Offaxis neuromuscular training of knee injuries using an offaxis robotic elliptical trainer

The goal of this study was to use an offaxis robotic elliptical trainer to improve off-axis neuromuscular control in people with knee injuries. Thirteen individuals with knee injuries participated in the study. Among them, 8 individuals participated in 18 sessions of pivoting offaxis intensity-adjustable neuromuscular control training (POINT) (3 sessions/week for 6 weeks including 3 evaluation sessions) to improve offaxis neuromuscular control, specifically dynamic lower limb stability in pivoting. 5 individuals served as controls who only participated in the three evaluations. Following POINT patients in the training group reduced pivoting instability (p=0.024), while the control group did not (p=0.118). Individuals in the training group were able to hop farther in a single leg hop for distance task, take shorter in 12 m hop time for time task, and reported reduced knee pain. The results suggest that subject-specific POINT utilizing the novel robotic elliptical trainer can be implemented as a rehabilitation protocol for patients with knee injuries to improve their lower limb functions and reduce knee symptoms.