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Official Journal of the American College of Sports Medicine 1533 Board #125 May 30, 2:00 PM - 3:30 PM Effectiveness of Cognitive Movement Training Machine for hemiplegic Patients Kimiyasu Hayakawa1 , Makoto Maruya1 , Takaaki Sekiya1 , Mayumi Takahashi1 , Kazuyuki Koike1 , Hisao Fujii1 , Minoru Hashimoto1 , Kando Kobayashi2 . 1Sendai University, Shibata, Miyagi, Japan. 2The University of Tokyo, Chiba, Japan. (No relationships reported) Functional recovery through rehabilitation is essential for patients with post-stroke hemiplegia. Various training methods based on approaches such as physical therapy and occupational therapy have been conducted for patients at medical and other facilities, and have been effective to some extent. PurPOsE: The objective of the present study was to elucidate the effectiveness of a “cognitive movement training machine” in hemiplegic patients. METhOds: Training using the cognitive movement training machine was conducted for Mr. A, a hemiplegic patient (age, 62 years; height, 172.0 cm; body weight, 70.2 kg; body fat percentage, 21.1%). The cognitive movement training machine is designed as a walking training device, and training using this device consists of both automatic (passive) exercise with electric control and active exercise involving conscious movement. The training aims to increase the stride during walking and to enable the legs to rotate more greatly and smoothly around the trunk. The present training machine was developed at the University of Tokyo (inventor: Kando Kobayashi). The subject engaged in training using this machine for approximately 45 min per week, and 50-m walking ability was measured for 1 year using a three-dimensional analysis device. rEsuLTs: Marked improvements were seen when compared to general medical findings. Specifically, the patient, who initially had difficulty maintaining balance while walking, even with the use of a walking stick, became able to walk without requiring a walking stick. The 50-m walking time improved from 85.6 s during the initial stages of training to 59.1 s (using a stick) after 5 months and 52.4 s after 10 months, while stride increased from 41.5 cm during the initial stage of training to 64.4 cm (using a stick) after 5 months and 58.5 cm after 10 months, indicating marked improvements in quality of motion (QOM). CONCLusION: The present training machine was developed with the objective of improving QOM in walking, an essential activity in daily life. Performance of the innovative balance exercise described above, which involves active and passive exercises, enhanced the effectiveness of rehabilitation for hemiplegic patients. D-30 Free Communication/Poster - Neuromuscular Mechanics May 30, 2013, 1:00 PM - 6:00 PM Room: Hall C 1534 Board #126 May 30, 2:00 PM - 3:30 PM Length and activation dependent Variations In Muscle shear Wave speed Laura Chernak, Ryan DeWall, Ken Lee, Darryl Thelen. University of Wisconsin-Madison, Madison, WI. (No relationships reported) Muscle mechanical properties, such as stiffness, are closely linked with neuromuscular health. Current clinical methods for quantifying these properties, however, have significant limitations including cost. We were interested in evaluating the capability of a novel quantitative ultrasound technique to characterize muscle stiffness. PurPOsE: To investigate the capability of ultrasound shear wave elastography (SWE) to measure load-dependent changes in muscle shear wave speed during both active and passive loading. METhOds: Ten healthy young adults (25 5.5 yrs) were recruited, and shear Vol. 45 No. 5 Supplement S299 wave speeds were evaluated by positioning an ultrasound transducer (Aixplorer Clinical Scanner, Supersonic Imagine, Aix-en-Provence, France) over the medial gastrocnemius. Data were collected from the relaxed muscle at ankle angles throughout the range of motion, and also during voluntary contractions of the plantarflexor muscles at a neutral ankle angle. rEsuLTs: Shear wave speed increased significantly with passive dorsiflexion from 2.62 m/s to 5.61 m/s when the knee was in an extended position, with little effect on shear wave speed noted during dorsiflexion when the gastrocnemius was shortened in a flexed knee posture. Active contractions in the extended knee posture also caused an increase in shear wave speed to 8.28 m/s when maximally contracted. A linear correlation between shear wave speed and normalized load was noted for both the active and passive conditions, with a steeper slope of shear wave speed to normalized load for the data collected during the passive trials. CONCLusION: SWE shows promise as a method for quantitatively measuring in vivo muscle loading, however, our results suggest that loading conditions are relevant to consider when using SWE to characterize in vivo muscle mechanical properties. Supported by NIH AR056201. 1535 Board #127 May 30, 2:00 PM - 3:30 PM Bilateral Tremor responses are Induced With Maximal Effort Contractions Of a single Limb Justin Kavanagh 1 , Andrew Cresswell 2 , Robert Stolz 1 , Surendran Sabapathy 1 , Timothy Carroll 2 . 1 Griffith University, Gold Coast, Australia. 2 University of Queensland, Brisbane, Australia. (Sponsor: A/Prof Belinda Beck, FACSM) (No relationships reported) Although within-limb physiological tremor has been extensively studied, betweenlimb tremor relationships are not well understood. Early investigations proposed that tremor in each limb was driven by parallel CNS oscillators. However, recent evidence suggests that bilateral tremor relationships emerge under perturbed conditions such as maximal effort muscle contractions and neuromuscular fatigue. PurPOsE: To examine bilateral tremor responses to maximal effort intermittent contractions of a single limb. METhOds: Nine healthy subjects (age: 26 ± 5 yr) adopted a seated posture where each humerus was held vertical and the elbows were flexed to 90 degrees. Lightweight accelerometers were attached over the head of radius so that tremor about the elbow joint could be measured. Surface EMG was measured for biceps brachii and brachioradialis. An intermittent protocol was performed which consisted of maximal effort isometric elbow flexions of the preferred limb, with 1 s of rest between contractions. The protocol continued until the maximum torque that the subject could generate about the elbow joint declined by 50%. Subjects were continually encouraged to relax their non-exercising limb during testing. rEsuLTs: In the initial stages of the protocol, maximal effort contractions of a single limb resulted in increased tremor and muscle activity in both the active and non-active limbs. When the unilateral contractions were repeated until elbow joint torque declined by 50%, tremor and brachioradialis EMG were decreased in the fatigued limb but increased in the contralateral non-fatigued limb. CONCLusION: Maximal effort unilateral contractions induced tremor and muscle responses in the non-active contralateral limb. Bilateral responses were most likely mediated by increased cortical drive to the target and non-target motor neuron pool, and changes to the gain of the stretch reflex which plays a major role in tremor generation. 1536 Board #128 May 30, 2:00 PM - 3:30 PM Neuromechanical analysis of Overload Eccentric Contractions of Elbow Flexors Frederico Leal. University of Saskatchewan, Saskatoon, SK, Canada. (No relationships reported) Eccentric (ECC) overload in training settings utilizes loads higher than concentric (CON) one repetition maximum (1RM). There is no clear definition of ECC “failure” or 1RM using conventional weights; ECC 1RM is defined between 145-190% CON 1RM. The highest intensity used for ECC overload is typically 120% despite little research using conventional weights with higher ECC intensities. PurPOsE: To conduct an exploratory neuromechanical analysis of different intensities of elbow flexors ECC overload using free weights by examining angular kinematics during contraction. METhOds: Twenty male participants with weight training experience had unilateral concentration curl isometric (ISO) peak torque (dynamometer) and CON 1RM (dumbbells) assessed with biceps brachii electromyography (EMG) and elbow joint angle (electrogoniometer) recordings. Elbow joint torques were estimated using inverse dynamics. Participants were randomly assigned in counter balanced order to perform ECC actions at 120%, 140%, 150%, 160% and 170% CON 1RM with 4 minutes rest between. Variables included peak torque (PT), angular velocity at PT (AVp), impulse (IM), power (PW), mean EMG, and EMG normalized to peak ISO (EMG%). Data were analyzed using repeated measures ANOVA or a Friedman test. rEsuLTs: AVp was significantly lower for 120% (65.3 ± 40.8°/s) compared to all Abstracts were prepared by the authors and printed as submitted. Thursday, May 30, 2013
Thursday, May 30, 2013 S300 Vol. 45 No. 5 Supplement other conditions (range: 65.3 ± 40.8 to 162.1 ± 75.2°/s; p
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