Muscle demand and kinematic similarities between pediatric-modified motor-assisted elliptical training at fast speed and fast overground walking: Real-world implications for pediatric gait rehabilitation

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The purpose of this research was to compare children's lower extremity muscle activity and kinematics while walking at fast pace and training at fast speeds with and without motor-assistance on a pediatric-modified motor-assisted elliptical. Twenty-one children without disabilities were recruited and fifteen completed all three training conditions at self-selected fast pace. Repeated-measures ANOVAs identified muscle demand (peak, mean, duration) differences across device conditions and fast walking. Root mean square error compared overall kinematic profiles and statistical parametric mapping identified kinematic differences between conditions. Motor-assisted training reduced lower extremity muscle demands compared to training without the motor's assistance (16 of 21 comparisons) and to fast walking (all but one comparison). Training without the motor's assistance required less muscle effort than fast walking (16 of 21 comparisons). Kinematic differences between device conditions and fast walking were greater distally (thigh, knee, ankle) than proximally (trunk, pelvis, hip). In summary, transitioning from training with to without the motor's assistance promoted progressively greater activity across the lower extremity muscles studied, with sagittal plane kinematic changes most apparent at the distal joints. Our findings highlight how motor-assistance can be manipulated to customize physiologic challenges to lower extremity muscles prior to fast overground walking.

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