Partial Body Weight Research Articles

Exploring the Efficacy of a Dynamic Harness System on Gross Motor Development and Motivation for Infants With Down Syndrome: A Pilot Study.

To explore the benefits of a Partial Body Weight Support (PBWS) harness system within a play enriched environment on gross motor development and mastery motivation of infants with Down Syndrome (DS). A randomized crossover study with 17 pre-walking infants with DS in two conditions-play with or without the harness engaged-each for 3×/week over 3weeks with a 1-week washout. Assessments took place at baseline, crossover, and completion. Statistically and clinically significant changes were evident on the Gross Motor Function Measure-88; however, there were no significant changes in parent-reported mastery motivation. The combination of PBWS harness system support and high frequency-facilitated play within an enriched play environment positively affected gross motor development. The intervention did not impact mastery motivation skills, and the direct impact of the harness remains unclear.

Design and Validation of an Ambulatory User Support Gait Rehabilitation Robot: NIMBLE

Relearning to walk requires progressive training in real scenarios—overground—along with assistance in basic tasks, such as balancing. In addition, user ability must be maximized through compliant robotic assistance as needed. Despite decades of research, gait rehabilitation robotic devices yield controversial results. This article presents the conceptual design of a novel walking assistance and rehabilitation robot, the NIMBLE robot, aimed at providing ambulatory, bodyweight-supported gait training, assisting the user’s center of mass trajectory to aid weight transfer and dynamic balance during walking. NIMBLE consists of a robotic mobile frame, a partial bodyweight support (PBWS) system, an ambulatory lower-limb exoskeleton (Exo-H3) and a cable-driven pelvis-assisting robot. Designed as a modular structure, it differentiates hierarchical communication levels through a Robot Operating System (ROS) 2 network. We present the mechatronic design and experimental results assessing the impact of the mechatronic coupling between the robotic modules on the walking kinematics and the frame movement control performance. The robotic frame hardly affects the walking kinematics up to 2 degrees in both the sagittal and frontal planes, making it feasible for lateral balance and weight translation training. Moreover, it successfully tracks and follows user trajectories. The NIMBLE robotic frame assessment shows promising results for ambulatory gait rehabilitation.

Development of a Body Weight Support System Employing Model-Based System Engineering Methodology

Partial body weight support systems have proven to be a vital tool in performing physical therapy for patients with lower limb disabilities to improve gait. Developing this type of equipment requires rigorous design process that obtains a robust system, allowing physiotherapy exercises to be performed safely and efficiently. With this in mind, a “Model-Based Systems Engineering” design process using SysML improves communication between different areas, thereby increasing the synergy of interdisciplinary workgroups and positively impacting the development process of cyber-physical systems. The proposed development process presents a work sequence that defines a clear path in the design process, allowing traceability in the development phase. This also ensures the observability of elements related to a part that has suffered a failure. This methodology reduces the integration complexity between subsystems that compose the partial body weight support system because is possible to have a hierarchical and functional system vision at each design stage. The standard allowed requirements to be established graphically, making it possible to observe their system dependencies and who satisfied them. Consequently, the Partial Weight Support System was implemented through with a clear design route obtained by the MBSE methodology.

The effectiveness of partial body weight support treadmill training on walking in people with cerebral palsy

Background: People with Cerebral Palsy (CP) face daily motor, sensory, and cognitive impairments that significantly impact their quality of life. This systematic review aimed to investigate RCTs regarding the effectiveness of treadmill walking with partial body weight support (PBWSTT) in individuals with CP. Methods: A search was performed in PubMed, Scopus and Research Gate. The study selection process was conducted by two separate reviewers. The quality of the final studies included in the systematic review was assessed using the PEDro scale. Results: Out of the 673 studies initially identified, 6 studies were included. The results showed that (PBWSTT) leads to an increase in scores on the GMFM scale, as well as improvement in walking pattern, speed, endurance, and rhythm. The method of PBWSTT in comparison to conventional physiοtherapy did not show better results, as the included studies in this review showed conflicting results. Conclusion: The effect of therapeutic exercise with partial body weight support has a positive impact on improving the gross motor function of patients with Cerebral Palsy. However, the question of whether PBWSTT is more effective than conventional physiotherapy and over-ground walking exercise cannot be conclusively answered yet, highlighting the importance of conducting further research in this field.

Assessment of compression forces in a digitally modified short leg cast for pressure injury risk monitoring in healthy children.

Casting is an essential treatment for neuro-orthopedic conditions in children with cognitive, sensory, and communicational disabilities. However, a main side-effect is the development of pressure injuries resulting in additional (wound) therapies and prolongation of the hospital stay. The primary aim of our study was to investigate the potential of objective pressure measurements in casts to assess the risk for pressure injury development. Five pediatric healthy participants were included in this study. We measured the global and the local compression force at body sites prone to pressure injury development for different body positions and the transfer in-between in a cast equipped with pressure sensors. These conditions resulted in partial or full body weight loading. The global maximum compression force was affected significantly by body postures with partial and full loading of the cast and during transfer. The local compression force significantly correlated with the global compression force at the heel and instep area. In conclusion, the integration of sensing technologies into casts bears a high potential for early recognition of critical conditions inside the cast and inducing preventive measures in the at-risk population.

EFFECTS OF TREADMILL GAIT TRAINING ON BALANCE IN PARKINSON'S PATIENTS AFTER DEEP BRAIN STIMULATION.

After deep brain stimulation (DBS), patients with Parkinson's disease (PD) typically still present significant gait and postural stability problems, and thus additional interventions are needed. In this way, our purpose was evaluate the comparative effectiveness of treadmill training, with and without body weight support, on balance outcomes among patients with PD after DBS. Eleven patients with PD that were using bilateral subthalamic nucleus DBS were evaluated using Time Up and Go test (TUG); Berg Balance Scale (BBS) and Static Posturography. In phase 1, all subjects participated in 8-weeks of treadmill training in conjunction with conventional physiotherapy. After six weeks (wash-out), each patient then participated in a subsequent 8-weeks of treadmill training with partial body weight support. After the phase 1, there were improvements on the cognitive TUG performance (Before: 15.7 ± 1,8 sec; After: 13.7 ± 3.1 sec; p < 0.01) and an increase of anteroposterior and medio-lateral body oscillation with eyes closed. After the phase 2, there were improvements in conventional (Before: 12.3 ± 2.0 sec; After: 10.7 ± 1.7 sec; p < 0.01) and cognitive (Before: 14.6 ± 3.5 sec; After: 12.5 ± 1.6 sec; p < 0.05) TUG performances. There were no significant changes in the Berg Balance Scale following either training protocol. Both trainings improved static and dynamic balance and had similar results; however, supported treadmill training seemed to be a potentially superior option, as patients tended to feel safer. Level of Evidence II, therapeutic studies - investigation of treatment outcomes.

303 Accuracy of the Smartscale In-Pen Weighing System

Abstract The Beef Improvement Federation recommends repeated body weight (BW) measures in a 70-d test period for accurate assessment of average daily gain (ADG) in growing animals. In-pen automated scale systems enable daily monitoring of BW and ADG without the additional labor, time, and animal stress that is associated with recording static chute BW. The objective of the current study was to determine the utility of partial body weight (pBW) for estimating full BW and average daily gain (ADG) in growing steers. SmartScales (C-Lock Inc.) were positioned in front of water troughs and used to measure front-quarter pBW while animals were drinking. Partial body weight was used to estimate full BW using an internally developed slope-intercept equation. The dataset consisted of pBW, estimated BW, and recorded BW for 300 steers in a 50-d feed performance test. Single-day chute BW were recorded on days 14, 28, 35, and 50. Relationships and errors between estimated BW and recorded BW were evaluated. Individual animal ADG estimates were calculated and compared using estimated and recorded BW measurements. Steers in the study visited the water trough an average of 4.3 ± 2.6 times per day. On average, pBW explained 96.1% variation in recorded BW. Average predicted BW and recorded BW differed by 8.3 ± 6.4 kg, or 0.15 ± 3.0 %-units. Average daily gain calculated from pBW and recorded BW were strongly correlated (r = 0.83). On average, ADG calculated using pBW and recorded BW differed by 0.14 ± 0.12 kg, or 8.8 ± 8.0 %-units. Real-time pBW collected using in-pen weighing systems can be used to accurately estimate full BW and ADG.

Motion planning and control strategy of a cable-driven body weight support gait training robot

Abstract. In this paper, a cable-driven body weight support gait training robot (C-BWSGTR) that provides patients with partial body weight support as well as a kind of stable gait training driving force was designed; this device enabled those patients to walk again. Firstly, the overall configuration of the C-BWSGTR was determined, and the structural composition and working principle of the robot were established. Secondly, the vector algebra method was applied to carry out the kinematic analysis and establish the mathematical model of the C-BWSGTR. The displacement of each cable during the patient gait training was also calculated. Thirdly, the motion planning of the C-BWSGTR was carried out in stages, using the time–phase distribution relationship based on an S-shaped speed curve. Meanwhile, the displacement, speed, and acceleration of each cable during the patient gait training were calculated and corresponding change curves were generated. Finally, a position servo composite control strategy for the C-BWSGTR was designed by analyzing the robot's dynamic characteristics of the forward channel transfer function. The simulation analysis and prototype experiment in this paper verified that the designed composite position servo control strategy can meet the requirements of the system with respect to stability and a fast response of the system to the loading command.

Konjac glucomannan attenuate high-fat diet-fed obesity through enhancing β-adrenergic-mediated thermogenesis in inguinal white adipose tissue in mice.

Konjac glucomannan (KGM) has been reported to prevent high-fat diet-induced obesity, and we study investigated whether dietary supplementation with KGM can prevent obesity by increasing energy expenditure in inguinal white adipose tissue (iWAT) of high-fat diet (HF) -fed mice. Weaned mice fed the control diet (Con), HF, or HF plus KGM (8%, w/w, HFK) were divided into three groups. The results showed that 10-week supplementation with KGM significantly reduced partial adipose tissue weight and body weight, and improved glucose tolerance. Compared to the HF group, plasma lipid concentrations in the HFK group were greatly decreased to the control level. Moreover, transcriptomic research has shown that genes that are mainly associated with energy and lipid metabolism are significantly altered in iWAT. Mechanistically, KGM stimulated thermogenesis by promoting the expression of uncoupling protein-1 (UCP1) and the β3-adrenergic receptor (ADR3β). Taken together, our results suggest that dietary supplementation with konjac glucomannan can effectively alleviate obesity induced by a high-fat diet by activating ADR3β-mediated iWAT thermogenesis. Dietary supplementation with KGM can effectively alleviate high fat diet- induced obesity mice by via activating ADR3β-mediated thermogenesis of iWAT.

ACTIVE STRIDES-CP: protocol for a randomised trial of intensive rehabilitation (combined intensive gait and cycling training) for children with moderate-to-severe bilateral cerebral palsy

IntroductionFor children with cerebral palsy (CP), who are marginally ambulant, gross motor capacity peaks between 6 and 7 years of age with a subsequent clinical decline, impacting their ability to...

Dopamine replacement therapy normalizes reactive step length to postural perturbations in Parkinson's disease

BackgroundPostural instability is one of the most disabling motor symptoms of Parkinson’s disease (PD) given its association with falls and loss of independence. Previous studies have assessed biomechanical measures of reactive stepping in response to perturbations, showing that individuals with PD exhibit inadequate postural responses to regain balance. Research questionDoes dopamine replacement therapy normalize step length in response to balance perturbations? MethodsIn this study, we estimated reactive step length, to a postural perturbation, retrospectively from a dataset of frontal plane video using 2D motion tracking and direct linear transform methods. We compared two perturbation methods: support surface translation and shoulder pull (the clinical standard) in 14 individuals with PD and 13 without PD (on and off medication), with and without partial body weight support (BWS). The primary outcome was the length of the first step taken to regain balance after the perturbation analyzed with mixed effects ANOVA, with post hoc analysis of anteroposterior (AP) and mediolateral (ML) components. ResultsPD OFF medication exhibited shorter reactive step length compared to PD ON and compared to control groups for the surface translation perturbations, but no significant difference was observed for the shoulder pull perturbations. SignificanceDopamine replacement therapy affects step length in response to perturbation more robustly for surface translations than for a pull by the shoulders.

Pulmonary Function Improves in Persons with Paraplegia after Partial Body Weight Supported Treadmill Training: a Prospective Randomized Study

Objectives: To evaluate changes in Pulmonary Function Test (PFT) parameters in individuals with paraplegia following Partial Body Weight Supported Treadmill Training (PBWSTT).&#x0D; Design: Randomized controlled trial&#x0D; Setting: Inpatient rehabilitation facility&#x0D; Participants: Adults with chronic SCI (n = 42).&#x0D; Intervention: Patients were randomly allocated in CR group (N= 20) receiving Conventional Rehabilitation or in PBWSTT group (N=22) receiving both Conventional Rehabilitation and PBWSTT for 4 weeks. &#x0D; Main outcome measure(s): Changes in % predicted PFT parameter for the subject’s age, sex and BMI.&#x0D; Results: With PBWSTT, significant PFT changes were VC (P =.009), PEF (p = .001) and ERV (p = .032). In complete SCI, PEF (p = .026) improved, while in incomplete SCI VC (p = .005), ERV (p = .029), PEF( p = .001) improved with PBWSTT. In upper neurological level of injury (NLI) (T6-T11), PBWSTT improved PEF (p = .004) alone while in lower NLI (T12-L2), with PBWSTT both ERV (p = .016) and PEF (p = .035) improved.&#x0D; Conclusions: With added PBWSTT most parameters including Vital Capacity, the global measure of PFT, improved significantly, especially in Lower NLI and incomplete SCI. The positive role of this noninvasive exercise based intervention in improving lung functions comes as an added benefit to the usual benefit of locomotion. This may encourage researchers to design future larger studies to validate it aiming the inclusion of PBWSTT in routine SCI rehabilitation protocols.

Combination of standard physical therapy with partial body weight supported treadmill training in children with spastic diplegic cerebral palsy

Standard physical therapy (SPT) with ground gait training is well recognized to improve the motor skill in cerebral palsy (CP) disease. Confirmation is required on achieving better gross motor function with partial body weight supported treadmill training (PBWSTT). The objective of the study is to analyze combination of SPT with PBWSTT for gross motor function children with spastic diplegic CP who able to walk. A prospective design was conducted in CP patients 2-7 years of age with Gross Motor Function Classification System (GMFCS) I-III and received physical therapy 2 times per week, 20 minutes per session, a total of 20 sessions. The treatment group is continued by PBWSTT for 20 minutes per session. Gross Motor Function Measure (GMFM)-66 of walking, running, and jumping (dimension E) is measured in pre and post-physical therapy. Data were analyzed descriptively. There were 10 subjects and divided into 5 subjects in the control and the rest in the treatment group. The mean age was 48.4 months and 63.4 months respectively. The Average score of GMFM-66 dimension E pre and post-SPT were 63.54 and 65.24, the difference is 1.7 (2.67%) from the initial score.

Postural instability in Parkinson's disease assessed with clinical "pull test" and standardized postural perturbations: effect of medication and body weight support.

This experiment tested if balance performance differed between a standardized treadmill surface perturbation task and a clinical pull test and was affected by medication or the presence of body weight support in people with Parkinson's disease (PD). Twenty-seven individuals were tested (14 PD in both ON- and OFF-medication states). Clinical pull test and rapid forward (backward fall) translations of the support surface were applied to induce postural reactions requiring at least 1 step to restore balance. The effects of pull type (clinical vs. treadmill), partial bodyweight support (0 vs 20% body weight) and group (control, PD ON-meds and PD OFF-meds) on reactive stepping as well as practice/learning effect were examined. The number of steps taken and the first step duration were entered in linear repeated-measures mixed-effect models separately. The effects of pull type, group, and bodyweight support were all significant in both metrics, as was ON- vs. OFF-medication. A significant interaction term (group x pull type) was found in the first step duration, showing that the group difference was greater in treadmill compared to the clinical pull test. A significant practice effect was also observed within and across testing sessions. A standardized treadmill perturbation performed slightly better than the classical pull test in distinguishing between groups, and partial weight support did not substantially degrade the test's performance to detect the balance deficits in people with PD.

Arm-free overground walking with partial body weight support in children with cerebral palsy: A case study

Arm-free overground walking with partial body weight support in children with cerebral palsy: A case study

Comparison of Integrated Task Oriented Bodyweight Supported Overground Training with Body-Weight Supported Treadmill Training to Improve Functional Mobility in Children with Spastic Diplegic Cerebral Palsy - A Single Blinded Randomized Control Trial

Functional gait training in cerebral palsy can involve over ground gait training or treadmill-based gait training which incorporates partial body weight support (PBWS) system. Insufficient clinical evidence prevails to recommend the superiority over the other intervention. ICF model has created a paradigm shift in understanding motor learning mechanisms, with the use of repetitive, task-specific movements beneficial to restructuring motor pathways. The primary aim of the study was to compare the effect of integrated task oriented Body Weight Supported overground Training (BWSOGT) against the Body Weight Supported Treadmill Training (BWSTT) and the conventional gait training protocols to improve the functional mobility in Cerebral Palsy. Methods: A Single-blinded, randomised control design. Sixty-children with GMFCS Level of III, IV were recruited in the study with an age ranges between 4 to 14 years (mean age = 9). Participants were randomly assigned into three groups using simple randomisation method with 20 subjects in each group for 8 weeks. The training programme consists of Group A with 40% of body weight supported walker with overhead pulley system which allows multiple degrees of freedom. Body weight- supported treadmill training (Group B) in a closed environment and conventional gait protocol using standard walkers (Group C). Outcome measures: Gross Motor Function Measure dimension-88 (GMFM-88) score. Gait kinematics (Stride length, Step length, Cadence) and 10 meter walk test. Tukey’s Post Hoc for group and time interactions, Krushkal Wallis test for overall significance and Mann Whitney’s U test to compare the significance between the groups. BWSOGT group showed significance over the BWSTT and Control group in GMFM score with p = 0.000 p = 0.002, respectively. Step length of gait parameter remained unchanged in all the three groups. Integrated task oriented BWSOGT might be an effective intervention to improve functional ambulation in children with spastic cerebral palsy due to the usage of a context specific environment and the training protocol.

Long-term improvement of adipocyte insulin action during body weight relapse after bariatric surgery: a longitudinal cohort study.

There are few long-term mechanistic studies in adipose tissue that investigate the metabolic effects of bariatric surgery. Changes in lipogenesis may be involved in long-term weight development. To investigate the long-term effect of bariatric surgery on lipogenesis in abdominal fat cells and whether surgical treatment could induce an epigenetic memory that would maintain improved lipogenesis in spite of body weight relapse. Karolinska University Hospital in Stockholm County, Sweden. A total of 22 women with obesity living in the Stockholm area were examined before, 2, 5, and 10 years after bariatric surgery. Abdominal adipose tissue biopsies were obtained. Fat cells were isolated and spontaneous and insulin stimulated glucose incorporation into lipids were assayed. CpG-methylation profiling was performed on adipocytes using the Infinium EPIC BeadChips. Bariatric surgery was associated with improvement in adipocyte spontaneous and insulin stimulated lipogenesis, which was maintained despite some later weight regain (29 % of initial weight loss). There was also an increase in fat cell size between 2- and 10-year follow-up, albeit not to presurgery levels. There were 7729 differentially methylated CpG sites (DMS) at 2 years that showed no sign of return to baseline at either 5 or 10 years. Merging results with expression profiles identified 1259 genes with DMS which showed early response or continual change in expression in one direction after surgery. Upregulated genes with DMS were enriched in gene sets linked to cellular response to insulin stimulus (e.g., IRS1, IRS2, PDE3B, and AKT2) and regulation of lipid metabolic processes. Bariatric surgery leads to long-term improvement of lipogenesis and insulin responsiveness in subcutaneous adipocytes in women in spite of some partial body weight regain postoperatively. This may to some extent be explained by epigenetic modifications of fat cell function.

Effect of Two Different Rehabilitation Approaches on Pulmonary Functional Tests, Neuromuscular Functions and Quality of Life in Juvenile Myasthenia Gravis: A Randomized Controlled Trial Study.

Background and Objectives: Children with juvenile myasthenia gravis have a variety of symptoms, ranging from isolated intermittent ocular complaints to overall muscle weakness with or without respiratory insufficiency. This study aimed to investigate the efficacy of a specialized physical therapy with or without partial body weight supported treadmill training on pulmonary functional tests, neuromuscular functions, and quality of life. Materials and Methods: Thirty children, ranging in age from 13 to 16 years, were distributed randomly into two study groups (A or B). Both groups underwent a designed physical therapy program. In addition, group A underwent the partial body weight supported treadmill training. The treatment was conducted three times a week for 12 weeks successively. Pulmonary functional tests (FVC, FEV1, PEFR, and MVV), neuromuscular function tests (compound motor action potential, isometric muscle force of biceps brachii and rectus femoris, balance, walking endurance, and fatigue), and quality of life were measured before and after 12 successive weeks. Results: A significant improvement in all investigated variables were recorded in both groups in favor of group A. Conclusions: Both a specialized physical therapy and partial body weight supported treadmill training are effective in terms of enhancing pulmonary functional tests, neuromuscular functions, and quality of life. Partial body weight supported treadmill training is an excellent adjunctive to the physical therapy program.

Study protocol of a randomised controlled trial for the effectiveness of a functional partial body weight support treadmill training (FPBWSTT) on motor and functional skills of children with ataxia

IntroductionA great heterogeneity characterises the paediatric population with ataxia, which has been studied poorly. The lack of postural control and coordination, in addition with features of the ‘ataxic’ gait are...

Constraint manipulation as a feasible strategy for gait alteration and intervention: a scoping review

In this paper, we describe general information regarding the use of the partial body weight support (BWS) paradigm as a strategy to manipulate constraints during walking by individuals with and without gait impairments. We present two overground BWS systems implemented by our research group and the main studies that have been conducted so far. Non-disabled young adults, individuals with stroke, and children with cerebral palsy were considered in our investigations. Gait assessment with different amounts of body weight unloading on both the treadmill and the ground, as well as gait training protocols with BWS on these surfaces, were conducted, and general results are reported. Based on our investigations, we suggest that the use of a BWS system on a treadmill and on the ground, as a strategy for manipulating constraints, enables individuals with gait impairment to walk. More importantly, professionals in the field of gait rehabilitation can carry out training protocols throughout the manipulation of implements that assist walking, such as using a harness connected to a structure.