Using a simple rope-pulley system that mechanically couples the arms, legs, and treadmill reduces the metabolic cost of walking.
Arms
Assistive device
Coordination
Energetics
Gait rehabilitation
Legs
Locomotion biomechanics
Walking
Journal
Journal of neuroengineering and rehabilitation
ISSN: 1743-0003
Titre abrégé: J Neuroeng Rehabil
Pays: England
ID NLM: 101232233
Informations de publication
Date de publication:
07 06 2021
07 06 2021
Historique:
received:
14
10
2020
accepted:
25
05
2021
entrez:
8
6
2021
pubmed:
9
6
2021
medline:
26
11
2021
Statut:
epublish
Résumé
Emphasizing the active use of the arms and coordinating them with the stepping motion of the legs may promote walking recovery in patients with impaired lower limb function. Yet, most approaches use seated devices to allow coupled arm and leg movements. To provide an option during treadmill walking, we designed a rope-pulley system that physically links the arms and legs. This arm-leg pulley system was grounded to the floor and made of commercially available slotted square tubing, solid strut channels, and low-friction pulleys that allowed us to use a rope to connect the subject's wrist to the ipsilateral foot. This set-up was based on our idea that during walking the arm could generate an assistive force during arm swing retraction and, therefore, aid in leg swing. To test this idea, we compared the mechanical, muscular, and metabolic effects between normal walking and walking with the arm-leg pulley system. We measured rope and ground reaction forces, electromyographic signals of key arm and leg muscles, and rates of metabolic energy consumption while healthy, young subjects walked at 1.25 m/s on a dual-belt instrumented treadmill (n = 8). With our arm-leg pulley system, we found that an assistive force could be generated, reaching peak values of 7% body weight on average. Contrary to our expectation, the force mainly coincided with the propulsive phase of walking and not leg swing. Our findings suggest that subjects actively used their arms to harness the energy from the moving treadmill belt, which helped to propel the whole body via the arm-leg rope linkage. This effectively decreased the muscular and mechanical demands placed on the legs, reducing the propulsive impulse by 43% (p < 0.001), which led to a 17% net reduction in the metabolic power required for walking (p = 0.001). These findings provide the biomechanical and energetic basis for how we might reimagine the use of the arms in gait rehabilitation, opening the opportunity to explore if such a method could help patients regain their walking ability. Study registered on 09/29/2018 in ClinicalTrials.gov (ID-NCT03689647).
Sections du résumé
BACKGROUND
Emphasizing the active use of the arms and coordinating them with the stepping motion of the legs may promote walking recovery in patients with impaired lower limb function. Yet, most approaches use seated devices to allow coupled arm and leg movements. To provide an option during treadmill walking, we designed a rope-pulley system that physically links the arms and legs. This arm-leg pulley system was grounded to the floor and made of commercially available slotted square tubing, solid strut channels, and low-friction pulleys that allowed us to use a rope to connect the subject's wrist to the ipsilateral foot. This set-up was based on our idea that during walking the arm could generate an assistive force during arm swing retraction and, therefore, aid in leg swing.
METHODS
To test this idea, we compared the mechanical, muscular, and metabolic effects between normal walking and walking with the arm-leg pulley system. We measured rope and ground reaction forces, electromyographic signals of key arm and leg muscles, and rates of metabolic energy consumption while healthy, young subjects walked at 1.25 m/s on a dual-belt instrumented treadmill (n = 8).
RESULTS
With our arm-leg pulley system, we found that an assistive force could be generated, reaching peak values of 7% body weight on average. Contrary to our expectation, the force mainly coincided with the propulsive phase of walking and not leg swing. Our findings suggest that subjects actively used their arms to harness the energy from the moving treadmill belt, which helped to propel the whole body via the arm-leg rope linkage. This effectively decreased the muscular and mechanical demands placed on the legs, reducing the propulsive impulse by 43% (p < 0.001), which led to a 17% net reduction in the metabolic power required for walking (p = 0.001).
CONCLUSIONS
These findings provide the biomechanical and energetic basis for how we might reimagine the use of the arms in gait rehabilitation, opening the opportunity to explore if such a method could help patients regain their walking ability.
TRIAL REGISTRATION
Study registered on 09/29/2018 in ClinicalTrials.gov (ID-NCT03689647).
Identifiants
pubmed: 34098979
doi: 10.1186/s12984-021-00887-3
pii: 10.1186/s12984-021-00887-3
pmc: PMC8186224
doi:
Banques de données
ClinicalTrials.gov
['NCT03689647']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
96Références
J Neurophysiol. 2018 Mar 1;119(3):1095-1112
pubmed: 29212917
Exp Brain Res. 2007 Apr;178(4):427-38
pubmed: 17072607
J Appl Physiol (1985). 2013 Jul 1;115(1):34-42
pubmed: 23661622
Am J Physiol. 1999 Feb;276(2):R611-5
pubmed: 9950944
Gait Posture. 1999 Jul;9(3):207-31
pubmed: 10575082
Arch Phys Med Rehabil. 1984 Sep;65(9):517-21
pubmed: 6477083
Acta Physiol Scand. 1965 Mar;63:296-310
pubmed: 14329151
Proc Biol Sci. 2009 Oct 22;276(1673):3679-88
pubmed: 19640879
IEEE Trans Neural Syst Rehabil Eng. 2020 Jun;28(6):1353-1362
pubmed: 32340953
J Neurol Rehabil. 1995;9(4):183-90
pubmed: 11539274
J Appl Physiol (1985). 2003 May;94(5):1766-72
pubmed: 12506042
J Neurophysiol. 2008 Jun;99(6):2946-55
pubmed: 18450579
Eur J Neurosci. 2001 Dec;14(11):1906-14
pubmed: 11860485
Phys Ther. 2000 Jul;80(7):688-700
pubmed: 10869131
J Exp Biol. 2005 Feb;208(Pt 3):439-45
pubmed: 15671332
Hum Nutr Clin Nutr. 1987 Nov;41(6):463-71
pubmed: 3429265
J Electromyogr Kinesiol. 2012 Apr;22(2):199-206
pubmed: 21945656
J Neurophysiol. 2018 Jun 1;119(6):2194-2211
pubmed: 29364074
J Appl Physiol (1985). 2004 Oct;97(4):1299-308
pubmed: 15180979
Gait Posture. 2014 Jun;40(2):321-6
pubmed: 24865637
J Physiol. 2007 Jul 1;582(Pt 1):209-27
pubmed: 17463036
J Gerontol A Biol Sci Med Sci. 2003 May;58(5):M419-24
pubmed: 12730250
J Appl Physiol (1985). 2005 Jul;99(1):23-30
pubmed: 16036902
Physiol Rep. 2015 Mar;3(3):
pubmed: 25742956
J R Soc Interface. 2010 Sep 6;7(50):1329-40
pubmed: 20356877
J Am Paraplegia Soc. 1991 Oct;14(4):150-7
pubmed: 1683668
Neuroscientist. 2004 Aug;10(4):347-61
pubmed: 15271262
Nature. 2015 Jun 11;522(7555):212-5
pubmed: 25830889
J Appl Physiol (1985). 1999 May;86(5):1657-62
pubmed: 10233132
Gait Posture. 2013 Jul;38(3):495-9
pubmed: 23465319
Clin Neurophysiol. 2009 Sep;120(9):1741-9
pubmed: 19699677
J Physiol. 2019 Aug;597(15):4053-4068
pubmed: 31192458
Paraplegia. 1994 Aug;32(8):540-53
pubmed: 7970859
Neural Plast. 2016;2016:1517968
pubmed: 27403344
J Exp Biol. 2009 Feb;212(Pt 4):523-34
pubmed: 19181900
J Exp Biol. 2014 Jul 15;217(Pt 14):2456-61
pubmed: 25031455
J Exp Biol. 2019 Jun 4;222(Pt 11):
pubmed: 31064856
J Neurophysiol. 1997 Feb;77(2):797-811
pubmed: 9065851
Exerc Sport Sci Rev. 2006 Jul;34(3):113-20
pubmed: 16829738
J Biomech. 2001 Nov;34(11):1387-98
pubmed: 11672713