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Royal Aeronautical Society Conference on Human Space Flight
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The Functional Re-adaptive
Exercise Device
Dr Nick Caplan
Reader in Health and Rehabilitation
Achieving a stable spine
Microgravity effects the spinal muscles
Current post flight rehabilitation
Specific local motor control training
Helping astronauts re-establish their physiological
spinal curves in upright alignment against gravity
Improve motor control of lumbo-pelvic muscles
Pros
Safer than general strength exercise programmes in
deconditioned individuals (Hides et al., 2011)
Sufficient to re-store deep spinal muscle volume
(Hides et al., 2011)
Cons
Little functional relevance
Difficult to teach and master
Supervision + biofeedback required From 2nd Berlin Bed Rest Study, with kind
permission from Gunda Lambrecht
The Functional Re-adaptive Exercise Device
The Evolution of FRED
2009 2011 2013
FRED recruits deep spinal muscles
multifidus muscle
thickness on FRED vs
voluntary contraction or
standing on ground
superior inferior
L4/5
L5/S1L3/4
medial lateral
TrA
IO
EO
A
B
FRED achieves ↑ spinal stability
FRED vs walking
↓ axial trunk rotation on
FRED
FRED promotes tonic activity in superficial
spinal extensors
FRED vs walking
Tonic activity of spinal
extensors
Reduction in spinal
flexor activity
FRED promotes tonic activation in deep
spinal extensors
FRED preferrentially recruits deep spinal
muscles compared to walking
TrA LM
ES OE OI
P < 0.05 P < 0.05 P < 0.05
FRED gait
Mean EMG [% peak activation]
0
20
40
60
Effect of foot movement amplitude
15
16
17
18
19
20
21
22
Crank 2 Crank 3 Crank 4 Crank 5
LM normalised to rest (%)
0
0.5
1
1.5
2
2.5
3
Crank 2 Crank 3 Crank 4 Crank 5
max-min LM thickness (mm)
FRED has potential for in-flight use
Summary
FRED promotes:
Tonic activity of the deep and superficial spinal
extensor muscles and postural muscles
Preferential recruitment of deep spinal muscles
Increased spinal stability
FRED settings can be adjusted to enable
progressive training programme
FRED could even be used in space
Current FRED studies
Spinal kinematics in low back pain
Movement control feedback
Influence of time spent on FRED on
kinematics
Future directions
Intervention in clinical populations (LBP)
Post-bedrest rehabilitation
Acknowledgements
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