Disclosures: Rohit Nalamasu, DO, MS: No financial relationships or conflicts of interest

Objective : Motor-assisted elliptical training is used to address function, fitness, and lower extremity strength deficits following serious injuries and illnesses. However, little is known about the impact of different training conditions on the upper extremity. This research explored the influence of different motor-assisted elliptical conditions on upper extremity muscle demands to help guide the treatment of patients with complex rehabilitation needs.

Design: Prospective repeated measures design.

Setting : Biomechanics laboratory

Participants : 10 impairment-free adults.

Interventions: Participants completed three motor-assisted elliptical conditions in the forward direction [motor Actively Assisting (AA), overriding the motor’s Active Assistance (AA+), and training against Resistance (R)] using reciprocally moving handles integrated with the motor’s assistance.

Main Outcome Measures: 3×1 ANOVAs with repeated measures compared the dominant limb anterior deltoid, posterior deltoid, biceps, triceps, wrist flexors, and wrist extensors peak, mean, and duration of electromyography (EMG, expressed as percentage of manual muscle test EMG, % MMT) across AA, AA+ and R conditions.

Results: Peak EMG varied significantly (p≤0.018) across motor-assisted elliptical conditions for anterior deltoid (R>AA), posterior deltoid (R>AA+,AA), biceps (R,AA+>AA), triceps (R>AA,AA+), wrist flexors (R,AA+>AA), and wrist extensors (R,AA+>AA). Mean EMG varied significantly (p≤0.022) for anterior deltoid (R,AA+>AA), posterior deltoid (R>AA+,AA), triceps (R>AA+), wrist flexors (R>AA+>AA), and wrist extensors (R>AA)]. EMG duration varied significantly (p≤0.015) for posterior deltoid (R>AA+, AA), wrist flexors (R>AA), and wrist extensors (R>AA).

Conclusions: Resisted ICARE training consistently resulted in the greatest muscle activation (peak, mean, duration). In contrast, and importantly, the motor’s assistance could be used to reduce muscle demands. The capacity to customize upper extremity muscle demands to the unique needs of the patient, while simultaneously addressing lower extremity training goals, could be of value when attempting to efficiently and comprehensively address patients’ rehabilitation needs. Future research in selected patient populations (e.g., stroke, breast cancer) is expected to refine treatment guidelines.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/motor-assistance-and-resistance-during-elliptical-training-alter-upper-extremity-muscle-activation-patterns-when-using-reciprocally-moving-handles/