Coactivation of lower leg muscles during body weight-supported treadmill walking decreases with age in adolescents

Child-Adult differences in antagonist muscle coactivation: A systematic review

Antagonist coactivation is the simultaneous activation of agonist and antagonist muscles during a motor task. Age-related changes in coactivation may contribute to observed differences in muscle performance between children and adults. Our aim was to systematically summarize age-related differences in antagonist muscle coactivation during multi-joint dynamic and single-joint isometric and isokinetic contractions. Electronic databases were searched for peer-reviewed studies comparing coactivation in upper or lower extremity muscles between healthy children and adolescents/young adults. Of the 1083 studies initially identified, 25 met eligibility criteria. Thirteen studies examined multi-joint dynamic movements, 10 single-joint isometric contractions, and 2 single-joint isokinetic contractions. Of the studies investigating multi-joint dynamic contractions, 83% (11/13 studies) reported at least one significant age-related difference: In 84% (9/11 studies) coactivation was higher in children, whereas 16% (2/11 studies) reported higher coactivation in adults. Among single-joint contractions, only 25% (3/12 studies) reported significantly higher coactivation in children. Fifty six percent of studies examined females, with no clear sex-related differences. Child-adult differences in coactivation appear to be more prevalent during multi-joint dynamic contractions, where generally, coactivation is higher in children. When examining child-adult differences in muscle function, it is important to consider potential age-related differences in coactivation, specifically during multi-joint dynamic contractions.

Skeletal Muscle Measurements in Pediatric Hematology and Oncology: Essential Components to a Comprehensive Assessment

Children with hematologic and oncologic health conditions are at risk of impaired skeletal muscle strength, size, and neuromuscular activation that may limit gross motor performance. A comprehensive assessment of neuromuscular function of these children is essential to identify the trajectory of changes in skeletal muscle and to prescribe therapeutic exercise and monitor its impact. Therefore, this review aims to (a) define fundamental properties of skeletal muscle; (b) highlight methods to quantify muscle strength, size, and neuromuscular activation; (c) describe mechanisms that contribute to muscle strength and gross motor performance in children; (d) recommend clinical assessment measures; and (e) illustrate comprehensive muscle assessment in children using examples of sickle cell disease and musculoskeletal sarcoma.

Effect of Antigravity Treadmill Training on Gait and Balance in Patients with Diabetic Polyneuropathy: A Randomized Controlled Trial

Background: Diabetic polyneuropathy (DPN) is the most prevalent consequence of diabetes mellitus, and it has a significant impact on the patient's health. This study aims to evaluate effects of antigravity treadmill training on gait and balance in patients with DPN. Methods: The study included 45 males with type 2 diabetes who were randomly assigned to one of two groups: the experimental group (n=23) or the control group (n=22). For a period of 12 weeks, the experimental group received antigravity treadmill training (75% weight bearing, 30 min per session, three times per week) combined with traditional physical therapy. During the same time period, the control group received only traditional physical therapy. The Biodex Balance System was used to assess postural stability indices, while the GAITRite Walkway System was used to assess spatiotemporal gait parameters. All measurements were obtained before and at the end of the study after 12 weeks of treatment. Results: The mean values of all measured variables improved significantly in both groups (P<0.05), with the experimental group showing significantly greater improvements than the control group. The post-treatment gait parameters ( i.e., step length, step time, double support time, velocity, and cadence) were 61.3 cm, 0.49 sec, 0.25 sec, 83.09 cm/sec, and 99.78 steps/min as well as 56.14 cm, 0.55 sec, 0.29 sec, 75.73 cm/sec, and 88.14 steps/min for the experimental and control group, respectively. The post-treatment overall stability index was 0.32 and 0.70 for the experimental and control group, respectively. Conclusions: Antigravity treadmill training in combination with traditional physical therapy appears to be superior to traditional physical therapy alone in terms of gait and balance training. As a result, the antigravity treadmill has been found to be an effective device for the rehabilitation of DPN patients.

Effects of Antigravity Treadmill Training on Gait and Balance in Patients with Diabetic Polyneuropathy: A Randomized Controlled Trial

Background: Diabetic polyneuropathy (DPN) is the most prevalent consequence of diabetes mellitus, and it has a significant impact on the patient's health. This study aims to evaluate effects of antigravity treadmill training on gait and balance in patients with DPN. Methods: The study included 45 males with type 2 diabetes who were randomly assigned to one of two groups: the experimental group (n=23) or the control group (n=22). For a period of 12 weeks, the experimental group received antigravity treadmill training (75% weight bearing, 30 min per session, three times per week) combined with traditional physical therapy. During the same time period, the control group received only traditional physical therapy. The Biodex Balance System was used to assess postural stability indices, while the GAITRite Walkway System was used to assess spatiotemporal gait parameters. All measurements were obtained before and at the end of the study after 12 weeks of treatment. Results: The mean values of all measured variables improved significantly in both groups (P<0.05), with the experimental group showing significantly greater improvements than the control group. The post-treatment gait parameters ( i.e., step length, step time, double support time, velocity, and cadence) were 61.3 cm, 0.49 sec, 0.25 sec, 83.09 cm/sec, and 99.78 steps/min as well as 56.14 cm, 0.55 sec, 0.29 sec, 75.73 cm/sec, and 88.14 steps/min for the experimental and control group, respectively. The post-treatment overall stability index was 0.32 and 0.70 for the experimental and control group, respectively. Conclusions: Antigravity treadmill training in combination with traditional physical therapy appears to be superior to traditional physical therapy alone in terms of gait and balance training. As a result, the antigravity treadmill has been found to be an effective device for the rehabilitation of DPN patients.

Effect of Antigravity Treadmill Training on Gait and Balance in Patients with Diabetic Polyneuropathy: A Randomized Controlled Trial

Background: Diabetic polyneuropathy (DPN) is the most prevalent consequence of diabetes mellitus, and it has a significant impact on the patient's health. This study aims to evaluate effects of antigravity treadmill training on gait and balance in patients with DPN. Methods: The study included 45 males with type 2 diabetes who were randomly assigned to one of two groups: the experimental group (n=23) or the control group (n=22). For a period of 12 weeks, the experimental group received antigravity treadmill training (75% weight bearing, 30 min per session, three times per week) combined with traditional physical therapy. During the same time period, the control group received only traditional physical therapy. The Biodex Balance System was used to assess postural stability indices, while the GAITRite Walkway System was used to assess spatiotemporal gait parameters. All measurements were obtained before and at the end of the study after 12 weeks of treatment. Results: The mean values of all measured variables improved significantly in both groups (P<0.05), with the experimental group showing significantly greater improvements than the control group. The post-treatment gait parameters ( i.e., step length, step time, double support time, velocity, and cadence) were 61.3 cm, 0.49 sec, 0.25 sec, 83.09 cm/sec, and 99.78 steps/min as well as 56.14 cm, 0.55 sec, 0.29 sec, 75.73 cm/sec, and 88.14 steps/min for the experimental and control group, respectively. The post-treatment overall stability index was 0.32 and 0.70 for the experimental and control group, respectively. Conclusions: Antigravity treadmill training in combination with traditional physical therapy appears to be superior to traditional physical therapy alone in terms of gait and balance training. As a result, the antigravity treadmill has been found to be an effective device for the rehabilitation of DPN patients.

The effects of direction and speed on treadmill walking in typically developing children

BACKGROUND

Backward walking and fast walking have distinctive gait patterns in adults; however, there is minimal literature describing these gait modifications in typically developing children. Additionally, most of previous research focused on overground backward walking, but not on a treadmill.

RESEARCH QUESTION

How do typically developing children adapt their gait patterns, including spatiotemporal parameters, joint kinematics, and muscle activation, to changes in direction and speed during treadmill walking?

METHODS

We recruited 19 children (10 M/9 F) aged 6-12 years. Treadmill conditions included forward and backward walking at three speeds: slow (75 % of normal speed), normal speed, and fast (125 % of normal speed). Subjects completed a 2-minute trial under each condition. Spatiotemporal, kinematic, kinetic and electromyography data were collected and analyzed. Correlations between forward and time-reversed backward walking were calculated for joint angles and vertical ground reaction force.

RESULTS

During backward walking, children (a) decreased step lengths and increased step widths and foot clearance, (b) decreased peak hip and knee flexion and increased peak ankle dorsiflexion, and (c) increased muscle activity at the vastus lateralis, rectus femoris, and tibialis anterior. At faster speeds, children increased step lengths and inconsistently increased overall muscle activity. Both the hip and knee showed high correlation between forward and time-reversed backward walking, while correlation at the ankle was low.

SIGNIFICANCE

Overall, children adapt their gait to changes in direction and speed of treadmill walking in similar ways to adults. However, notable differences emerged in that children limited their ankle range of motion. Our results suggest that, while many aspects of gait are mature enough by this age to adapt to backward walking on a treadmill, neuromuscular control at the ankle may still be lacking in children while walking backward on a treadmill.

Analysis of Movement Acceleration of Down's Syndrome Teenagers Playing Computer Games

OBJECTIVE

This study aimed to evaluate movement acceleration characteristics in adolescents with Down syndrome (DS) and typical development (TD), while playing bowling and golf videogames on the Nintendo^® Wii™.

MATERIALS AND METHODS

The sample comprised 21 adolescents diagnosed with DS and 33 with TD of both sexes, between 10 and 14 years of age. The arm swing accelerations of the dominant upper limb were collected as measures during the bowling and the golf games. The first valid measurement, verified by the software readings, recorded at the start of each of the games, was used in the analysis.

RESULTS

In the bowling game, the groups presented significant statistical differences, with the maximum (M) peaks of acceleration for the Male Control Group (MCG) (M = 70.37) and Female Control Group (FCG) (M = 70.51) when compared with Male Down Syndrome Group (MDSG) (M = 45.33) and Female Down Syndrome Group (FDSG) (M = 37.24). In the golf game the groups also presented significant statistical differences, the only difference being that the maximum peaks of acceleration for both male groups were superior compared with the female groups, MCG (M = 74.80) and FCG (M = 56.80), as well as in MDSG (M = 45.12) and in FDSG (M = 30.52).

CONCLUSION

It was possible to use accelerometry to evaluate the movement acceleration characteristics of teenagers diagnosed with DS during virtual bowling and golf games played on the Nintendo Wii console.

Effect of Body-Weight-Support Running on Lower-Limb Biomechanics

Study Design Controlled laboratory study. Background Body-weight-support (BWS) running is increasing in popularity, despite limited evidence of its effects on running mechanics. Objectives To determine the effect of increasing BWS on lower-limb biomechanics during lower-body positive-pressure (LBPP) treadmill running. Methods Fourteen male recreational runners completed 15 randomized trials on an LBPP treadmill at 5 levels of BWS and 3 velocities (1-minute trials with 3-minute recovery). Knee and ankle kinematic data were recorded continuously via electrogoniometry. Synchronous in-shoe plantar-pressure data identified stride onset and quantified foot-segment forces. Data were recorded during the final 30 seconds of each trial and averaged over 10 consecutive stride cycles. Results Higher levels of BWS resulted in significantly (P<.001) increased stride duration, reduced stride frequency, and reduced ground contact time (GCT). In addition, normalized GCT (GCT/stride duration) was significantly reduced (P<.001), indicating increased flight time. Increasing BWS resulted in significant reductions (P<.001) in peak knee flexion and dorsiflexion and reduced overall knee and ankle range of motion during the stance phase. Conclusion Running on an LBPP treadmill alters lower-limb kinematics, resulting in reduced ankle and knee joint range of motion. In addition, increased BWS alters stride characteristics, resulting in shorter GCT and longer flight time. Clinicians must be aware of lower-limb kinematic alterations to provide safe and effective parameters for rehabilitation involving LBPP treadmills. J Orthop Sports Phys Ther 2016;46(9):784-793. doi:10.2519/jospt.2016.6503.