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Item EFFECTS OF KAATSU TRAINING ON UPPER EXTREMITY SIZE AND STRENGTH(Office of the Vice Chancellor for Research, 2012-04-13) Weatherholt, Alyssa M.; Greer, Stephanie A.; Ruark, Dana L.; Grider, Blake J.; Mock, Marla J.; Beekley, Matthew D.; Mikesky, AlanConventional resistance training involves lifting heavy loads (~70% max-imal strength), which can be poorly tolerated or contraindicated in many clinical populations. KAATSU training is a novel training mode from Japan that combines muscle blood flow restriction with low load lifting (~20% max-imal strength). The purpose of this study was to investigate the effects of a KAATSU training program on upper extremity size and strength. Forty healthy subjects ages 18 to 30 were divided into exercise (EX) or control (CON) groups. Subjects reported to the laboratory three times per week for eight weeks. The EX group performed 3 sets of 15 repetitions of unilateral bicep curls and triceps extensions lifting loads equivalent to 20% of their predetermined maximal strength while wearing a pneumatic cuff to restrict blood flow on one arm (CUFF) and nothing on the other (NCUFF). The CON group did not perform any exercises but wore the cuff on one arm for a time comparable to the EX group. CUFF and NCUFF arms were randomly as-signed. Strength, girth, skin folds and tomography scans were taken pre-, during, and post-eight weeks. In the EX group, bicep curl (17.4% +4.1% and 18.7% +4.9%) and triceps extension (15.8% +3.4% and 10.7% +2.7%) strength increased significantly over the 8-week period for both the CUFF and NCUFF arms, respectively. No significant differences in strength occurred between the CUFF and NCUFF arms within the group. No strength changes were noted in the CON group for the CUFF and NCUFF arms. Arm girth and muscle cross-sectional area (mCSA) increased significantly in the EX subjects compared to the CON subjects, however no significant differ-ences were found when within group comparisons were made between the CUFF and NCUFF arms. This study indicates that KAATSU training can in-crease muscle strength and mCSA.Item Robotic task-specific training of the upper extremity in children with Cerebral Palsy(Office of the Vice Chancellor for Research, 2011-04-08) Cardinal, Ryan E.; Altenburger, Peter A.; Krebs, Hermano I.; Dierks, Tracy A.Background: Cerebral Palsy (CP) affects at least 2 in 1,000 children in the United States. The disorder is non-progressive, yet secondary impairments can worsen over time leading to contracture, decreased strength, increased tone and ultimately, impaired mobility and function. Robotic therapy has been found to have positive outcomes for similar impairments in stroke neuro-recovery, suggesting the need for the application of this technology to CP. Purpose: The purpose of this study was to investigate whether specific upper extremity (UE) robotic training improves UE function in children with CP. Methods: This is an ongoing study currently with 5 children (ages 4-12) with CP that have completed the treatment intervention. Inclusion criteria included a hemiplegic presentation of the UE, a modified Ashworth scale (MAS) score of 2 or less and wrist extension equal to or greater than 0o in the affected arm, and sufficient cognition to attain to a task for 40-60 minutes. Each child participated in 16 total robotic training sessions occurring twice weekly, with each session consisting of 1,040 task-specific reaching movements of the affected arm with real-time impedance control. Pre- and post-testing and a 1-month follow-up were performed for each subject. Clinical outcome measures included active range of motion (AROM), passive range of motion (PROM), manual muscle tests (MMT), and grip strength, in addition to functional tests including the MAS, adaptive Fugl-Meyer scale, and the Pediatric Evaluation of Disability Inventory (PEDI) assessed by parents. Lastly, spatial-temporal control patterns were collected during each session, allowing for a visual assessment of a child’s progress in refining UE movement patterns to 16 positions across all quadrants. Results: For AROM and PROM, 4 of 5 subjects demonstrated an increase in at least 2 joints by 1-month follow-up. The remaining measurements produced no change or change within the standard error for goniometry (+/- 5o), while no decline was noted in any subjects. Pre-test MMT revealed strength measures ranging from 3/5 to 5/5. By 1-month follow-up, 85% of all measurements were 5/5, with the remaining 15% at 4+/5. For grip strength, 3 of 4 subjects (fifth subject unavailable) doubled their strength by 1-month follow-up, with the last demonstrating symmetry with the unaffected limb. Tone, as measured by MAS, did not appear to be a limiting factor as only 1 child displayed any noticeable tone (MAS of 2) across the measured motions. For the Fugl-Meyer, 4 of 5 subjects improved coordination by more than 2 points by 1- month follow-up, while the fifth maintained throughout the study. Parents reported via the PEDI an overall improvement in performing functional tasks for all children during the study, with 4 of 5 subjects improving by 10 or more points. Lastly, spatial-temporal control patterns showed marked improvement for all subjects by 1-month follow-up. Conclusion: Early results indicate that the application of robotic training to children with CP improved several clinical measures of the affected limb. This likely resulted in increased use of the affected limb, leading to improved functional performance.