Training with robot-applied resistance in people with motor-incomplete spinal cord injury: Pilot study.
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.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
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 |
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.