-. During the braking phase, only ANX+ showed significant increases in BF (+41 ± 15%, p < 0.001) and STSM (+53 ± 27%, p < 0.001) activities. During the push-off phase, ANX+ showed a more than twofold increase in STSM activity compared to ANX- (+119 ± 10% vs. +48 ± 27, p < 0.001 for both). Conclusion: The increase in hamstring activity during the braking and push-off phases may have accelerated the subsequent swing of the free-leg, likely counteracting the unweighting-induced slowing of stride frequency. This was even more pronounced in ANX+ than in ANX-, in an increased attempt not to deviate from their preferred running pattern. These results highlight the importance of individualizing LBPPT training and rehabilitation protocols, with particular attention to individuals with weak or injured hamstrings.

Effects of backward walking exercise using lower body positive pressure treadmill on knee symptoms and physical function in individuals with knee osteoarthritis: a protocol for RCT

ObjectivesThe primary aim is to compare the effects of backward walking exercise to forward walking exercise on knee pain, knee functions, and thigh muscle strength in individuals with mild to moderate knee osteoarthritis using lower body positive pressure, in addition to mobility functions, balance, and self-reported health status.MethodsThe study is a single blind randomized clinical trial with two independent groups. This study will enroll 26 participants with mild to moderate knee osteoarthritis. The participants will be randomized into either experimental group (backward walking exercise) or control group (forward walking exercise). Both groups will use lower body positive pressure treadmill for walking exercise. Both groups will perform regular conventional exercise and worm-up exercise before walking exercise. The treatment will be three times a week for six weeks. Walking session will be up to 30 min each session. Data collection will be collected during pre- and post- intervention including primary outcomes including numeric pain rating scale (NPRS), knee injury and osteoarthritis outcome score (KOOS), and thigh muscle strength test. The secondary outcomes include five times sit to stand test (FTSTS), 3-meter backward walk test (3MBWT), timed up and go test (TUG), four square step test (FSST), functional reach test (FRT), 10-meter walk test (10-MWT), six minute walk test (6MWT), medical outcomes study short form 12 (SF-12), patient health questionnaire -9 (PHQ-9), and rapid assessment of physical activity (RAPA). An independent t-test will be used to evaluate the effect of treatment on the outcome measures.ResultsNot applicable.ConclusionUsing lower body positive pressure may have promising results against knee osteoarthritis. Moreover, walking backward exercise using lower body positive pressure might add more benefits to individuals with knee osteoarthritis and help clinicians in decision making.Trial registration: This study was registered in ClinicalTrails.gov (ID: NCT05585099).

Lower Body Positive Pressure Treadmill Gait Training for Walking Recovery After Stroke

Lower Body Positive Pressure Treadmill Gait Training for Walking Recovery After Stroke

Comparison of those with high versus low kinesiophobia on the lower body positive pressure treadmill.

Dear Editor, Individuals living with knee osteoarthritis (KOA) tend to have difficulty with various daily activities, including squatting, stair climbing, and walking.1–3 An important activity barrier identified by individuals with KOA is exercise-induced pain. Individuals with KOA often have increased walking disability, with decreases in both gait velocity and endurance, as well as increased pain with walking.1,3 Kinesiophobia, fear of movement, is a maladaptive strategy that causes the avoidance of physical activity because of pain-related fear.4,5 Damsgard et al. studied increased pain with activity in individuals with chronic musculoskeletal conditions.6 These authors reported that increased pain during activity was present in 66% of participants with chronic pain and that fear of movement was a significant factor associated with increased pain during activity. Lower body positive pressure treadmills (LBPPT) use air pressure to decrease body weight while an individual is walking or running. There is a decrease in pain during walking on an LBPPT in patients with KOA, compared with an increase in pain while walking on a regular treadmill for the same amount of time.7,8 The purpose of the present study was to the compare the within-group and between-group pain responses and walking speeds with an unweighted walking protocol of subjects with high kinesiophobia versus subjects with low kinesiophobia.

Bodyweight support alters the relationship between preferred walking speed and cost of transport

Humans tend to select a preferred walking speed (PWS) that minimizes the metabolic energy consumed per distance traveled, i.e. the Cost of Transport (CoT). The aims of this study were to: 1. compare PWS overground vs. on a treadmill at 100 and 50% of body weight, and 2. explore whether with body weight support, PWS corresponds to the speed that minimizes CoT. Fifteen healthy adults walked overground and on a lower body positive pressure treadmill with and without bodyweight support. Walking speeds (m.s−1) were recorded for each condition. Rate of energy expenditure (J.kg−1.min−1) and CoT (J.kg−1.m−1) were then determined from 5-min walking trials with 50% bodyweight support at PWS and ± 30% of the self-selected walking speed for that condition. PWS did not differ across conditions. With 50% body weight support, for each 30% increase in walking speed, rates of metabolic energy expenditure increased ∼15% while CoT decreased by ∼14%. Thus, with 50% body weight support, PWS did not correspond with the speed that minimized CoT. Bodyweight support decreases cost of maintaining an upright body but does not decrease the metabolic demand of limb advancement, contributing to the linear yet not proportional changes in rates of energy expenditure and CoT. We conclude that bodyweight support via an AlterG® treadmill disconnects the association between PWS and minimum CoT. These findings have implications for clinical populations (e.g., obese, elderly) who may benefit from walking on a bodyweight supporting treadmill but may select speeds incompatible with their physical activity goals.

The Effectiveness of Lower-Body Positive Pressure Treadmill Gait Training on Mobility Function and Quality of Life in Individuals with Chronic Stroke: Prospective Cohort Study

Background: Lower body positive pressure (LBPP) emerges for rehabilitation practice tool for athletic and orthopedic conditions. However, LBPP may provide an opportunity therapeutic intervention for gait training in neurological conditions. Objectives: To assess the effectiveness of LBPP gait training on ambulation ability, gait speed, walking endurance, dynamic and static balance, and quality of life in individuals with chronic stroke. Methods: Participants performed LBPP gait training three days a week for six weeks. The main outcome measures were functional ambulation categories (FAC), 10-meter walk test (10-MWT), 6 minutes walking test (6MWT), timed up and go (TUG), functional reach test (FRT), and short-form (SF-36) health survey. Results: Nine chronic stroke (one female, eight males) aged 57 ± 15.4 years with stroke since 4.8 ± 3.9 years participated in LBPP gait training. participants showed significant improvement in FAC (pre, 4 ± 2; post, 5 ± 1; P = 0.034); 10-MWT (pre, 16.35 ± 9.34 s; post, 13.25 ± 7.57 s; P = 0.021) and 6 MWT (pre, 166.22 ± 94.15; post, 206.66 ± 103.64; P = 0.048). No significant differences were observed in the other outcomes. Conclusions: Six weeks of LBPP gait training may potentially improve ambulation ability, gait speed, and walking endurance in individuals with chronic stroke.

The combined influence of body weight support and running direction on self-selected movement patterns

We investigated metabolic costs, muscle activity, and perceptual responses during forward and backward running at matched speeds at different body weight support (BWS) conditions. Participants ran forward and backward on a lower body positive pressure treadmill at 0%BWS, 20%BWS, and 50%BWS conditions. We measured oxygen uptake, carbon dioxide production, heart rate, muscle activity, and stride frequency. Additionally, we calculated metabolic cost of transport. Furthermore, we used rating of perceived exertion and feeling scale to investigate perceptual responses. Feeling scale during running was higher with increasing BWS (0–50%BWS), regardless of running direction (p < 0.05). Oxygen uptake, heart rate, and metabolic cost of transport were influenced by the interaction of running direction and BWS (p < 0.01). For example, metabolic cost of transport during backward running was greater than when running forward only when running at 0%BWS (i.e., 4.4 ± 1.1 and 5.8 ± 1.4 J/kg/m for forward and backward running, respectively: p < 0.001). However, rectus femoris muscle activity, stride frequency, and rating of perceived exertion during backward running were averages of 113.5%, 11.3%, and 2.8 rankings greater than when running forward, respectively, regardless of BWS (p < 0.001). We interpret our observations to indicate that environment (in the context of effective body weight) is a critical factor that determines self-selected movement patterns during forward and backward running.

The Safety and Feasibility of Lower Body Positive Pressure Treadmill Training in Individuals with Chronic Stroke: An Exploratory Study.

Lower body positive pressure (LBPP) may provide a novel intervention for gait training in neurological conditions. Nonetheless, studies investigating the safety and feasibility of LBPP in patients with stroke are insufficient. The purpose of this study was to evaluate the safety and feasibility of LBPP as a rehabilitation intervention for individuals with chronic stroke. Individuals with chronic stroke were recruited from the community to participate in LBPP gait training three times a week for six weeks. The LBPP's safety and feasibility were documented throughout the study and at the end of six weeks. Safety and feasibility referred to the incidence of adverse events, complications, the participant and therapist satisfaction questionnaire, and the device limitation including but not limited to technical issues and physical constraints. In addition, blood pressure, pulse rate, and oxygen saturation were taken pre- and post-session. Dependent t-tests were used to analyze the difference between assessments. A Wilcoxon test was used to assess the ordinal data (Trial registration number NCT04767334). Nine individuals (one female, eight males) aged 57 ± 15.4 years were enrolled. All participants completed the intervention without adverse events. All participants reported positive scores from 4 (very satisfying) to 5 (extremely satisfying) in the safety and feasibility questionnaire. No significant differences were observed in blood pressure and oxygen saturation during the intervention sessions. However, significant increases were observed in heart rate from 82.6 ± 9.1 beats/min (pre-session) to 88.1 ± 6.8 beats/min (post-session) (p = 0.027). LBPP is a safe and feasible rehabilitation tool to use with individuals with chronic stroke.

Physiological Responses To Running On The Boost Anti-gravity Treadmill

Lower body positive pressure treadmills have become popular as a training supplement to full weight bearing running. However, the effects of reduced body mass (BM) on an individual’s physiological response to running at high velocity on the Boost Treadmill (BT) has not been investigated. PURPOSE: To determine the physiological responses of running at a range of running velocities and BM support using the BT. METHODS: Twenty trained collegiate distance runners (11 M, 9F, 20 ± 1 yrs) completed maximal running GXTs at three different percentages (100%, 90%, 80%) of BM in a counterbalance manner separated by 7-days. Cardiorespiratory responses were measured at each incremental stage until participants were no longer able to sustain steady-state VO2. Thereafter, the treadmill was increased by 1% grade per minute until volitional exhaustion. An independent t-test was used to compare differences in the dependent variables between genders at 9 and 10 mph and maximal velocity. ANOVA with repeated measures were used to assess differences in these variables at 100, 90 and 80% BM with significance set at p < 0.05. RESULTS: VO2max was different between genders at all three BM percentages (64 ± 4 to 52 ± 3, 66 ± 4 to 55 ± 3, and 71 ± 5 to 60 ± 4 ml*kg-1*min-1 for M vs F at 100%, 90% 80%, respectively, p < 0.05). Gender combined VO2 values were lower at 80% BM at 9 and 10mph than at 90% and 100% BM (44 ± 5 vs 45 ± 5 and 45 ± 4 and 49 ± 6 vs 50 ± 6 and 50 ± 4 ml*kg-1*min-1,p < 0.05) and greater at maximal velocity (66 ± 7 vs 61 ± 7 and 58 ± 8 ml*kg-1*min-1, p,0.05) but not different between 90% and 100% BM. Fractional utilization of O2 measurements were lower at 80% BM at 9 and 10mph than at 90% and 100% BW (67 ± 8 vs 74 ± 9 and 77 ± 10 and 74 ± 9 vs 82 ± 8 and 83 ± 6%, respectively, p < 0.05) but not different between 90% and 100% BM. HR responses were lower at 80% BM at 10mph than at 90% and 100% BM (155 ± 14 vs 169 ± 13 and 172 ± 10 bpm, respectively, p < 0.05). CONCLUSION: The results are predicated on the fact that the participants in this study were actually tested at 94%, 90%, and 80% of their BM. The 100% setting produces positive lifting pressure on the participant resulting in a mean 6% reduction in BM. The metabolic demands of running at 80% BM is significant less than running at 90% and 100% BM and minuscule differences in the metabolic demands while running at the same velocity at the 90% and 100% BM settings on the BT

Novice Users of a Bodyweight-Supporting Treadmill Require Familiarization.

Previous work has demonstrated an improvement in running economy during sustained running on a lower body positive pressure treadmill, but neuromuscular and spatiotemporal measures have only been investigated during short-duration running bouts on these devices. The current study sought to replicate the noted metabolic response and investigate whether neuromuscular and/or spatiotemporal adaptations underlie the noted improvements in running economy. Cross-sectional. Fifteen trained runners (11 males and 4 females) ran three 15-minute trials with 30% bodyweight support at 70% of the speed that elicited their peak oxygen consumption while running on a standard treadmill. A series of 1-way analyses of variance with repeated measures were used to explore differences in dependent variables over the 45minutes of running. Dependent variables included oxygen consumption, root-mean-square electromyography of the vastus medialis and medial gastrocnemius during stance, and spatiotemporal parameters. Oxygen consumption decreased after the initial exposure, with no further reductions after 20minutes. Root-mean-square electromyography of the vastus medialis and medial gastrocnemius also decreased over time, with no further reductions after 20 and 10minutes, respectively. No differences in spatiotemporal parameters were found. Future research should provide sufficient time for runners to develop a more economical gait pattern prior to collecting dependent variables, and previous findings using lower body positive pressure treadmills may need to be reconsidered. Athletes using these devices for training or rehabilitation should note that increased economy will lower the intensity of a given treadmill setting over time.

Relationships between Percentage of Body Weight Support and Individual Characteristics on a Lower Body Positive Pressure Treadmill for Participants with Knee Osteoarthritis

Relationships between Percentage of Body Weight Support and Individual Characteristics on a Lower Body Positive Pressure Treadmill for Participants with Knee Osteoarthritis

Lower-Body Positive Pressure Treadmill Training for Pediatric Gait Disorders: A Scoping Review

The purpose of this scoping review was to examine the literature on the use of anti-gravity treadmills and its effects on lower-limb motor functions in children and adolescents with locomotor impairments. Method: Four databases (MEDLINE, CINAHL, Embase, Web of Science) were searched for articles from inception to August 2021. Inclusion criteria were: (1) experimental or quasi-experimental studies using anti-gravity training as the primary intervention; (2) studies conducted in pediatric participants; (3) articles reporting outcomes related to lower-limb functions; and (4) studies published in French or English. Results: Fifteen articles were included in the review. Studies included children and adolescents aged 4–18 years with locomotor impairments. Intervention duration ranged from 2 to 12 weeks, with 2–5 sessions per week. Included studies reported that anti-gravity training induces improvements in muscle strength, balance, spatiotemporal gait parameters, and walking endurance in children with locomotor impairments. Conclusion: This review provides relevant information about interventions, outcomes and limits associated with anti-gravity training in pediatrics. Overall, anti-gravity treadmill training could be viewed as a valuable training modality, specifically for children with cerebral palsy. However, a more precise and comprehensive description of anti-gravity training protocols would be useful.

Reliability of pain scores during a body weight support protocol in individuals with knee osteoarthritis

Purpose To explore the reliability of percentage of Body Weight Support (BWS) needed for maximal pain relief and of pain scores across 12 walking conditions including pre and post-over-ground walking and an unweighting protocol from 0% to 40% BWS on a lower body positive pressure (LBPP) treadmill for individuals with knee osteoarthritis (OA). Materials and methods Twenty individuals (64 ± 9.44 years) with knee OA completed over-ground walking and an unweighting protocol on an LBPP treadmill. The amount of BWS started at 0% and increased by 5% increments until it reached 40%. Pain scores were recorded at the end of each increment. Results The reliability of pain scores was assessed using a Spearman’s rho. This study found moderate reliability of the percentage of BWS for maximal pain relief. Additionally, there was good reliability of pain scores with pre and post-over-ground walking and from 0% BWS to 30% BWS, but moderate reliability of pain scores was found at 35% and 40% BWS. Conclusion This study supports the use of pain scores as a reliable measure during an unweighted walking session on an LBPP treadmill. IMPLICATIONS FOR REHABILITATION Both the OARSI and ACR recommend exercise in the treatment of individuals with knee OA but acknowledge that pain during exercise and exercise preference/accessibility are important when considering the type of exercise for an individual. LBPP treadmills decrease pain in individuals with knee OA during walking. Pain scores during unweighted walking show moderate to good reliability for individuals with knee OA. This study provides an unweighting protocol to use clinically to determine the Body Weight Support needed to decrease pain.

Analysis of running gait kinematics using an OptoGait at varying degrees of loading on a lower body positive pressure treadmill

Purpose: The use of lower body positive pressure (LBPP) treadmills is becoming more apparent in both rehabilitation and as a supplementary training tool. LBPP treadmills have been shown to reduce ground reaction forces associated with running, whilst maintaining a cardiovascular training stimulus. Additionally, LBPP treadmills are being utilised in orthopaedic, elderly and neurological rehabilitation protocols, due to the ability to offload the forces experienced by lower limbs. The current study aims to investigate the spatiotemporal parameters of the gait cycle at various degrees of body weight support.

Use of Pressure-Measuring Insoles to Characterize Gait Parameters in Simulated Reduced-Gravity Conditions.

Prior researchers have observed the effect of simulated reduced-gravity exercise. However, the extent to which lower-body positive-pressure treadmill (LBPPT) walking alters kinematic gait characteristics is not well understood. The purpose of the study was to investigate the effect of LBPPT walking on selected gait parameters in simulated reduced-gravity conditions. Twenty-nine college-aged volunteers participated in this cross-sectional study. Participants wore pressure-measuring insoles (Medilogic GmBH, Schönefeld, Germany) and completed three 3.5-min walking trials on the LBPPT (AlterG, Inc., Fremont, CA, USA) at 100% (normal gravity) as well as reduced-gravity conditions of 40% and 20% body weight (BW). The resulting insole data were analyzed to calculate center of pressure (COP) variables: COP path length and width and stance time. The results showed that 100% BW condition was significantly different from both the 40% and 20% BW conditions, p < 0.05. There were no significant differences observed between the 40% and 20% BW conditions for COP path length and width. Conversely, stance time significantly differed between the 40% and 20% BW conditions. The findings of this study may prove beneficial for clinicians as they develop rehabilitation strategies to effectively unload the individual’s body weight to perform safe exercises.

Influence Of Running Direction On Metabolic Costs May Be Attenuated By Body Weight Support

During running on land, backward running produces greater metabolic and muscular demands than when running forward at the same speed. This type of research is important to identify the similarities and differences of forward and backward running, in order to best prescribe backward running as a cross-training stimulus for forward running. PURPOSE: The purpose of this study was to investigate the influence of running direction on metabolic, biomechanical, and perceptual demands during running at different levels of body weight support (BWS). METHODS: Thirteen participants ran forward and backward on a lower body positive pressure treadmill at 0%BWS, 20%BWS, and 50%BWS conditions at the same speed. We measured oxygen uptake (VO2), heart rate (HR), muscle activity (rectus femoris, biceps femoris, tibialis anterior, gastrocnemius), and stride frequency during the tests. Additionally, we calculated metabolic cost of transport (CoT). Furthermore, we used rating of perceived exertion (RPE) and feeling scale to investigate participants’ perceptual demands during the tests. VO2, HR, CoT, RPE, feeling scale, muscle activity, and stride frequency were analyzed using a 2 (directions) x 3 (BWS) repeated measures analysis of variance (α = 0.05). RESULTS: VO2, HR, and CoT were influenced by the interaction of BWS and running direction (P < 0.01). For example, CoT during backward running were greater than when running forward only when running at 0%BWS (4.5 ± 1.1 and 5.8 ± 1.4 J/kg/m in CoT for forward and backward running, respectively: P < 0.001). However, muscle activity from the rectus femoris, stride frequency, and RPE during backward running were averages of 113.5%, 11.3%, and 2.8 rankings greater than when running forward, respectively, regardless of BWS (P < 0.001). CONCLUSIONS: Backward running may require greater biomechanical and perceptual demands compared to forward running at the same speed, regardless of BWS. However, the influence of a change in running direction on metabolic demands may be attenuated by BWS. Supported by JSPS Grant Number 16 K01663.