Journal of Rehabilitation Research & Development (JRRD)

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Volume 50 Number 3, 2013
   Pages 367 — 378

Abstract — Investigation of robotic-assisted tilt-table therapy for early-stage spinal cord injury rehabilitation

Colm T. D. Craven, MEngSc;1–2* Henrik Gollee, PhD;1–2 Sylvie Coupaud, PhD;1–2 Mariel A. Purcell, MRCGP;2–3 David B. Allan, FRCS2–3

1Centre for Rehabilitation Engineering, School of Engineering, University of Glasgow, Glasgow, UK; 2Scottish Centre for Innovation in Spinal Cord Injury, Glasgow, UK; 3Queen Elizabeth National Spinal Injuries Unit, Southern General Hospital, Glasgow, UK

Abstract — Damage to the spinal cord compromises motor function and sensation below the level of injury, resulting in paralysis and progressive secondary health complications. Inactivity and reduced energy requirements result in reduced cardiopulmonary fitness and an increased risk of coronary heart disease and cardiovascular complications. These risks may be minimized through regular physical activity. It is proposed that such activity should begin at the earliest possible time point after injury, before extensive neuromuscular degeneration has occurred. Robotic-assisted tilt-table therapy may be used during early-stage spinal cord injury (SCI) to facilitate stepping training, before orthostatic stability has been achieved. This study investigates whether such a stimulus may be used to maintain pulmonary and coronary health by describing the acute responses of patients with early-stage (<1 yr) motor-complete SCI (cSCI) and motor-incomplete SCI (iSCI) to passive, active, and electrically stimulated robotic-assisted stepping. Active participation was found to elicit an increased response from iSCI patients. The addition of electrical stimulation did not consistently elicit further increases. Extensive muscle atrophy was found to have occurred in those patients with cSCI, thereby limiting the potential effectiveness of electrical stimulation. Active participation in robotic-assisted tilt-table therapy may be used to improve cardiopulmonary fitness in iSCI patients if implemented as part of a regular training program.

Key words: cardiopulmonary fitness, functional electrical stimulation, lower limb, orthostatic hypotension, pulmonary response, rehabilitation, robotic assistance, spinal cord injury, tilt table, ventilatory response.


View HTML  ¦  View PDF  ¦  Contents Vol. 50, No. 3
This article and any supplemental material should be sited as follows:
Craven CT, Gollee H, Coupaud S, Purcell MA, Allan DB. Investigation of robotic-assisted tilt-table therapy for early-stage spinal cord injury rehabilitation. J Rehabil Res Dev. 2013;50(3):367–78.
http://dx.doi.org/10.1682/JRRD.2012.02.0027
ResearcherID/ORCID: Colm T. D. Craven, MEngSc: A-8031-2012; Henrik Gollee, PhD: E-9247-2010; Sylvie Coupaud, PhD: E-9245-2010
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