off-axis elliptical training to reduce gait abnormalities in … · 2014-05-23 · gait...
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1Liang-Ching Tsai, 2Yupeng Ren, 2Liang Wang, 1Song Joo Lee, 2Sang Hoon Kang, 1,2Deborah J Gaebler-Spira, 1,2Li-Qun Zhang 1Northwestern University, Chicago, IL, USA; 2Rehabilitation Institute of Chicago, IL, USA
Email: [email protected]; [email protected]
Off-axis Elliptical Training to Reduce Gait Abnormalities in Children with Cerebral Palsy
Rehabilitation Institute of Chicago
BACK GROUND Gait abnormalities in the frontal and transverse planes (off-axis planes), such as femoral internal rotation and adduction, are commonly observed in persons with cerebral palsy (CP). However, no objective assessment/treatment tools are currently available to monitor and reduce the excessive motions of the lower extremities in the off-axis planes in persons with CP.
OBJECTIVES To demonstrate the use of an off-axis elliptical trainer to strengthen the control of the lower extremity off-axis motions in children with CP.
SIGNIFICANCE ● Novel off-axis training for children with CP ● Training under a functional and weight-
bearing stepping maneuver ● Suitable for individuals with different levels of disabilities − Via the assistance provided by the motorized
wheel and body weight support system
OFF-‐AXIS ELLIPTICAL TRAINING SYSTEM (Fig. 1) ● Robotic Elliptical Trainer
− Motorized foot plates that allow for frontal-plane sliding & transverse-plane rotation/pivoting (Fig. 2)
− Motorized wheel to provide assistance during elliptical exercise
● Body-Weight Support
ACKNOWLEDGMENT 1. NIH R01AR056050 2. NSF SBIR IIP-1058612 3. NIDRR RERC (H133E100007) 4. Switzer Fellowship, NIDRR (H133F130031) 5. All study participants
PRELIMINARY FINDINGS ● Participants − 5 subjects with CP (15.8 ± 3.3 y/o)
● 6-week (18 sessions) off-axis training ● Improved off-axis pivoting control (Fig. 5) ● Improved off-axis muscle strength (Fig. 6)
● Real-time Visual & Audio Feedback (Fig. 3) − Foot pivoting position
and leg alignment − Potential to integrate
with game and virtual reality environment
Fig. 2. Motorized foot plates for pivo0ng and sliding mo0ons.
Body Weight Support
Motorized Foot Plates
Fig. 1. Off-‐Axis Ellip0cal System that includes motorized foot plates, dynamic body weight support, and motorized wheel.
● Multiple Training Modes (Fig. 4) − Fixed, Spring, Free,
Perturbation modes − Participant-specific
training program
Fig. 3. Real 0me Visual and audio feedback about foot posi0on and leg alignment.
Fig. 4. Mul0ple training modes from the easiest to the most difficult level of off-‐axis control.
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4
8
12
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20
Ext. Rotation Int. Rotation
Musc
le To
rque
(Nm)
Pre Post
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2
4
6
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10
Entire Cycle 1ST Half 2ND Half
RM
S A
ngle
(°)
Pre Post
Fig. 5. Lower extremity off-‐axis muscle strength pre-‐ and post-‐training.
Fig. 6. Lower extremity off-‐axis pivo0ng control pre-‐ and post-‐training.