Usability evaluation of an interactive leg press training robot for children with neuromuscular impairments.

BACKGROUND: The use of robotic technology for neurorehabilitative applications has become increasingly important for adults and children with different motor impairments. OBJECTIVE: The aim of this study was to evaluate the technical feasibility and usability of a new interactive leg-press training robot that was developed to train leg muscle strength and control, suitable for children with neuromuscular impairments. METHODS: An interactive robotic training system was designed and constructed with various control strategies, actuators and force/position sensors to enable the performance of different training modes (passive, active resistance, and exergames). Five paediatric patients, aged between 7 and 16 years (one girl, age 13.0 ± 3.7 years, [mean ± SD]), with different neuromuscular impairments were recruited to participate in this study. Patients evaluated the device based on a user satisfaction questionnaire and Visual Analog Scale (VAS) scores, and therapists evaluated the device with the modified System Usability Scale (SUS). RESULTS: One patient could not perform the training session because of his small knee range of motion. Visual Analog Scale scores were given by the 4 patients who performed the training sessions. All the patients adjudged the training with the interactive device as satisfactory. The average SUS score given by the therapists was 61.2 ± 18.4. CONCLUSION: This study proposed an interactive lower limb training device for children with different neuromuscular impairments. The device is deemed feasible for paediatric rehabilitation applications, both in terms of technical feasibility and usability acceptance. Both patients and therapists provided positive feedback regarding the training with the device.

Technical feasibility of constant-load and high-intensity interval training for cardiopulmonary conditioning using a re-engineered dynamic leg press.

BACKGROUND: Leg-press devices are one of the most widely used training tools for musculoskeletal strengthening of the lower-limbs, and have demonstrated important cardiopulmonary benefits for healthy and patient populations. Further engineering development was done on a dynamic leg-press for work-rate estimation by integrating force and motion sensors, power calculation and a visual feedback system for volitional work-rate control. This study aimed to assess the feasibility of the enhanced dynamic leg press for cardiopulmonary exercise training in constant-load training and high-intensity interval training. Five healthy participants aged 31.0±3.9 years (mean ± standard deviation) performed two cardiopulmonary training sessions: constant-load training and high-intensity interval training. Participants carried out the training sessions at a work rate that corresponds to their first ventilatory threshold for constant-load training, and their second ventilatory threshold for high-intensity interval training. RESULTS: All participants tolerated both training protocols, and could complete the training sessions with no complications. Substantial cardiopulmonary responses were observed. The difference between mean oxygen uptake and target oxygen uptake was 0.07±0.34 L/min (103 ±17%) during constant-load training, and 0.35±0.66 L/min (113 ±27%) during high-intensity interval training. The difference between mean heart rate and target heart rate was -7±19 bpm (94 ±15%) during constant-load training, and 4.2±16 bpm (103 ±12%) during high-intensity interval training. CONCLUSIONS: The enhanced dynamic leg press was found to be feasible for cardiopulmonary exercise training, and for exercise prescription for different training programmes based on the ventilatory thresholds.

Investigation of cardiopulmonary exercise testing using a dynamic leg press and comparison with a cycle ergometer.

BACKGROUND: Leg-press machines are widely employed for musculoskeletal conditioning of the lower-limbs and they provide cardiovascular benefits for resistance training in cardiac patients. The aim of this study was to assess the feasibility of a dynamic leg press (DLP) for incremental cardiopulmonary exercise testing (CPET) and to compare the results with those obtained using a cycle ergometer (CE). METHODS: Twelve healthy participants aged 27±4 years (mean ± standard deviation) performed incremental cardiopulmonary exercise tests on a DLP and on a CE. To facilitate CPET, the DLP was augmented with force and angle sensors, a work rate estimation algorithm, and a visual feedback system. Gas exchange variables and heart rate were recorded breath-by-breath using a cardiopulmonary monitoring system. RESULTS: Peak oxygen uptake and peak heart rate were significantly lower for the DLP than for the CE: peak oxygen uptake was 3.2±0.5 vs. 4.1±0.5 L/min (DLP vs. CE, p=6.7×10-6); peak heart rate was 174±14 vs. 182±13 bpm (DLP vs. CE, p=0.0016). Likewise, the sub-maximal cardiopulmonary parameters, viz. the first and second ventilatory thresholds, and ramp duration were significantly lower for the DLP. CONCLUSIONS: The dynamic leg press was found to be feasible for CPET: the approach was technically implementable and all peak and sub-maximal cardiopulmonary parameters were able to be identified. The lower outcome values observed with the DLP can be attributed to a peripheral factor, namely the earlier onset of muscular fatigue.