Disclosures: Bryan Baker, DO: No financial relationships or conflicts of interest
Objective : Backward walking has been proposed as a therapeutic tool to improve forward gait, balance, and function following neurologic injury/illness. Motor-assisted elliptical training might provide an alternative approach for practicing a backward gait-like activity. This research explored similarities of lower extremity joint kinematics and muscle demands between backward walking and reverse motor-assisted elliptical training.
Design: Prospective repeated measures design
Setting : Gait analysis laboratory
Participants : 10 adults without known disability
Interventions: Participants walked backward (BW) and completed three motor-assisted elliptical conditions in the reverse direction [Backward Active Assist (BAA), Backward Active Assist Plus (BAA+), Backward Resistive (BR)] at self-selected comfortable speeds.
Main Outcome Measures: Coefficient of multiple correlations (CMCs) compared sagittal plane hip, thigh, knee and ankle kinematics between BW and each motor-assisted elliptical condition. 4x 1 ANOVAs with repeated measures evaluated gluteus maximus (GM), medial hamstring (MH), vastus lateralis (VL), and soleus (SOL) peak and mean electromyography (EMG, expressed as percentage of peak backward gait EMG) across conditions.
Results: Motor-assisted elliptical kinematics were most similar to BW at the hip (CMC’s: BAA=0.93, BAA+=0.92, BR=0.90), thigh (CMC’s: BAA=0.94, BAA+=0.92, R=0.90), and knee (CMC’s: BAA=0.83, BAA+=0.83, BR=0.82), and least at the ankle (CMC’s: BAA=0.76, BAA+=0.77, BR=0.77). Peak EMG demands varied significantly (p≤0.002) across conditions for GM (BW>R,BAA+,BAA), MH (BW,BR>BAA+,BAA), VL (BR>BW,BAA), and SOL (BW>BR>BAA+,BAA;). Mean EMG demands varied significantly (p≤0.024) for GM (BW>BAA), MH (BR,BW>BAA), VL (BR>BAA), and SOL (BR,BW>BAA+,BAA).
Conclusions: While hip, thigh, and knee sagittal plane kinematics during all reverse motor-assisted elliptical conditions demonstrated similarity to backward gait, further work is required to refine reverse motor-assisted elliptical ankle kinematics. The capacity to vary lower extremity muscle demands based on selected level of motor-assistance could provide clinicians with a tool to customize practice of a backward gait-like activity to patients’ unique and evolving strength capabilities during rehabilitation.
Level of Evidence: Level II
To cite this abstract in AMA style:
Baker B, Burnfield JM, Buster T, Cesar GM, Mestelle Z, Mestelle C. Comparison of Lower Extremity Joint Kinematics and Electromyographic Demands During Backward Walking and Reverse Motor-Assisted Elliptical Training [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/comparison-of-lower-extremity-joint-kinematics-and-electromyographic-demands-during-backward-walking-and-reverse-motor-assisted-elliptical-training/. Accessed May 14, 2025.« Back to AAPM&R Annual Assembly 2020
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/comparison-of-lower-extremity-joint-kinematics-and-electromyographic-demands-during-backward-walking-and-reverse-motor-assisted-elliptical-training/