The Raynaud's Treatment Study: Biofeedback Protocols and Acquisition of Temperature Biofeedback Skills

The Raynaud's Treatment Study (RTS) compared temperature biofeedback training and a behavioral control procedure (frontalis EMG biofeedback) with nifedipine-XL and a medication placebo for treatment of primary Raynaud's phenomenon (RP) in a large (N = 313) multicenter trial. The present study describes the RTS biofeedback protocols and presents data on the acquisition of digital skin temperature and frontalis EMG responses in the RTS. The findings point to substantial problems with acquisition of physiological self-regulation skills in the RTS. Only 34.6% of the Temperature Biofeedback group (N = 81) and 55.4% of the EMG Biofeedback group (N = 74) successfully learned the desired physiological response. In contrast, 67.4% of a Normal Temperature Biofeedback group (N = 46) learned hand warming. Multivariate analysis found that coping strategies, anxiety, gender, and clinic site predicted acquisition of hand-warming skills whereas variables related to RP disease severity did not. Physiological data showed vasoconstriction in response to the onset of biofeedback and also found that performance in the initial sessions was critical for successful acquisition. These findings indicate that attention to the emotional and cognitive aspects of biofeedback training, and a degree of success in the initial biofeedback sessions, are important for acquisition.     

Electromyographic (EMG) Biofeedback in the Comprehensive Treatment of Central Pain and Ataxic Tremor Following Thalamic Stroke

Peripheral pain and ataxic tremor can appear suddenly following thalamic stroke and can significantly alter a patient's psychological, social, and physical functioning. The present paper reports the case of a 70-year-old Caucasian female who sustained an acute left posterior cerebral artery infarction involving the thalamus and left mesiotemporal regions. She subsequently developed Central Poststroke Pain and ataxic movement of her right arm and hand in addition to a significant right-side claudication. She was treated over 16 weeks (6 weeks of EMG biofeedback and 10 weeks of psychotherapy) with a combination of EMG biofeedback, progressive muscle relaxation, behavioral pain coping skills training, Forced Use Therapy, and Cognitive Behavioral Therap 7 years after her initial cerebral accident. The case demonstrates the utility of biofeedback when combined as part of a comprehensive treatment program to address the multiple complications associated with thalamic stroke.     

The Effects of Respiratory Sinus Arrhythmia Biofeedback on Heart Rate Variability and Posttraumatic Stress Disorder Symptoms: A Pilot Study

Recent studies have found a significant association between PTSD and low heart rate variability (HRV), a biomarker of autonomic dysregulation. Research indicates that respiratory sinus arrhythmia (RSA) biofeedback increases HRV while reducing related pathological symptoms. This controlled pilot study compared RSA biofeedback to progressive muscle relaxation (PMR) as adjunctive interventions for 38 persons with PTSD symptoms in a residential treatment facility for a substance use disorder. Both groups were assessed at pre-intervention and 4-week post-intervention. Group × time interactions revealed significantly greater reductions in depressive symptoms and increases in HRV indices for the RSA group. Both groups significantly reduced PTSD and insomnia symptoms and a statistical trend was observed for reduced substance craving for the RSA group. Increases in HRV were significantly associated with PTSD symptom reduction. Overall, these results provide preliminary support for the efficacy of RSA biofeedback in improving physiological and psychological health for individuals with PTSD.     

A Pilot Study on the Effects of Heart Rate Variability Biofeedback in Patients with Depression and in Healthy Subjects

Decreased vagal activity and increased sympathetic arousal have been proposed as major contributors to the increased risk of cardiovascular mortality in patients with depression. It was aim of the present study to assess the feasibility of using heart rate variability (HRV) biofeedback to treat moderate to severe depression. This was an open-label study in which 14 patients with different degrees of depression (13 f, 1 m) aged 30 years (18–47; median; range) and 12 healthy volunteers attended 6 sessions of HRV biofeedback over two weeks. Another 12 healthy subjects were observed under an active control condition. At follow up BDI was found significantly decreased (BDI 6; 2–20; median 25%–75% quartile) as compared to baseline conditions (BDI 22;15–29) in patients with depression. In addition, depressed patients had reduced anxiety, decreased heart rate and increased HRV after conduction of biofeedback (p < 0.05). By contrast, no changes were noted in healthy subjects receiving biofeedback nor in normal controls. In conclusion, HRV biofeedback appears to be a useful adjunct for the treatment of depression, associated with increases in HRV.     

Muscle tension and physiologic hyperarousal,performance, and state affectivity: assessing the independence of effects in frequent headache and depression

Anxiety, depression, and frequent headache are closely associated. The comorbidity may be due to selection bias (such as inherent in treatment seeking), shared environmental or genetic factors, or a common underlying process. In this study, comorbidity is considered an alternative explanation for correlates of frequent headache found in earlier work. This study addressed whether EMG, peripheral temperature, performance measures, and measures of affect were independently attributable to depression or headache proneness, after control of trait anxiety. Headache state was evaluated in parallel analysis. Seventy-two participants, comprising four groups, were tested: depressedt/ptheadache-prone, depressed/headache-resistant, not depressed/headache-prone, and not depressed/headache-resistant. Participants completed a performance task that allowed assessment of ambition and performance accuracy while measures of affect, headache state, EMG, and peripheral temperature were obtained. Headache proneness, independently of depression and trait anxiety, was related to heightened EMG. Depression was related to EMG, ambition, and performance accuracy independently of headache proneness and trait anxiety. Headache state was associated only with negative affect, independently of depression and anxiety. These results suggest that headache states during assessment, as well as comorbid depression and anxiety, are not primarily responsible for the heightened EMG found in headache-prone individuals. Negative affect often reported in the headache prone, however, may be due to concommitant anxiety. Other analyses address a variety of issues surrounding distinctions among these variables raised in previous research.     

Reinforcement in the banded darter Etheostoma zonale: The effect of sex and sympatry on preferences

Reinforcement occurs when selection against hybrid offspring strengthens behavioral isolation between parental species and may be an important factor in speciation. Theoretical models and experimental evidence indicate that both female and male preferences can be strengthened upon secondary contact via reinforcement. However, the question remains whether this process is more likely to affect the preferences of one sex or the other. Males of polygynous species are often predicted to exhibit weaker preferences than females, potentially limiting the ability for reinforcement to shape male preferences. Yet, in darters (Percidae: Etheostoma), male preference for conspecific mates appears to arise before female preferences during the early stages of allopatric speciation, and research suggests that male, but not female, preferences become reinforced upon secondary contact. In the current study, we aimed to determine whether the geographically widespread darter species Etheostoma zonale exhibits a signature of reinforcement, by comparing the strength of preference for conspecific mates between populations that are sympatric and allopatric with respect to a close congener, E. barrenense. We examined the strength of preference for conspecifics for males and females separately to determine whether the preferences of one or both sexes have been strengthened by reinforcement. Our results show that both sexes of E. zonale from sympatric populations exhibit stronger conspecific preferences than E. zonale from allopatric populations, but that female preferences appear to be more strongly reinforced than male preferences. Results therefore suggest that reinforcement of female preferences may promote behavioral isolation upon secondary contact, even in a genus that is characterized by pervasive male mate choice.     

个体化生物反馈训练联合早期排便功能训练对低位直肠癌保肛术后患者肠道功能、肛肠动力学和生活质量的影响

摘要 目的：探讨个体化生物反馈训练联合早期排便功能训练对低位直肠癌保肛术后患者肠道功能、肛肠动力学和生活质量的影响。方法：纳入我院2018年4月~2021年9月期间收治的90例行低位直肠癌保肛术患者。按照住院号奇偶数将患者分为对照组（早期排便功能训练,45例）和研究组（对照组基础上结合个体化生物反馈训练,45例）。对比两组肠道功能、肛肠动力学和生活质量、肛门失禁情况及控便满意度。结果：两组干预后排便受饮食影响、便频便急、排便感觉异常评分均下降,但研究组高于对照组（P<0.05）。两组干预后健康调查量表简表（SF-36）各维度评分均升高,且研究组高于对照组（P<0.05）。研究组的肛门失禁例数少于对照组,控便满意度则高于对照组（P<0.05）。两组干预后肛管静息压、肛管最大收缩压、直肠最大耐受容量均下降,但研究组高于对照组（P<0.05）。结论：个体化生物反馈训练联合早期排便功能训练可促进低位直肠癌保肛术后患者肠道功能恢复,改善肛肠动力学和生活质量,减少肛门失禁情况发生,控便满意度较好。     

Effects of ovine CRF injections into the dorsomedial, dorsolateral and lateral columns of the periaqueductal gray: a functional role for the dorsomedial column

Corticotropin-releasing factor (CRF) and its receptor subtypes have been implicated in the regulation of endocrine, behavioral and autonomic responses to stress, fear and anxiety. Ovine CRF (oCRF) is a nonspecific CRF receptor agonist that produces anxiogenic-like effects when injected locally into the dorsal aspects of the periaqueductal gray (PAG). This structure is subdivided into four distinct longitudinal columns but their exact functional role is not fully understood. The purpose of the present study was to characterize the effects of oCRF (0.25, 0.5 and 1 microg/0.2 microL) injections into the dorsomedial (dmPAG), dorsolateral (dlPAG) and lateral (lPAG) columns of the PAG using an analysis of the exploratory behavior of rats in the elevated plus-maze (EPM) test. The results showed that microinjections of oCRF intra-dmPAG reduced entries and time spent in the open arms and decreased end-arm exploration and head-dipping. In contrast, oCRF intra-dlPAG or lPAG did not affect the exploratory behavior of the animals in the EPM. These findings point to a columnar specificity for the oCRF effects in the PAG, that is, it increased spatial avoidance measures of the EPM test only in the dmPAG. The proaversive effects of oCRF in the dmPAG gain further relevance when combined with previous immunohistochemical studies showing that CRF-containing projections from the periventricular hypothalamic system arch dorsomedially to the PAG, which could function as an important relay station in the midbrain tectum for avoidance behaviors.     

EGF、bFGF和PHGF对大鼠骨骼肌卫星细胞增殖的影响

用MTT、流式细胞技术、溴脱氧核甘尿嘧啶(bromodeoxyuridine,BrdU)掺入法及免疫细胞化学检测增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)的方法探讨了表皮生长因子(epidermal growth factor,EGF)、碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)及促肝细胞生长因子(hepatocyte growth-promoting factor,PHGF)对大鼠骨骼肌卫星细胞增殖的影响。结果表明bFGF、PHGF对骨骼肌卫星细胞有较强的促增殖作用,且两者之间无差别,bFGF最佳作用浓度为5μg／L,PHGF最佳作用浓度为10μg／ml。与其他生长因子相比,PHGF价格低廉易于获取,适宜推广。EGF增殖作用不明显。     

Potential Effects of Ateline Extinction and Forest Fragmentation on Plant Diversity and Composition in the Western Orinoco Basin,Colombia

Cattle and agricultural farming in the western Orinoco Basin began in 1555, and since then fragmentation of continuous forest has occurred. We evaluated the effects of the disturbances and the absence of large primates on plant community composition, diversity, and regeneration patterns. Atelines (Lagothrix and Ateles) inhabited the lowlands close to the Andean mountains, but no longer live in fragmented habitats. Their absence may have negative effects on plant populations because atelines play important roles as seed dispersers in neotropical forests, especially for large-seeded plants, which are rarely swallowed by other seed dispersers. We compared 2 1-ha vegetation plots in forest fragments north of the La Macarena Mountains with 7 plots in continuous forest in Tinigua National Park. Both sites share the same climatic conditions and have similar geological origins. There is floristic affinity between forests with similar ecological characteristics; the fragmented forests are also less diverse than the continuous forests. As predicted, the forest fragments have fewer individuals with large seeds. The results suggest that forest fragmentation and local ateline extinctions affect plant communities, reducing diversity and affecting large-seeded plants.     

The Effects of Resveratrol,Metformin, Cold and Strength Training on the Level of Perilipin 5 in the Heart,Skeletal Muscle and Brown Adipose Tissues in Mouse

The high accumulation of lipid droplets in the cell is related to metabolic disorders, such as obesity. Perilipin 5 (Plin5), plays an important role in triglyceride hydrolysis in the lipid droplets. In this study, this protein has been evaluated in different tissues and conditions in mice. Fifty male mice were divided into 5 groups and treated for 45 days with Resveratrol, Metformin, strength training, and 4?°C cold. Brown adipose tissue (BAT), gastrocnemius skeletal muscle and heart were isolated for RNA extraction. The Plin5 gene expression was evaluated, using Real-Time PCR, and the plin5 was analyzed at the protein level, using western blot. In BAT, Resveratrol significantly reduced the plin5 protein level and gene expression (p?<?0.05). In heart tissue, Resveratrol and strength training, decreased (p?<?0.05) the plin5 expression, but Metformin increased the gene expression (p?<?0.05). In skeletal muscle, resveratrol, strength training, cold and Metformin significantly increased the plin5 expression at the gene and protein level (p?<?0.05). In BAT, Resveratrol has a greater effect in decreasing lipid deposits, compared with the strength training and cold; thus, it can play a better role in preventing lipid accumulation. In heart tissue, Resveratrol probably decreases insulin resistance, due to the increased expression of plin5 in skeletal muscle.     

The Incremental Validity of Lumbar Surface EMG, Behavioral Observation, and a Symptom Checklist in the Assessment of Patients with Chronic Low-Back Pain

This study evaluated the comparative ability of lumbar surface EMG, behavioral observation, and a symptom checklist to correctly classify three groups of participants, (1) 18 patients with chronic low-back pain (CLBP), demonstrating excessive and/or anatomically inconsistent motor, sensory, and tenderness responses during a neurological examination, (2) 33 patients with CLBP exhibiting few or no inconsistent responses, and (3) 30 healthy matched controls. Discriminant analyses were used to develop predictive models. Correct classification rates for the individual assessments and all combinations of assessments were contrasted. Each modality predicted group membership significantly better than weighted chance (23%), with the symptom checklist approach having the highest individual correct classification rate (64%). The best combination of modalities was the symptom checklist and lumbar surface EMG (70% correct classification rate). The sensitivity and specificity of the individual assessments and all combinations of assessments are also presented.     

硒对大鼠心、肝、肌、胰、肺和肾脏细胞线粒体~(45)Ca摄取的影响

用低硒饲料和该饲料补硒分别喂大鼠,对比观察硒对动物心、肝,肌、胰、肺和肾脏线粗体~(45)Ca摄取及心肌线粒体呼吸的影响。结果表明硒非常显著地刺激此六脏器细胞线粒体钙摄取,其中,对心、肝、肌的刺激强大而稳定;对胰、肺,在温育过程中逐渐增强;对肾则稍差。硒还非常显著地刺激心肌线粒体呼吸功能。提示硒对维持整体线粒体钙运转及心肌线粒体呼吸功能具重要作用。     

外加直流电场对血管平滑肌细胞形态及迁移行为的影响

在外加直流电场(electricalfields,EFs)作用下血管平滑肌细胞(VSMCs)膜表面细胞生长因子受体表达发生明显的变化,并影响细胞形态、迁移的特性。通过EFs干预装置干预体外培养的大鼠主动脉VSMCs,记录和分析细胞图像,研究不同强度电场、不同作用时间下VSMCs迁移和细胞形态的变化,并用免疫细胞化学或免疫荧光染色方法检测与VSMCs迁移相关的血小板衍化生长因子受体(PDGFR)、血管紧张素II1型受体(AT1R)和2型受体(AT2R)等受体的表达情况,研究EFs影响VSMCs形态及迁移的机制。研究结果提示,在EFs干预作用下,VSMCs膜PDGFR表达增加,部分细胞呈不对称分布,在EFs阴极面较集中;细胞中AT1R表达亦增加,但无明显不对称分布现象;AT2R表达没有改变;EFs长时间作用下,培养的VSMCs有明显的电场趋化性,细胞向阴极迁移的距离明显高于无EFs作用对照组,细胞膜向阴极方向伸展,发生形状改变,定向迁移依赖于EFs强度。EFs作用下,部分细胞生长因子受体的表达上调和重分布,可能与细胞定向迁移的启动和维持有关。     

盐度对哈氏仿对虾肌肉一般营养成分和氨基酸组成及含量的影响

通过调查不同盐度(12～36)环境下养殖的哈氏仿对虾(Parapenaeopsis hardwickii)肌肉一般营养成分和氨基酸组成及含量,研究了盐度对该虾肌肉营养品质的影响。结果显示,肌肉的水分随环境盐度升高出现显著的直线下降,而粗蛋白含量随环境盐度升高而直线升高;各盐度组的粗脂肪含量虽然没有明显差异,但其含量随盐度升高有一定的线性下降趋势;36盐度组的粗灰分含量比12、16、20和28盐度组的明显高,32盐度组的灰分含量比20和24盐度组的也明显高;所检测的肌肉干样16种氨基酸中,只有3种氨基酸的含量随盐度升高而升高,而其他13种氨基酸的含量随盐度升高明显降低,其中有10种氨基酸的含量在盐度12～24条件下的比盐度28～36条件下的明显高,而这些氨基酸含量在盐度12～24之间没有明显差异。各盐度组间氨基酸总量和鲜味氨基酸含量均没有明显差异;必需氨基酸和半必需氨基酸含量在盐度12～24条件下的均比盐度28～36条件下的明显高,而在12～24盐度组之间以及28～36盐度组之间均没有明显差异。必需氨基酸/氨基酸总量的比值和必需氨基酸/非必需氨基酸比值随盐度升高均明显线性降低;盐度12～24组的必需氨基酸指数(66.13～67.42)高于盐度28～36组的(62.56～64.46)。综上所述,盐度12～24环境下养殖的哈氏仿对虾肌肉营养价值相对较高,表现为低盐趋向,考虑到肌肉的水分含量和生长性能,哈氏仿对虾在养殖期间选择16～24盐度范围比较合适,同时也说明哈氏仿对虾适合大多数沿海地区环境的盐度条件。     

The influence of R:FR ratio on the growth, photosynthesis and rooting ability of Terminalia spinosa Engl. and Triplochiton scleroxylon K. Schum

Stockplants of the tropical hardwoods Terminalia spinosa Engl, and Triplochiton scleroxylon K. Schum were grown in a controlled environment under red:far-red (R:FR) ratios ranging from 0.5-3.1. In both species, rates of shoot height increment were higher (P < 0.05) under the low R:FR ratios as a result of increased internode elongation. In Terminalia spinosa , specific leaf area (SLA) was also significantly higher under lower R:FR ratios, values ranging from 175 to 210 cm² g^-1 in the 3.1 and 0.9 treatments respectively. No effect of R:FR ratio on SLA was recorded in Triplochiton scleroxylon. Pre-severance photo-synthetic rate, stomatal conductance and water-use efficiency were increased under the higher R:FR ratios in Terminalia spinosa , rates of photosynthesis ranging between 2.68-4.59 μmol m^-2 s^-1 in the 0.5 and 3.1 R:FR treatments respectively. Gas exchange rates of Triplochiton scleroxylon were unaffected by R:FR treatment. These contrasting responses to variation in R:FR ratio were associated with differences in rooting ability. In Terminalia spinosa , significantly higher percentage rooting was recorded in the cuttings from the 3.1 R:FR treatment than from 0.5, with values of 93.7% and 77.5% recorded respectively. R:FR ratio also affected rooting percentages of Triplochiton scleroxylon , but in this case, higher rooting percentages were recorded in the lower R:FR ratios, values ranging from 31.1–54.1% in the 3.0 and 0.5 R.FR treatments respectively. This difference in rooting response is attributed to the contrasting effects of R:FR ratio on the leaf and stem morphology of the two species. The implications of these results for stockplant management are discussed.     

Effects of Contaminant Concentration,Aging, and Soil Properties on the Bioaccessibility of Cr(III) and Cr(VI) in Soil

Contaminated soils at numerous U.S. Department of Defense, Department of Energy, and other industrial facilities often contain huge inventories of toxic metals such as chromium. Ingestion of soil by children is often the primary risk factor that drives the need for remediation. Site assessments are typically based solely on total soil-metal concentrations and do not consider the potential for decreased bioaccessibility due to metal sequestration by soil. The objectives of this research are to investigate the effect of soil properties on the bioaccessibility of Cr(III) and Cr(VI) as a function of contaminant concentration and aging. The A and upper B horizons of two well-characterized soils, representative of Cr-contaminated soils in the southeastern United States, were treated with varying concentration of Cr(III) and Cr(VI) and allowed to age. The bioaccessibility of the contaminated soils was measured over a 200-d time period using a physiologically based extraction test (PBET) that was designed to simulate the digestive process of the stomach. The sorption of Cr(III) and Cr(VI) varied significantly as a function of soil type and horizon, and the oxidation state of the contaminant. Solid phase concentrations with Cr(III) were significantly greater than Cr(VI) for any given initial Cr concentration. This is consistent with the mechanisms of Cr(III) vs. Cr(VI) sequestration by the soils, where the formation of Cr(III)-hydroxides can result in the accumulation of large mass fractions of contaminant on mineral surfaces. Overall, Cr bioaccessibility decreased with duration of exposure for all soils and at all solid phase concentrations, with aging effects being more pronounced for Cr(III). The decrease in Cr bioaccessibility was rapid for the first 50 d and then slowed dramatically between 50 and 200 d. In general, the effects of Cr solid phase concentration on bioaccessibility was small, with Cr(III) showing the most pronounced effect; higher solid phase concentrations resulted in a decrease in bioaccessibility. Chemical extraction methods and X-ray Adsorption Spectroscopy analyses suggested that the bioaccessibility of Cr(VI) was significantly influenced by reduction processes catalyzed by soil organic carbon. Soils with sufficient organic carbon had lower Cr bioaccessibility values (～10 to 20%) due to an enhanced reduction of Cr(VI) to Cr(III). In soils where organic carbon was limited and reduction processes were minimal, the bioaccessibility of Cr(VI) dramatically increased (～60 to 70%).     

The role of NCAM in auditory fear conditioning and its modulation by stress: a focus on the amygdala

Chronic stress in rodents was shown to induce structural shrinkage and functional alterations in the hippocampus that were linked to spatial memory impairments. Effects of chronic stress on the amygdala have been linked to a facilitation of fear conditioning. Although the underlying molecular mechanisms are still poorly understood, increasing evidence highlights the neural cell adhesion molecule (NCAM) as an important molecular mediator of stress‐induced structural and functional alterations. In this study, we investigated whether altered NCAM expression levels in the amygdala might be related to stress‐induced enhancement of auditory fear conditioning and anxiety‐like behavior. In adult C57BL/6J wild‐type mice, chronic unpredictable stress resulted in an isoform‐specific increase of NCAM expression (NCAM‐140 and NCAM‐180) in the amygdala, as well as enhanced auditory fear conditioning and anxiety‐like behavior. Strikingly, forebrain‐specific conditional NCAM‐deficient mice (NCAM‐floxed mice that express the cre‐recombinase under the control of the promoter of the α‐subunit of the calcium‐calmodulin‐dependent protein kinase II), whose amygdala NCAM expression levels are reduced, displayed impaired auditory fear conditioning which was not altered following chronic stress exposure. Likewise, chronic stress in these conditional NCAM‐deficient mice did not modify NCAM expression levels in the amygdala or hippocampus, while they showed enhanced anxiety‐like behavior, questioning the involvement of NCAM in this type of behavior. Together, our results strongly support the involvement of NCAM in the amygdala in the consolidation of auditory fear conditioning and highlight increased NCAM expression in the amygdala among the mechanisms whereby stress facilitates fear conditioning processes.     

The Combined Effects of Body Weight Support and Gait Speed on Gait Related Muscle Activity: A Comparison between Walking in the Lokomat Exoskeleton and Regular Treadmill Walking

Background

For the development of specialized training protocols for robot assisted gait training, it is important to understand how the use of exoskeletons alters locomotor task demands, and how the nature and magnitude of these changes depend on training parameters. Therefore, the present study assessed the combined effects of gait speed and body weight support (BWS) on muscle activity, and compared these between treadmill walking and walking in the Lokomat exoskeleton.

Methods

Ten healthy participants walked on a treadmill and in the Lokomat, with varying levels of BWS (0% and 50% of the participants’ body weight) and gait speed (0.8, 1.8, and 2.8 km/h), while temporal step characteristics and muscle activity from Erector Spinae, Gluteus Medius, Vastus Lateralis, Biceps Femoris, Gastrocnemius Medialis, and Tibialis Anterior muscles were recorded.

Results

The temporal structure of the stepping pattern was altered when participants walked in the Lokomat or when BWS was provided (i.e. the relative duration of the double support phase was reduced, and the single support phase prolonged), but these differences normalized as gait speed increased. Alternations in muscle activity were characterized by complex interactions between walking conditions and training parameters: Differences between treadmill walking and walking in the exoskeleton were most prominent at low gait speeds, and speed effects were attenuated when BWS was provided.

Conclusion

Walking in the Lokomat exoskeleton without movement guidance alters the temporal step regulation and the neuromuscular control of walking, although the nature and magnitude of these effects depend on complex interactions with gait speed and BWS. If normative neuromuscular control of gait is targeted during training, it is recommended that very low speeds and high levels of BWS should be avoided when possible.