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Training with robot-applied resistance in people with motor-incomplete spinal cord injury: Pilot study.

Journal of rehabilitation research and development
January 1, 2015
Tania Lam et al. (6 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

The researchers aimed to determine if a robotic-based gait rehabilitation strategy (Loko-R) could feasibly and effectively improve skilled walking in individuals with motor-incomplete spinal cord injury (m-iSCI).

Results Summary

Loko-R training was feasible and showed better performance in skilled overground walking tasks (SCI-FAP) compared to conventional training, with sustained improvements at follow-up assessments. Participants in Loko-R reported higher perceived exertion but no severe adverse effects.

Population

Individuals with chronic (>1 year) motor-incomplete spinal cord injury (m-iSCI).

Effective Dosage

45-minute sessions, 3 times/week.

Duration

3 months.

Interactions

None mentioned.

Extracted Claims (4)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Lokomat-applied resistance (Loko-R) training
no change
feasibility
people with motor-incomplete spinal cord injury (m-iSCI)
-
could be feasibly applied
#1
Lokomat-applied resistance (Loko-R) training
increase
perceived exertion during training
participants in Loko-R
-
tended to report higher levels
#2
Lokomat-applied resistance (Loko-R) training
increase
Spinal Cord Injury-Functional Ambulation Profile (SCI-FAP)
participants in the Loko-R group
-
performed significantly better
#3
Lokomat-applied resistance (Loko-R) training
increase
skilled overground walking tasks
people with m-iSCI
-
may help improve performance
#4
Abstract

UNLABELLED: People with motor-incomplete spinal cord injury (m-iSCI) can recover basic walking function but still have difficulty performing the skilled walking required for everyday environments. We hypothesized that a robotic-based gait rehabilitation strategy founded on principles of motor learning would be a feasible and potentially effective approach for improving skilled walking in people with m-iSCI. Fifteen individuals with chronic (>1 yr) m-iSCI were randomly allocated to body weight-supported treadmill training (BWSTT) with Lokomat-applied resistance (Loko-R) or conventional Lokomat-assisted BWSTT (Control). Training sessions were 45 min, 3 times/week for 3 mo. Tolerance to training was assessed by ratings of perceived exertion and reports of pain/soreness. Overground skilled walking capacity (Spinal Cord Injury-Functional Ambulation Profile [SCI-FAP]), as well as walking speed and distance were measured at baseline, posttraining, and 1 and 6 mo follow-up. Our results indicate that Loko-R training could be feasibly applied for people with m-iSCI, although participants in Loko-R tended to report higher levels of perceived exertion during training. Participants in the Loko-R group performed significantly better in the SCI-FAP than Control at posttraining and in follow-up assessments. This study provides evidence that Loko-R training is feasible in people with m-iSCI. Furthermore, there is preliminary evidence suggesting that Loko-R may help improve performance in skilled overground walking tasks. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov; NCT00610974. "Enhancing Walking in People With Incomplete Spinal Cord Injury: a Pilot Study"; https://clinicaltrials.gov/ct2/show/NCT00610974.

Medical Subject Headings (MeSH)
AdultCervical VertebraeDouble-Blind MethodExercise TestExercise ToleranceFemaleGaitHumansLocomotionMaleMiddle AgedMuscle StrengthPhysical ExertionPilot ProjectsResistance TrainingRoboticsSpinal Cord InjuriesThoracic VertebraeWalking
Study Links
Quality Scores
Safety80
Efficacy85/10
Quality90/10
Citation Metrics
Total Citations40
Citations/Year4.0
Relative Citation Ratio2.21
NIH Percentile77.5%
Research Impact Scores
APT Score0.75
Weight Score1.97
Normalized Score0.84
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