Functional resistance training during walking: do biomechanical and neural effects differ based on targeted joints?

IEEE Trans Med Robot Bionics. 2024 May;6(2):632-642. doi: 10.1109/tmrb.2024.3369894. Epub 2024 Feb 26.

Abstract

Devices for functional resistance training (FRT) during walking are often configured to resist the knee or both the hip and knee joints. Adding resistance to the hip in addition to the knee should alter the effects of training; however, these configurations have not been directly compared. We examined how FRT during walking differs during the knee or hip and knee conditions. Fourteen non-disabled individuals received FRT during treadmill walking with a device configured to provide a viscous resistance to the knee or the hip and knee during separate visits. Between these configurations, we compared gait kinetics, muscle activation, kinematic aftereffects, peripheral fatigue, and corticospinal excitability. Adding resistance to the hip increased hip flexion moment and concentric power during the swing phase. However, this did not result in significant differences in muscle activation, aftereffects, peripheral fatigue, or corticospinal excitability between the configurations. Instead, both configurations produced similar changes in these variables. These results indicate that, aside from kinetics, walking with resistance at the hip and knee was not different from resisting the knee in the acute setting. However, further research is needed to determine if long-term training with resistance at the hip induces differential effects than resisting the knee alone.

Keywords: electromyography; loading; physical therapy; statistical parametric mapping; task-specific; transcranial magnetic stimulation.