Offaxis neuromuscular training of knee injuries using an offaxis robotic elliptical trainer

The goal of this study was to use an offaxis robotic elliptical trainer to improve off-axis neuromuscular control in people with knee injuries. Thirteen individuals with knee injuries participated in the study. Among them, 8 individuals participated in 18 sessions of pivoting offaxis intensity-adjustable neuromuscular control training (POINT) (3 sessions/week for 6 weeks including 3 evaluation sessions) to improve offaxis neuromuscular control, specifically dynamic lower limb stability in pivoting. 5 individuals served as controls who only participated in the three evaluations. Following POINT patients in the training group reduced pivoting instability (p=0.024), while the control group did not (p=0.118). Individuals in the training group were able to hop farther in a single leg hop for distance task, take shorter in 12m hop time for time task, and reported reduced knee pain. The results suggest that subject-specific POINT utilizing the novel robotic elliptical trainer can be implemented as a rehabilitation protocol for patients with knee injuries to improve their lower limb functions and reduce knee symptoms.

[1]  Improvement in off-axis neuromuscular control through pivoting elliptical training: Implication for knee injury prevention , 2010, 2010 Annual International Conference of the IEEE Engineering in Medicine and Biology.

[2]  Li-Qun Zhang,et al.  Six degrees-of-freedom kinematics of ACL deficient knees during locomotion-compensatory mechanism. , 2003, Gait & posture.

[3]  J. G. Garrick Anterior Knee Pain (Chondromalacia Patellae). , 1989, The Physician and sportsmedicine.

[4]  M. Doherty,et al.  Physiotherapy for anterior knee pain: a randomised controlled trial , 2000, Annals of the rheumatic diseases.

[5]  G. Li,et al.  Variability of a three-dimensional finite element model constructed using magnetic resonance images of a knee for joint contact stress analysis. , 2001, Journal of biomechanical engineering.

[6]  R. A. Fellows,et al.  Patellofemoral joint kinematics in individuals with and without patellofemoral pain syndrome. , 2006, The Journal of bone and joint surgery. American volume.

[7]  J. Taunton,et al.  A Survey of Overuse Running Injuries. , 1981, The Physician and sportsmedicine.

[8]  T S Buchanan,et al.  Dynamic knee stability: current theory and implications for clinicians and scientists. , 2001, The Journal of orthopaedic and sports physical therapy.

[9]  T. Hewett,et al.  Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. , 2000, The Journal of the American Academy of Orthopaedic Surgeons.

[10]  C. Powers,et al.  Effect of Bracing on Patellofemoral Joint Stress While Ascending and Descending Stairs , 2004, Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine.

[11]  S P Baker,et al.  Sports and physical training injury hospitalizations in the army. , 2000, American journal of preventive medicine.

[12]  J. Taunton,et al.  A retrospective case-control analysis of 2002 running injuries , 2002, British journal of sports medicine.

[13]  P. Hodges,et al.  Physical therapy alters recruitment of the vasti in patellofemoral pain syndrome. , 2002, Medicine and science in sports and exercise.

[14]  J. Fulkerson,et al.  Diagnosis and Treatment of Patients with Patellofemoral Pain , 2002, The American journal of sports medicine.

[15]  S. Dye The pathophysiology of patellofemoral pain: a tissue homeostasis perspective. , 2005, Clinical orthopaedics and related research.

[16]  Samuel R Ward,et al.  The Effect of Bracing on Patellofemoral Joint Stress during Free and Fast Walking , 2004, The American journal of sports medicine.

[17]  L. Engebretsen,et al.  Neuromuscular Training Versus Strength Training During First 6 Months After Anterior Cruciate Ligament Reconstruction: A Randomized Clinical Trial , 2007, Physical Therapy.

[18]  Jack E. Taunton,et al.  1: 30 p.m.: A Survey Of Overuse Running Injuries , 1981 .

[19]  A M Jackson,et al.  Anterior knee pain. , 2001, The Journal of bone and joint surgery. British volume.