Lower Body Positive-pressure Exercise after Knee Surgery

Eastlack, Robert K.; Hargens, Alan R.; Groppo, Eli R.; Steinbach, Gregory C.; White, Klane K.; Pedowitz, Robert A.

doi:10.1097/01.blo.0000150459.92012.f7

Cited by 56 publications

(48 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Movements in deep water may help to maintain the aerobic fitness, but the neuromuscular training and the movement pattern are very different from normal movements, as the forces applied to the body in water differ significantly from the forces during overground movements (eg, [20][21][22] ). Ambulation in a LBPP chamber may be beneficial not only for early mobilization after injury and surgery, 23 but also as a motor evaluation and learning tool for neuromuscular patients, as motor control can be challenged systematically.…”

Section: Discussionmentioning

confidence: 99%

Muscle Activation and Estimated Relative Joint Force During Running with Weight Support on a Lower-Body Positive-Pressure Treadmill

Jensen

Hovgaard-Hansen²,

Cappelen³

2016

Journal of Applied Biomechanics

View full text Add to dashboard Cite

Running on a lower-body positive-pressure (LBPP) treadmill allows effects of weight support on leg muscle activation to be assessed systematically, and has the potential to facilitate rehabilitation and prevent overloading. The aim was to study the effect of running with weight support on leg muscle activation and to estimate relative knee and ankle joint forces. Runners performed 6-min running sessions at 2.22 m/s and 3.33 m/s, at 100%, 80%, 60%, 40%, and 20% body weight (BW). Surface electromyography, ground reaction force, and running characteristics were measured. Relative knee and ankle joint forces were estimated. Leg muscles responded differently to unweighting during running, reflecting different relative contribution to propulsion and antigravity forces. At 20% BW, knee extensor EMG peak decreased to 22% at 2.22 m/s and 28% at 3.33 m/s of 100% BW values. Plantar flexors decreased to 52% and 58% at 20% BW, while activity of biceps femoris muscle remained unchanged. Unweighting with LBPP reduced estimated joint force significantly although less than proportional to the degree of weight support (ankle). It was concluded that leg muscle activation adapted to the new biomechanical environment, and the effect of unweighting on estimated knee force was more pronounced than on ankle force. Keywords: rehabilitation, body weight support, EMG, estimated joint load, runningEarly mobilization after injury and surgery on the lower extremities is essential to reduce adverse effects of immobilization and to facilitate rehabilitation. Walking or running with weight support on a lower-body positive-pressure (LBPP) treadmill is a new training and rehabilitation modality. 1,2 A recent study indicated strong correlation between tibiofemoral force and treadmill ground reaction force in a small group of elderly patients during slow walking. 3 Another study showed that runners can reduce peak vertical ground reaction forces while maintaining the aerobic stimulus when running on a LBPP treadmill. 4 Even training at high speeds and high aerobic stimuli with the benefit of low vertical ground reaction force and near-normal movement pattern can be performed on the LBPP treadmill. 5 Furthermore, no adverse impact on systemic and head cardiovascular parameters has been found. 6 However, the effect of different levels of LBPP weight support during running on neuromuscular adaptations and their possible associations to joint forces have not been studied systematically.During level running, leg muscles support body weight (BW) against gravity and accelerate/decelerate the body mass in a forward direction. BW, as measured in Newton, is directly related to gravity, while body mass (kg) is independent of gravity. Therefore, by unweighting in a LBPP chamber, it is possible to create a new biomechanical environment where the vertical forces are reduced while forces associated with horizontal acceleration/deceleration of the body remain unchanged. This allows systematic study of individual leg muscle contribution to body support against grav...

show abstract

Section: Discussionmentioning

confidence: 99%

Muscle Activation and Estimated Relative Joint Force During Running with Weight Support on a Lower-Body Positive-Pressure Treadmill

Jensen

Hovgaard-Hansen²,

Cappelen³

2016

Journal of Applied Biomechanics

View full text Add to dashboard Cite

show abstract

“…Speed and weight can be gradually increased eventually progressing to running as healing advances and strength improves. Using LBPP has been shown to significantly decrease pain during ambulation in patients who recently underwent arthroscopic meniscectomy or ACLR [12] and has been utilized in rehabilitation program following microfracture of the knee [13].…”

Section: Unloaded Treadmillsmentioning

confidence: 99%

“…Ground reaction forces are reduced for running and walking at all levels of un-weighting using the LBPP treadmill versus full body weight [8,12,[14][15][16]. Running mechanics are not significantly affected with un-weighting with respect to stride length and knee and ankle sagittal plane ROM [8,17,18].…”

Section: Unloaded Treadmillsmentioning

confidence: 99%

Return to sport following hip injury

Draovitch

Maschi

Hettler

2012

Curr Rev Musculoskelet Med

View full text Add to dashboard Cite

Returning to both recreational and competitive sport requires the patient demonstrate the ability to perform their activity without pain, without compensation and without apprehension. The primary focus of this article will be to provide progressive weight bearing phased treatment solutions and both objective and empirical return to play testing suggestions. In addition to satisfactorily completing the test battery with maximum effort, the patient must demonstrate the ability to meet the demands for competing within their respective sport specific environment. Returning to competition will most likely include early phase movement screening and clinical clearance followed by late phase athletic and field testing. Hip structure will and must influence training program design. It is therefore important to recognize that indications for return to play must not focus on a single rehabilitation or exercise variable, but rather a combination of clinical, functional and sport specific demands.

show abstract

“…27 Anti-gravity treadmills are being increasingly used after knee surgery to reduce ground reaction forces during walking and running to facilitate postoperative rehabilitation. 4,9 Muscle activity decreases as body weight decreases on an antigravity treadmill, but the percentage change in muscle activity is less than the percentage change in body weight. 25 It is possible to achieve target knee forces during rehabilitation using an anti-gravity treadmill.…”

Section: Introductionmentioning

confidence: 99%