Hwang CH. Immediate muscle strengthening by an end-effector type gait robot with reduced real-time use of leg muscles: A case series and review of literature.
World J Clin Cases 2019;
7:2976-2985. [PMID:
31624745 PMCID:
PMC6795730 DOI:
10.12998/wjcc.v7.i19.2976]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 08/27/2019] [Accepted: 09/12/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND
De-afferentation or non-weight bearing induces rapid cortical and spinal α-motor neuron excitability. Author supposed that an end-effector type gait robot (EEGR) could provide patients with a training condition that was specific enough to activate rapid cortical/spinal neuroplasticity, leading to immediate muscle strengthening. The electromyographic and biomechanical comparisons were conducted.
AIM
To compare the electromyographic activities of the thigh and shank muscles and isometric peak torque (PT) before and after walking training on a floor or in the end-effector gait robot.
METHODS
Twelve outpatients without ambulatory dysfunction were recruited. Order of two interventions (5-min training on a floor at a comfortable pace or training in an EEGR with non-weight bearing on their feet and 100% guidance force at 2.1 km/h) were randomly chosen. Isometric PT, maximal ratio of torque development, amplitude of compound motor action potential (CMAP), and area under the curve (AUC) were evaluated before and 10 min after both interventions.
RESULTS
The degree of PT improvement of the dominant knee flexors was larger in the EEGR than on the floor (9.6 ± 22.4 Nm/BW, P < 0.01). The EEGR-trained patients had greater PT improvement of the dominant knee extensors than those who trained on the floor (4.5 ± 28.1 Nm/BW, P < 0.01). However, all electromyographic activities of the thigh and shank muscles (peak CMAP, mean and peak AUC) were significantly lower for the use of the EEGR than walking on the floor.
CONCLUSION
Immediate strengthening of the knee flexors and extensors was induced after the 5-min EEGR training, despite reduced muscular use.
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