Physiological and Biomechanical Responses to Running on Lower Body Positive Pressure Treadmills in Healthy Populations.

BACKGROUND: Lower body positive pressure treadmills (LBPPTs) aim to reduce musculoskeletal loading during running. As LBPPTs have become more commercially available, they have become integrated into athletic performance and clinical rehabilitation settings. Consequentially, published research examining the biomechanical and physiological responses to unweighted running has increased. OBJECTIVE: The purpose of this systematic review was to synthesize the literature in an attempt to provide researchers and clinicians with a comprehensive review of physiologic and biomechanical responses to LBPPT running. METHODS: Through a generic search of PubMed, CINAHL, MEDLINE, and SPORTDiscus using a comprehensive list of search terms related to LBPPT, unweighting, and body weight support during running, we identified all peer-reviewed publications that included LBPPT running. Two reviewers independently evaluated the quality of studies using a modified Downs and Black checklist for non-randomized studies. RESULTS: A total of 15 articles met the inclusion criteria for this review. Peak and active vertical ground-reaction forces were consistently reduced with unweighting, but regional loading within the foot was also altered towards a forefoot strike. LBPPTs also provide some horizontal assistance. Neuromuscular activation is generally reduced with LBPPTs, but the stabilizer muscle groups may respond differently than the propulsive muscle groups. Submaximal heart rate and volume oxygen consumption are reduced with unweighting, but physiologic response remains generally unchanged at maximal intensities. CONCLUSIONS: The current literature suggests that LBPPTs are effective in allowing individuals to achieve a given metabolic stimulus with reduced musculoskeletal loading. However, LBPPTs not only reduce impact but also change neuromuscular activation and biomechanics in a complex manner. Thus, clinicians must account for the specific biomechanical and physiological alterations induced by LBPPTs when designing training programs and rehabilitation protocols.

Effects of unweighting and speed on in-shoe regional loading during running on a lower body positive pressure treadmill.

The purpose of this study was to determine how unweighted running on a lower body positive pressure treadmill (LBPPT) modifies in-shoe regional loading. Ten experienced runners were fit with pressure distribution measurement insoles and ran at 100%, 120%, and 140% of self-reported easy training pace on a LBPPT at 20%, 40%, 60%, 80%, and 100% body weight percentage settings (BWSet). Speeds and BWSet were in random order. A linear mixed effect model (p<0.05 significance level) was used to compare differences in whole foot and regional maximum in-shoe plantar force (FMAX), impulse, and relative load distribution across speeds and BWSet. There were significant main effects (p<0.001) for running speed and BWSet for whole foot Fmax and impulse. The model revealed 1.4% and 0.24% increases in whole foot FMAX (times body weight) and impulse, respectively, for every unit increase in body weight percentage. There was a significant main effect for BWSet on Fmax and relative load (p<0.05) for each of the nine foot regions examined, though four regions were not different between 80% and 100% BWSet. There was a significant (p<0.001) main effect for BWSet on forefoot to rear foot relative load. Linear relationships were found between increases in BWSet and increases in-shoe Fmax and impulse, resulting from regional changes in foot pressure which represent a shift towards forefoot loading, most evident <80% BWSet. Estimating in-shoe regional loading parameters may be useful during rehabilitation and training to appropriately prescribe specific speed and body weight levels, without exceeding certain critical peak force levels while running.