Balance assessment with decreased base of support for children with disabilities.

Background: Children's ability to achieve an appropriate motor development is largely associated with their capacity to control balance. Furthermore, accomplishing balance tasks with a narrowed base of support is a necessary precursor to engaging in everyday functional activities and developing more complex balance abilities.

Purpose: To investigate the relationship between the tandem stance (TS) and the single-limb stance (SLS) items of the Pediatric Balance Scale (PBS) assessment tool with the PBS total score in children with impaired balance.

Lower extremity muscle activity during reactive balance differs between adults with chronic traumatic brain injury and controls.

Background: Control of reactive balance is key to achieving safe independent walking and engagement in life activities. After traumatic brain injury (TBI), motor impairments and mobility challenges are persistent sequelae. To date, no studies have explored muscle activity of individuals with chronic TBI during a task that requires reactive control of balance.

Effect of Data and Gap Characteristics on the Nonlinear Calculation of Motion During Locomotor Activities.

This study investigated how data series length and gaps in human kinematic data impact the accuracy of Lyapunov exponents (LyE) calculations with and without cubic spline interpolation. Kinematic time series were manipulated to create various data series lengths (28% and 100% of original) and gap durations (0.05-0.

Virtual reality augments effectiveness of treadmill walking training in patients with walking and balance impairments: A systematic review and meta-analysis of randomized controlled trials.

Objective: To systematically summarize and examine current evidence regarding the combination of virtual reality and treadmill training in patients with walking and balance impairments.

Data Sources: English language randomized controlled trials, participants with walking and balance impairments, intervention group used virtual reality and treadmill, control group only used treadmill with the same training frequency and number of sessions. Six bioscience and engineering databases were searched.

Effect of gap-filling technique and gap location on linear and nonlinear calculations of motion during locomotor activities.

Background: Marker occlusion during camera-based movement analysis is common. Different interpolation techniques are available for estimating location of missing marker trajectories.

Research Question: What is the effect of gap location and interpolation technique on linear and nonlinear measures for a given kinematic time series?

Methods: Kinematic data were recorded during motor-assisted elliptical training and treadmill walking.

Muscle demand and kinematic similarities between pediatric-modified motor-assisted elliptical training at fast speed and fast overground walking: Real-world implications for pediatric gait rehabilitation.

The purpose of this research was to compare children's lower extremity muscle activity and kinematics while walking at fast pace and training at fast speeds with and without motor-assistance on a pediatric-modified motor-assisted elliptical. Twenty-one children without disabilities were recruited and fifteen completed all three training conditions at self-selected fast pace. Repeated-measures ANOVAs identified muscle demand (peak, mean, duration) differences across device conditions and fast walking.

Feasibility of motor-assisted elliptical to improve walking, fitness and balance following pediatric acquired brain injury: A case series.

Purpose: Walking, fitness, and balance deficits are common following acquired brain injury (ABI). This study assessed feasibility, acceptability, and usefulness of a modified motor-assisted elliptical (ICARE) in addressing walking, fitness, and balance deficits in children with chronic ABIs.

Methods: Three children (> 5 years post-ABI) completed 24 ICARE exercise sessions (exercise time, speed, and time overriding motor-assistance gradually increased) to promote mass repetition of gait-like movements and challenge cardiorespiratory fitness.

Comparison of plantar pressure profile of young adults during training on elliptical devices and overground walking: A pilot study.

Background: Elliptical training may offer advantages over other cardiorespiratory exercises for those requiring podiatric care, since its constant double-limb support diminishes recurring high-impact plantar forces while allowing exercise in a functional, upright posture. Unknown is the impact of distinct elliptical models, that can alter user's body mechanics, on potential variations in plantar pressure patterns.

Purpose: To compare plantar pressure variables while exercising on four ellipticals and walking.

Effect of motor-assisted elliptical training speed and body weight support on center of pressure movement variability.

Background: A motor-assisted elliptical trainer is being used clinically to help individuals with physical disabilities regain and/or retain walking ability and cardiorespiratory fitness. Unknown is how the device's training parameters can be used to optimize movement variability and regularity. This study examined the effect of motor-assisted elliptical training speed as well as body weight support (BWS) on center of pressure (CoP) movement variability and regularity during training.

Variations in plantar pressure variables across elliptical trainers in older adults.

Background: Ellipticals are used to address walking and cardiorespiratory training goals of older adults, some of whom are at risk for foot injuries. Variations in joint kinematics and muscle demands when using different ellipticals could lead to plantar pressure differences. This study explored plantar pressure variables during gait and use of four ellipticals.

Test-retest reliability and minimal detectable change of the computerized dynamic posturography PROPRIO for adults with chronic traumatic brain injury.

Purpose: Balance deficits after brain injury, including reactive recovery from unexpected perturbations, can persist well after rehabilitation is concluded. While traditional clinical assessments are practical, the anticipatory nature of the tasks may mask perceptible balance control. Computerized dynamic posturography can directly quantify capacity to respond to unexpected, external perturbations.

Walking and Fitness Improvements in a Child With Diplegic Cerebral Palsy Following Motor-Assisted Elliptical Intervention.

Purpose: To quantify effects of motor-assisted elliptical (Intelligently Controlled Assistive Rehabilitation Elliptical [ICARE]) training on walking and fitness of a child with cerebral palsy (CP).

Key Points: A 12-year-old boy with walking limitations due to spastic diplegic CP (Gross Motor Function Classification System II) participated in 24 sessions of primarily moderate- to vigorous-intensity ICARE exercise. Fitness improvements were evidenced clinically across sessions by the child's capacity to train for longer periods, at faster speeds, and while overriding motor's assistance.

Kinematic and muscle demand similarities between motor-assisted elliptical training and walking: Implications for pediatric gait rehabilitation.

Many children with physical disabilities and special health care needs experience barriers to accessing effective therapeutic technologies to improve walking and fitness in healthcare and community environments. The expense of many robotic and exoskeleton technologies hinders widespread use in most clinics, school settings, and fitness facilities. A motor-assisted elliptical trainer that is being used to address walking and fitness deficits in adults was modified to enable children as young as three years of age to access the technology (Pedi-ICARE).

Computerized dynamic posturography detects balance deficits in individuals with a history of chronic severe traumatic brain injury.

Background: Mild balance deficits can be challenging to detect in individuals with long-standing traumatic brain injuries. This study compared Computerized Dynamic Posturography (CDP) scores from individuals with traumatic brain injuries (TBI) to controls to determine if CDP could differentiate between the two groups and determine if there was a learning effect associated with testing that could be used to guide evaluation of baseline balance.

Methods: Ten ambulatory individuals with a history of severe TBI and 10 individuals without participated in three CDP sessions (24-72 hours apart).

Partial body weight support treadmill training speed influences paretic and non-paretic leg muscle activation, stride characteristics, and ratings of perceived exertion during acute stroke rehabilitation.

Background: Intensive task-specific training is promoted as one approach for facilitating neural plastic brain changes and associated motor behavior gains following neurologic injury. Partial body weight support treadmill training (PBWSTT), is one task-specific approach frequently used to improve walking during the acute period of stroke recovery (<1month post infarct). However, only limited data have been published regarding the relationship between training parameters and physiologic demands during this early recovery phase.

Comparative analysis of speed's impact on muscle demands during partial body weight support motor-assisted elliptical training.

Individuals with walking limitations often experience challenges engaging in functionally relevant exercise. An adapted elliptical trainer (motor to assist pedal movement, integrated body weight harness, ramps/stairs, and grab rails) has been developed to help individuals with physical disabilities and chronic conditions regain/retain walking capacity and fitness. However, limited published studies are available to guide therapeutic interventions.

Comparative kinematic and electromyographic assessment of clinician- and device-assisted sit-to-stand transfers in patients with stroke.

Background: Workplace injuries from patient handling are prevalent. With the adoption of no-lift policies, sit-to-stand transfer devices have emerged as one tool to combat injuries. However, the therapeutic value associated with sit-to-stand transfers with the use of an assistive apparatus cannot be determined due to a lack of evidence-based data.

Monitoring cerebral hemodynamics with transcranial Doppler ultrasound during cognitive and exercise testing in adults following unilateral stroke.

An observational study was performed as a preliminary investigation into the use of transcranial Doppler ultrasound (TCD) for recording cerebral hemodynamic changes during multiple tasks. TCD is a method of measuring cerebral blood flow (CBF) using ultrasound transducers in contact with the surface of the head. Using the maximum flow envelope of the Doppler spectrum returning from the middle cerebral artery (MCA), standard clinical flow indices can be calculated and displayed in real time providing information concerning perturbations in CBF and their potential cause.

Kinematic and electromyographic analyses of normal and device-assisted sit-to-stand transfers.

Mechanical sit-to-stand devices assist patient transfers and help protect against work-related injuries in rehabilitation environments. However, observational differences between patient's movements within devices compared to normal sit-to-stand transfers deter clinician use. This study compared kinematics and muscle demands during sit-to-stand transfers with no device (ND), and device-assisted during which participants exerted no effort (DA-NE) and best effort (DA-BE).

Impact of elliptical trainer ergonomic modifications on perceptions of safety, comfort, workout, and usability for people with physical disabilities and chronic conditions.

Background: The popularity of elliptical training has grown in rehabilitation, fitness, and home settings as a means for improving fitness and walking, yet many people with physical disabilities and chronic conditions experience difficulties when trying to use elliptical trainers.

Objective: The purpose of this study was to compare, for people with disabilities and chronic conditions, perceptions of safety, comfort, workout, and usability of 4 elliptical trainers before and after the development of a set of low-cost adaptations.

Design: This study was a quasi-experimental repeated-measures investigation.