Overground walking patterns after chronic incomplete spinal cord injury show distinct response patterns to unloading.

BACKGROUND: Body weight support (BWS) is often provided to incomplete spinal cord injury (iSCI) patients during rehabilitation to enable gait training before full weight-bearing is recovered. Emerging robotic devices enable BWS during overground walking, increasing task-specificity of the locomotor training. However, in contrast to a treadmill setting, there is little information on how unloading is integrated into overground locomotion. We investigated the effect of a transparent multi-directional BWS system on overground walking patterns at different levels of unloading in individuals with chronic iSCI (CiSCI) compared to controls. METHODS: Kinematics of 12 CiSCI were analyzed at six different BWS levels from 0 to 50% body weight unloading during overground walking at 2kmh- 1 and compared to speed-matched controls. RESULTS: In controls, temporal parameters, single joint trajectories, and intralimb coordination responded proportionally to the level of unloading, while spatial parameters remained unaffected. In CiSCI, unloading induced similar changes in temporal parameters. CiSCI, however, did not adapt their intralimb coordination or single joint trajectories to the level of unloading. CONCLUSIONS: The findings revealed that continuous, dynamic unloading during overground walking results in subtle and proportional gait adjustments corresponding to changes in body load. CiSCI demonstrated diminished responses in specific domains of gait, indicating that their altered neural processing impeded the adjustment to environmental constraints. CiSCI retain their movement patterns under overground unloading, indicating that this is a viable locomotor therapy tool that may also offer a potential window on the diminished neural control of intralimb coordination.

Effects of a trail running competition on muscular performance and efficiency in well-trained young and master athletes.

To determine the acute effects of a trail running competition and the age-dependent differences between young and master athletes, 23 subjects [10 young (30.5 ± 7 years), 13 master (45.9 ± 5.9 years)] participated in a 55-km trail running competition. The study was conceived as an intervention study compromising pre, post 1, 24, 48 and 72 h measurements. Measurements consisted of blood tests, ergometer cycling and maximal isometric voluntary contractions (MVC). Parameters monitored included MVC, twitch- and M-wave properties, EMG (RMS) of the vastus lateralis, two locomotion efficiency calculations and muscle damage markers in the blood (CK, LDH). Results indicate post-race increases in CK and LDH, decreases in MVC values (-32 vs. -40% in young and master, P < 0.01), decreases in EMG, increases in contraction time and concomitant decreases in peak twitch values, and a decrease in locomotion efficiency (-4.6 vs. -6.3% in young and master, P < 0.05). Masters showed similar fatigue and muscle damage than young but recuperation was slowed in masters. This study shows that trail runs are detrimental to muscle function, and gives indication that training may not halt muscle deterioration through aging, but can help maintain performance level.