Influence of Treadmill Design on Gait: Does Treadmill Size Affect Muscle Activation Amplitude? A Musculoskeletal Calculation With Individualized Input Parameters of Gait Analysis.

With increasing age, gait changes often occur, leading to mobility problems and thus a higher risk of falling. Interest in training at home or at retirement homes has led to the development of "mobile treadmills." A difference in treadmill surface length may influence walking parameters (i.e., step length) and therefore may affect muscle activation. This led to the question: Does the treadmill size affect the muscle activation, i.e., with the length of the walking surface. The study aimed to investigate the influence of treadmill size, i.e., length of the walking surface, on gait pattern and to determine differences in the amplitude of muscle activation using a participant-specific musculoskeletal model (AnyBody Technology A/S, Aalborg, Denmark). For a prospective, randomized study gait parameters were collected from 47 healthy participants (aged 50.19 ± 20.58 years) while walking on two different treadmills, a small mobile treadmill (walking surface length 100 cm) and a conventional treadmill (walking surface length 150 cm), at their preferred speed, 2 km/h, and 4 km/h. Muscle activation amplitude patterns were similar between treadmills (M. gastrocnemius medialis: rmean = 0.94, M. gastrocnemius lateralis: rmean = 0.92, M. gluteus medius rmean = 0.90, M. gluteus minimus rmean = 0.94). However, the gait analysis showed a decreased preferred velocity (p < 0.001, z = 4.54), reduced stride length (preferred velocity: p = 0.03, z = -2.17; 2 km/h: p = 0.36, z = 2.10; 4 km/h: p = 0.006, z = 2.76), shorter stride time (2 km/h: p < 0.001, z = 4.65; 4 km/h: p < 0.001, z = 4.15), and higher cadence (2 km/h: p < 0.001, z = -4.20; 4 km/h: p = 0.029, z = -2.18) on the mobile treadmill than on the conventional treadmill. Our observations suggest that the treadmill design (e.g., a 50 cm difference in walking surface length) may not influence muscle activity amplitude during walking. However, the design of the treadmill may influence gait characteristics (e.g., stride length, cadence) of walking.

Differences between chronic low back pain patients in Germany and Thailand in terms of nature of disease and socioeconomic and psychological factors.

BACKGROUND: Worldwide, chronic low back pain (CLBP) is one of the most common causes of physical and psychological disabilities. The factors that affect low back pain (LBP) between Western and Eastern countries are different. OBJECTIVE: We assessed the factors associated with LBP and their impact in German and Thai CLBP participants. METHODS: This cross-sectional study was conducted in 100 Thai and 100 German CLBP participants. Data were collected before the participants received treatment in the outpatient rehabilitation clinic. We used standardized questionnaires to assess the demographic and socioeconomic data, clinical features of the pain, the impact of pain during daily activities, and psychological consequences. RESULTS: We found a statistically significant difference between the two groups for minimal pain intensity (NRS German = 3.01, Thai = 1.83), and the participants' acceptable pain intensity (NRS German = 1.97, Thai = 3.88). The German participants had a higher negative impact score in their daily living compared to the Thai participants (German = 23.5, Thai = 10). Also, the German participants suffered more often from depression (CES-D score; German = 17, Thai = 4). However, the average back pain intensity was the same for both groups. CONCLUSION: German CLBP participants had significantly more depressive symptoms and pain-related impairments compared to the Thai participants. On the other hand, there were no differences in maximum and average pain severities.

The effects of whole-body electromyostimulation (WB-EMS) in comparison to a multimodal treatment concept in patients with non-specific chronic back pain-A prospective clinical intervention study.

BACKGROUND: According to present guidelines, active exercise is one key component in the comprehensive treatment of nonspecific chronic back pain (NSCBP). Whole body electromyostimulation (WB-EMS) is a safe, and time-effective training method, that may be effective in NSCBP-patients. METHODS: In this prospective and controlled nonrandomized clinical study, two therapeutic approaches were compared. One group received 20 minutes WB-EMS per week. An active control group (ACG) received a multimodal therapy program. A third group included subjects without back pain. To all groups, the following measurement instruments were applied: Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), North American Spine Society Instrument (NASS); SF 36 survey and measurements for muscular function and postural stability. In the EMS-group: T0: baseline; T1: at 6 weeks; T2: at 12 weeks and T3: at 24 weeks. In the ACG: T0 baseline and T1 after 4 weeks. RESULTS: In the intervention group, 128 patients with low back pain were enrolled, 85 in the WB-EMS group and 43 in the ACG. 34 subjects were allocated to the passive control group. The average age was 58.6 years (18-86 years). In the EMS group, the NRS (1-10) improved statistically and clinically significantly by 2 points. The ODI was reduced by 19.7 points. The NASS and most of the SF 36 items improved significantly. In the multimodal treatment group, only the muscular function improved slightly. CONCLUSION: Our data support the hypothesis that WB-EMS is at least as effective as a multimodal treatment, which is often referred to as being the golden standard. Therefore WB-EMS may be an effective and, with 20 min./week training time, very time-efficient alternative to established multimodal treatment models.