Introduction: Lumbopelvic adaptations to microgravity include flexed posture (Buckey 2006), spinal lengthening, increased disc height and deconditioning, altered spinal curvatures (Sayson and Hargens 2008) and atrophy of lumbar multifidus (LM) and transversus abdominis (TrA) (Hides et al. 2011). Astronauts have 68% increased incidence of back pain (Sayson and Hargens 2008) and 4.3 times higher risk of herniated disc than controls (Johnston et al. 2010). A Functional Readaptive Exercise Device (FRED) is being developed to rehabilitate these changes. Methods FRED exercise is functional, involving an upright posture and sharing important elements with walking. The absence of external resistance requires (and trains) much greater coordination, balance and motor control of the legs and lumbo-pelvic area, than conventional exercise devices. Initial studies investigated recruitment of LM and TrA on FRED compared to traditional therapy (Debuse et al. 2013), lumbopelvic stability on FRED compared to walking (Gibbon, Debuse and Caplan 2013) and tonic contraction of LM and TrA during FRED exercise (Caplan et al. 2014). Ongoing studies are investigating muscle recruitment and acute effects of exercise on sagittal lumbopelvic posture on FRED compared to walking. Results The device recruits LM more than traditional therapy (p<0.05) and causes worthwhile increases in LM and TrA recruitment compared to rest. It increases anterior pelvic tilt (p<0.05), reduces transverse pelvic rotations (p<0.05) and increases lumbar extension (effect size≥0.2) compared with walking. More tonic LM activity is seen during exercise compared to walking (p<0.05). Discussion: The studies suggest the device is able to recruit the local muscles of the lumbopelvic region in a tonic fashion during functional activity and produce increased pelvic stability while promoting a more balanced sagittal plane lumbopelvic posture linked with increased activity in the local muscles. The data suggest the potential for FRED to provide a progressive and effective post-mission rehabilitation protocol.
|Publication status||Published - 2015|