Sydney Mcdonald, Tarleton State University

High-repetition Training for Improved FUNCTIONAL mobility in Neuromuscular Impairments

Abstract: Conventional therapy programs provide training protocols for rehabilitation following injury or disease. They are typically limited by reimbursement policies to several weeks of more or less closely supervised physical activities. While these programs are effective for sprains, strains, and various joint problems, the practice is wholly inadequate for the continued care of stroke survivors, spinal injuries, and diseases like cerebral palsy and spina bifida. PURPOSE: Therefore, the purpose of this investigation was to determine if access to high-repetition supervised training in Team Kinesiology® on a university campus would demonstrate gait improvement in a group of elderly volunteers. METHODS: Eighteen subjects (n=18, age= 70.5±10.7 yrs; ht =1.73±0.08 m ; wt=83.5±26.8 kg; BMI = 27.5±7.8 kg.m-2) volunteered and signed Informed Consents to participate in the training. Criterion measures from a 6-minute walk test were obtained from the Biodex Gait Trainer 3 (Biodex Medical Systems, Inc., Shirley, NY) prior to and following 10 weeks of training. The NuStep T5XR (NuStep, LLC, Ann Arbor, MI) provided reciprocal training of arms and legs and recorded training indices. Eight age-matched subjects participated in pretest and posttest gait tests and served as a control group not participating in high-repetition training. RESULTS:  There were no significant differences in any of the outcome measures between groups on any of the pre-experimental measurements.  An independent t-test revealed no significant differences between the control vs. experimental group in step length on either the left or right side (36.7±14.9 vs. 39.6±21.9; p=0.77; 37.0±14.9 vs 42.5±20.8; p=0.59, respectively).  Additionally, there were no significant differences in steps taken post-test nor in the distance covered (516.5±77.5 vs. 527.5±118.8 steps; p=0.83; 190.6±96 vs. 225.4±146.0 m; p=0.60, respectively).  While traditional null-hypothesis tests revealed no significant difference between groups, non-traditional but clinically relevant measures did indicate that the experimental group demonstrated a change different enough from control groups to be considered above the threshold for the smallest real difference (SRD).  The smallest real difference was determined utilizing previously published reliability data (Falnsbjer et al., 2005) and calculated with by the established formula of SRD = 1.96 x SEM x √2 which resulted in an SRD of 25 steps.  The difference between the two groups was 34 steps, which fell above the threshold of the SRD. CONCLUSION: Results from the current study suggest that exercise training does produce positive outcomes for both groups, which is novel in-and-of-itself as this population is typically not engaged in physical training.  More novel, though, is that the high-repetition training utilized within the experimental group demonstrated changes that were above the SRD threshold in gait improvements over the control group.  Further research is warranted at this time to further investigate the utility of exercise regimens aimed at improving functional mobility in this population.

Presentation Author(s):
Sydney Mcdonald*

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