Effects of bodyweight support and guidance force on muscle activation during Locomat walking in people with stroke: a cross-sectional study.
Jianhua Lin, Guojiong Hu, Jun Ran and 3 others
PMID 31931825WHAT IT FOUND
At 1.2 m/s, a normal speed for these participants, Locomat walking did not markedly reduce affected-leg muscle activity versus treadmill walking.
Only the inner thigh muscle showed lower activation with high support and guidance. Lowering support and guidance raised activity in some muscles.
Key findings
01At 1.2 m/s, mean muscle activity was often lower during Locomat walking than treadmill walking, except gluteus medius, biceps femoris and the 30% support and 40% guidance condition; only vastus medialis oblique under 50% support and 70% guidance was significantly lower.
02Reducing bodyweight support and guidance force tended to increase mean muscle activity, with significant increases in gluteus medius and tibialis anterior when support fell from 50 to 30% and guidance fell from 70 to 40%.
03When guidance force was 40%, lowering bodyweight support from 50 to 30% increased vastus medialis oblique activity significantly; when support was 30%, lowering guidance force increased rectus femoris activity significantly.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 14 participants were studied, and only one was female. Participants were at different times since stroke, from 1.5 to 31.4 months, so the findings do not apply equally to acute and chronic stroke. Everyone could walk independently at 1.2 m/s without assistance, so the results may not apply to people with lower walking capacity. The walking speed was 1.2 m/s, which the authors note is relatively high for stroke, so effects at lower speeds are unknown. The study measured immediate muscle activity during walking, not long-term training effects or walking outcomes. Timing within the gait cycle was shown visually but not analysed statistically, so phase-specific effects of support and guidance are unclear. Although tests showed changes for all muscles, only a few comparisons were significant, so some apparent differences may be unstable.
The easy way to misread this
Do not treat these muscle-activity changes as proof that Locomat training improves walking or recovery. The study measured immediate muscle activity in 14 people who could already walk independently at 1.2 m/s, and only one muscle showed a significant difference compared with treadmill walking.