Effect of Robotic-assisted Gait Training in Patients with Incomplete Spinal Cord Injury

Overview

Journal Ann Rehabil Med

Specialty Rehabilitation Medicine

Date 2015 Jan 8

PMID 25566469

Citations 37

Authors

Ji Cheol Shin

Ji Yong Kim

Han Kyul Park

Na Young Kim

Affiliations

Soon will be listed here.

Abstract

Objective: To determine the effect of robotic-assisted gait training (RAGT) compared to conventional overground training.

Methods: Sixty patients with motor incomplete spinal cord injury (SCI) were included in a prospective, randomized clinical trial by comparing RAGT to conventional overground training. The RAGT group received RAGT three sessions per week at duration of 40 minutes with regular physiotherapy in 4 weeks. The conventional group underwent regular physiotherapy twice a day, 5 times a week. Main outcomes were lower extremity motor score of American Spinal Injury Association impairment scale (LEMS), ambulatory motor index (AMI), Spinal Cord Independence Measure III mobility section (SCIM3-M), and walking index for spinal cord injury version II (WISCI-II) scale.

Results: At the end of rehabilitation, both groups showed significant improvement in LEMS, AMI, SCIM3-M, and WISCI-II. Based on WISCI-II, statistically significant improvement was observed in the RAGT group. For the remaining variables, no difference was found.

Conclusion: RAGT combined with conventional physiotherapy could yield more improvement in ambulatory function than conventional therapy alone. RAGT should be considered as one additional tool to provide neuromuscular reeducation in patient with incomplete SCI.

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References

Labruyere R, van Hedel H . Strength training versus robot-assisted gait training after incomplete spinal cord injury: a randomized pilot study in patients depending on walking assistance. J Neuroeng Rehabil. 2014; 11:4. PMC: 3905290. DOI: 10.1186/1743-0003-11-4. View

Swinnen E, Duerinck S, Baeyens J, Meeusen R, Kerckhofs E . Effectiveness of robot-assisted gait training in persons with spinal cord injury: a systematic review. J Rehabil Med. 2010; 42(6):520-6. DOI: 10.2340/16501977-0538. View

Alcobendas-Maestro M, Esclarin-Ruz A, Casado-Lopez R, Munoz-Gonzalez A, Perez-Mateos G, Gonzalez-Valdizan E . Lokomat robotic-assisted versus overground training within 3 to 6 months of incomplete spinal cord lesion: randomized controlled trial. Neurorehabil Neural Repair. 2012; 26(9):1058-63. DOI: 10.1177/1545968312448232. View

Varoqui D, Niu X, Mirbagheri M . Ankle voluntary movement enhancement following robotic-assisted locomotor training in spinal cord injury. J Neuroeng Rehabil. 2014; 11:46. PMC: 3974744. DOI: 10.1186/1743-0003-11-46. View

Fritz S, Merlo-Rains A, Rivers E, Peters D, Goodman A, Watson E . An intensive intervention for improving gait, balance, and mobility in individuals with chronic incomplete spinal cord injury: a pilot study of activity tolerance and benefits. Arch Phys Med Rehabil. 2011; 92(11):1776-84. DOI: 10.1016/j.apmr.2011.05.006. View

Martin Ginis K, Latimer A . The effects of single bouts of body-weight supported treadmill training on the feeling states of people with spinal cord injury. Spinal Cord. 2006; 45(1):112-5. DOI: 10.1038/sj.sc.3101911. View

Schwartz I, Sajina A, Neeb M, Fisher I, Katz-Luerer M, Meiner Z . Locomotor training using a robotic device in patients with subacute spinal cord injury. Spinal Cord. 2011; 49(10):1062-7. DOI: 10.1038/sc.2011.59. View

Benito-Penalva J, Edwards D, Opisso E, Cortes M, Lopez-Blazquez R, Murillo N . Gait training in human spinal cord injury using electromechanical systems: effect of device type and patient characteristics. Arch Phys Med Rehabil. 2012; 93(3):404-12. DOI: 10.1016/j.apmr.2011.08.028. View

Knikou M, Mummidisetty C . Locomotor training improves premotoneuronal control after chronic spinal cord injury. J Neurophysiol. 2014; 111(11):2264-75. DOI: 10.1152/jn.00871.2013. View

10.

Mehrholz J, Kugler J, Pohl M . Locomotor training for walking after spinal cord injury. Cochrane Database Syst Rev. 2012; 11:CD006676. PMC: 11848707. DOI: 10.1002/14651858.CD006676.pub3. View

11.

Mirbagheri M, Kindig M, Niu X, Varoqui D, Conaway P . Robotic-locomotor training as a tool to reduce neuromuscular abnormality in spinal cord injury: the application of system identification and advanced longitudinal modeling. IEEE Int Conf Rehabil Robot. 2013; 2013:6650497. DOI: 10.1109/ICORR.2013.6650497. View

12.

Shin J, Kim D, Yu S, Yang H, Yoon S . Epidemiologic change of patients with spinal cord injury. Ann Rehabil Med. 2013; 37(1):50-6. PMC: 3604234. DOI: 10.5535/arm.2013.37.1.50. View

13.

AuYong N, Lu D . Neuromodulation of the lumbar spinal locomotor circuit. Neurosurg Clin N Am. 2013; 25(1):15-23. DOI: 10.1016/j.nec.2013.08.007. View

14.

Hicks A, Adams M, Martin Ginis K, Giangregorio L, Latimer A, Phillips S . Long-term body-weight-supported treadmill training and subsequent follow-up in persons with chronic SCI: effects on functional walking ability and measures of subjective well-being. Spinal Cord. 2005; 43(5):291-8. DOI: 10.1038/sj.sc.3101710. View

15.

Lennon S, Baxter D, Ashburn A . Physiotherapy based on the Bobath concept in stroke rehabilitation: a survey within the UK. Disabil Rehabil. 2001; 23(6):254-62. DOI: 10.1080/096382801750110892. View

16.

van Middendorp J, Hosman A, Pouw M, van de Meent H . ASIA impairment scale conversion in traumatic SCI: is it related with the ability to walk? A descriptive comparison with functional ambulation outcome measures in 273 patients. Spinal Cord. 2008; 47(7):555-60. DOI: 10.1038/sc.2008.162. View

17.

Morawietz C, Moffat F . Effects of locomotor training after incomplete spinal cord injury: a systematic review. Arch Phys Med Rehabil. 2013; 94(11):2297-308. DOI: 10.1016/j.apmr.2013.06.023. View

18.

Lam T, Pauhl K, Krassioukov A, Eng J . Using robot-applied resistance to augment body-weight-supported treadmill training in an individual with incomplete spinal cord injury. Phys Ther. 2010; 91(1):143-51. DOI: 10.2522/ptj.20100026. View

19.

Mirbagheri M, Niu X, Kindig M, Varoqui D . The effects of locomotor training with a robotic-gait orthosis (Lokomat) on neuromuscular properties in persons with chronic SCI. Annu Int Conf IEEE Eng Med Biol Soc. 2013; 2012:3854-7. DOI: 10.1109/EMBC.2012.6346808. View

20.

Dobkin B, Apple D, Barbeau H, Basso M, Behrman A, Deforge D . Weight-supported treadmill vs over-ground training for walking after acute incomplete SCI. Neurology. 2006; 66(4):484-93. PMC: 4102098. DOI: 10.1212/01.wnl.0000202600.72018.39. View