Impact of Underwater Treadmill Training on Lower-Extremity Strength, Balance, and Functional Mobility in Adults with Incomplete - Rehabilitation Institute of Chicago

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Wed, Mar 16

Speaker: Sandra Stevens OT, PhD (Tennessee State University; postdoctoral candidate)

Title: Impact of Underwater Treadmill Training on Lower-Extremity Strength, Balance, and Functional Mobility in Adults with Incomplete Spinal Cord Injury

Abstract: (1) Objective: To document the effects of underwater treadmill training on lower-extremity strength, balance, walking speed, walking endurance, and daily step activity in adults with incomplete spinal cord injury (SCI).

(2) Design: Pre-test, post-test design.

(3) Participants/methods: Lower-extremity strength, balance, preferred and rapid walking speed, 6-minute walk distance, and daily step activity over a 7-day period were assessed in 11 adults with incomplete SCI (7 males, 4 females; age = 48 + 14 years; 5 + 8 years post-injury) before and after eight weeks (3x/week) of underwater treadmill (UT) training. During each session, participants completed three walks at personalized levels of water height and walking speed. Body weight support remained constant for each participant and ranged from 29% to 47% of land body weight. Conversely, alternating weekly incremental increases in speed and duration were imposed in a gradual fashion.

(4) Results: Repeated-measures analysis of variance demonstrated significant (p < 0.05) increases in lower-extremity strength (13.17 + 3.19 N.kg-1 to 20.69 + 5.18 N.kg-1), balance (23.55 + 11.74 to 32.82 + 13.37 Berg Balance Scores), preferred walking speed (0.41 + 0.27 m&#8729;s-1 to 0.55 + 0.28 m&#8729;s-1), rapid walking speed (0.44 + 0.31 m&#8729;s-1 to 0.71 + 0.40 m&#8729;s-1), 6-minute walk distance (97.3 + 80.2 m to 177.0 + 122.3 m), and daily step activity (593 + 782 steps to 1310 + 1258 steps per day) following UT training.

(5) Conclusion: Statistically significant and clinically meaningful improvements in lower-extremity strength, balance, preferred and rapid walking speed, walking endurance, and daily step activity can be observed following a structured program of underwater treadmill training featuring individually-selected levels of body weight support and carefully staged increases in speed and duration. From a clinical perspective, these findings highlight the potential of this specialized form of gait therapy to improve functional mobility in persons with gait disorders.

Host: Arun Jayaraman

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Speaker: Cara Stepp, PhD (University of Washington; faculty candidate)

Title: Sensorimotor Rehabilitation through Human-Machine Interaction

Abstract:  Loss of sensorimotor function due to neurological impairment or injury can impede mobility, communication, and the ability to perform the activities necessary for independent living.  Engineering offers unique tools that can be applied to improve the quality of life of individuals with sensorimotor injury.  This presentation will introduce the use of multimodal sensory feedback and virtual reality to improve sensorimotor rehabilitation outcomes and chronic assistive device experience for individuals with neurological impairment or amputation, and will highlight some current projects:  sensory substitution for users of prosthetic hands, modulation of neural coherence during fine motor control of the hand and vocal mechanism, and future work utilizing videogaming for swallowing rehabilitation.

Bio:  Cara E. Stepp received the S.B. in engineering science from Smith College in 2004, the S.M. in electrical engineering and computer science from the Massachusetts Institute of Technology in 2008, and the Ph.D. in biomedical engineering from the Harvard-MIT Division of Health Sciences & Technology in 2009. She is currently a Postdoctoral Research Associate at the University of Washington in the Departments of Computer Science & Engineering and Rehabilitation Medicine.   Her research uses neural, electrical and mechanical engineering to design advanced therapeutic innovations for sensorimotor disorders.

Host: William Z. Rymer