Search Results (8)

Background/Objectives: Anterior cruciate ligament (ACL) injuries continue to present significant clinical and rehabilitative challenges. Despite advances in surgical techniques and rehabilitation protocols, persistent reinjury rates and increased pressure for early return to sport require a critical reassessment of current practices. This narrative review provides a comprehensive overview of the evolution, current standards, and future directions of ACL surgery and rehabilitation. Content: The literature search was conducted primarily in PubMed/MEDLINE and Web of Science using ACLRelated keywords, with emphasis on systematic reviews, randomized controlled trials, registry data, and consensus guidelines published within the past two decades. The evolution of ACL treatment is shaped by the transition from open to arthroscopic and anatomic reconstructions, as well as the refinement of fixation and augmentation techniques. In parallel, rehabilitation concepts shifted from rigid, time-based schedules to criteria-driven, individualized approaches. Key aspects include early mobilization, prehabilitation, and the integration of innovative tools such as anti-gravity treadmill and blood flow restriction training. Evidence on bracing suggests no routine benefit, while structured prevention programs have proven effective. Return-to-play strategies now emphasize objective functional criteria and psychological readiness. Conclusions: ACL therapy has evolved toward personalized, function-oriented rehabilitation. Future developments—including markerless motion analysis, AI-supported rehabilitation, and digital health applications promise for further individualization of care and optimization of long-term outcomes. Full article

The study’s objective was to identify the features of internal movement structure that depend on speed and the importance of unloading when jogging on an anti-gravity treadmill. The aim was to investigate whether the internal structure of running changes under unloaded conditions, using an anti-gravity treadmill. Twenty male competitive middle- and long-distance runners with the following characteristics participated in the study: age, 25 ± 5 years; body weight, 67.2 ± 8.9 kg; body height, 177 ± 11 cm; and training experience, 9 ± 5 years. The gastrocnemius (GC), tibialis anterior (T), quadriceps femoris (Q), biceps femoris (B), and gluteus (G) were the five lower limb muscles whose muscle activity was evaluated. Surface electromyography (sEMG) was used to measure muscle activation while jogging and running on the AlterG Anti-Gravity Treadmill. The study method involved capturing the examined muscular activity at four different speeds: 6, 10, 14, and 18 km/h. At each of these speeds, four two-minute measurements were taken with varying body weight relief: 100%, 75%, 50%, and 25% of body weight. Repeated measures multivariate analysis of variance (RM-MANOVA) [F = 3.4663 p = 0.0001] showed that as running speed increases, the muscular activity of each muscle, expressed as a percentage of maximum muscle tension (%MVIC), decreases significantly. Results indicate that running pace affects the dynamics of the reduction in muscle activity in every examined muscle. As one runs faster, the decline in dynamics becomes more intense. At the slowest jogging pace (6 km/h), the variations were almost negligible (±4 percentage points between 25% and 100% body weight relief) as unloading increased. However, the discrepancies reached up to 14 percentage points at the fastest running speed (18 km/h). In every muscle studied, distinctive patterns and significant dynamics at high speeds were observed. The study’s findings suggest that using an anti-gravity treadmill for training can be beneficial, yet it is important to consider the significant relationships between speed and relief, as these variables could impact maintaining a proper movement pattern and running style. This knowledge may be useful when choosing the right training regimens and loads for runners recovering from injuries. Full article

Background and Objectives: This study explored the efficacy of customized anti-gravity treadmill (AGT) training, with adjustments in speed and incline, on rehabilitation outcomes for stroke patients, focusing on knee extensor muscle strength, joint angle, balance ability, and activities of daily living (ADLs). Materials and Methods: In this study, 30 individuals diagnosed with a stroke were divided into three groups. Experimental group 1 (EG1) underwent training without changes to speed and incline, experimental group 2 (EG2) received training with an increased incline, and experimental group 3 (EG3) underwent training with increased speed. Initially, all participants received AGT training under uniform conditions for two weeks. Subsequently, from the third to the sixth week, each group underwent their specified training intervention. Evaluations were conducted before the intervention and six weeks post-intervention using a manual muscle strength tester for knee strength, TETRAX for balance ability, Dartfish software for analyzing knee angle, and the Korean version of the Modified Barthel Index (K-MBI) for assessing activities of daily living. Results: Within-group comparisons revealed that AGT training led to enhancements in muscle strength, balance ability, joint angle, and ADLs across all participant groups. Between-group analyses indicated that EG2, which underwent increased incline training, demonstrated significant improvements in muscle strength and balance ability over EG1. EG3 not only showed significant enhancements in muscle strength, joint angle, and ADLs when compared to EG1 but also surpassed EG2 in terms of knee strength improvement. Conclusions: In conclusion, the application of customized AGT training positively impacts the rehabilitation of stroke patients, underscoring the importance of selecting a treatment method tailored to the specific needs of each patient. Full article

The purpose of this scoping review was to examine the literature on the use of anti-gravity treadmills and its effects on lower-limb motor functions in children and adolescents with locomotor impairments. Method: Four databases (MEDLINE, CINAHL, Embase, Web of Science) were searched for articles from inception to August 2021. Inclusion criteria were: (1) experimental or quasi-experimental studies using anti-gravity training as the primary intervention; (2) studies conducted in pediatric participants; (3) articles reporting outcomes related to lower-limb functions; and (4) studies published in French or English. Results: Fifteen articles were included in the review. Studies included children and adolescents aged 4–18 years with locomotor impairments. Intervention duration ranged from 2 to 12 weeks, with 2–5 sessions per week. Included studies reported that anti-gravity training induces improvements in muscle strength, balance, spatiotemporal gait parameters, and walking endurance in children with locomotor impairments. Conclusion: This review provides relevant information about interventions, outcomes and limits associated with anti-gravity training in pediatrics. Overall, anti-gravity treadmill training could be viewed as a valuable training modality, specifically for children with cerebral palsy. However, a more precise and comprehensive description of anti-gravity training protocols would be useful. Full article

Prior researchers have observed the effect of simulated reduced-gravity exercise. However, the extent to which lower-body positive-pressure treadmill (LBPPT) walking alters kinematic gait characteristics is not well understood. The purpose of the study was to investigate the effect of LBPPT walking on selected gait parameters in simulated reduced-gravity conditions. Twenty-nine college-aged volunteers participated in this cross-sectional study. Participants wore pressure-measuring insoles (Medilogic GmBH, Schönefeld, Germany) and completed three 3.5-min walking trials on the LBPPT (AlterG, Inc., Fremont, CA, USA) at 100% (normal gravity) as well as reduced-gravity conditions of 40% and 20% body weight (BW). The resulting insole data were analyzed to calculate center of pressure (COP) variables: COP path length and width and stance time. The results showed that 100% BW condition was significantly different from both the 40% and 20% BW conditions, p < 0.05. There were no significant differences observed between the 40% and 20% BW conditions for COP path length and width. Conversely, stance time significantly differed between the 40% and 20% BW conditions. The findings of this study may prove beneficial for clinicians as they develop rehabilitation strategies to effectively unload the individual’s body weight to perform safe exercises. Full article

Lower body positive pressure treadmills (LBPPTs) as a strategy to reduce musculoskeletal load are becoming more common as part of sports conditioning, although the requisite physiological parameters are unclear. To elucidate their role, ten well-trained runners (30.2 ± 3.4 years; VO_2max: 60.3 ± 4.2 mL kg⁻¹ min⁻¹) ran at 70% of their individual velocity at VO_2max (vVO_2max) on a LBPPT at 80% body weight support (80% BW_Set) and 90% body weight support (90% BW_Set), at 0%, 2% and 7% incline. Oxygen consumption (VO₂), heart rate (HR) and blood lactate accumulation (LA) were monitored. It was found that an increase in incline led to increased VO₂ values of 6.8 ± 0.8 mL kg⁻¹ min⁻¹ (0% vs. 7%, p < 0.001) and 5.4 ± 0.8 mL kg⁻¹ min⁻¹ (2% vs. 7%, p < 0.001). Between 80% BW_Set and 90% BW_Set, there were VO₂ differences of 3.3 ± 0.2 mL kg⁻¹ min⁻¹ (p < 0.001). HR increased with incline by 12 ± 2 bpm (0% vs. 7%, p < 0.05) and 10 ± 2 bpm (2% vs. 7%, p < 0.05). From 80% BW_Set to 90% BW_Set, HR increases of 6 ± 1 bpm (p < 0.001) were observed. Additionally, LA values showed differences of 0.10 ± 0.02 mmol l⁻¹ between 80% BW_Set and 90% BW_Set. Those results suggest that on a LBPPT, a 2% incline (at 70% vVO_2max) is not yet sufficient to produce significant physiological changes in VO₂, HR and LA—as opposed to running on conventional treadmills, where significant changes are measured. However, a 7% incline increases VO₂ and HR significantly. Bringing together physiological and biomechanical factors from previous studies into this practical context, it appears that a 7% incline (at 80% BW_Set) may be used to keep VO₂ and HR load unchanged as compared to unsupported running, while biomechanical stress is substantially reduced. Full article

This study aimed to identify the effect of anti-gravity treadmill training on isokinetic lower-limb muscle strength and muscle activities in patients surgically treated for a hip fracture. A total of 34 participants were randomly assigned into two groups: anti-gravity treadmill training group (n = 17) and control group (n = 17). The isokinetic muscle strength and endurance of hip flexor and extensor and the activities of the vastus lateralis (VL), vastus medialis (VM), gluteus maximus (GM), and gluteus medialis (Gm) muscles were measured before and after 4 weeks of the interventions. Significant improvements were observed in isokinetic muscle strength and endurance of hip flexors and extensors in both groups (p < 0.05); however, no significant differences were observed between the groups (p > 0.05) except for muscle strength of the hip extensor (d = 0.78, p = 0029). Statistically significant increases in the muscle activity of VL, VM, GM, and Gm were found before and after the intervention (p < 0.05), and significant differences in muscle activities of GM (d = 2.64, p < 0.001) and Gm (d = 2.59, p < 0.001) were observed between the groups. Our results indicate that both groups showed improvement in muscle strength, endurance, and activities after the intervention. Additionally, anti-gravity treadmill training improved significantly more muscle strength at 60°/s of the hip extensor and gluteus muscle activities than conventional therapy, which may be appropriate for patients with hip fracture surgery. Full article

Background: Parkinson’s disease (PD) is a neurodegenerative disorder characterized by motor impairment. Freezing of gait, impaired mobility and falls are common problems in these patients. We aimed to evaluate the effect of a novel therapy for these patients. Methods: We studied patients with moderate to severe freezing of gait who underwent antigravity treadmill training twice a week for 4 consecutive weeks with 50% reduction of body weight. Results: We enrolled 26 consecutive patients with PD, 19 completed the study. There were 10 males; mean age at evaluation was 72.7 ± 10.1 years. Compared to baseline, patients showed improvement in the Freezing of Gait Questionnaire (p = 0.001); and a mean reduction of 7 s in the Timed Up & Go (TUG) test (p = 0.004). Moderate or significant improvement in gait was reported by 84% of patients. Conclusions: Antigravity treadmill training improved freezing of gait and mobility in patients with PD. Full article