Journal of Rehabilitation Research & Development (JRRD)

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Volume 52 Number 1, 2015
   Pages 113 — 130

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

Tania Lam, PhD;1–2* Katherine Pauhl, MSc;1–2 Amanda Ferguson, BScPT;3 Raza N. Malik, BKin;1–2 Andrei Krassioukov, MD, PhD;2,4–5 Janice J. Eng, PhD2,5–6

1School of Kinesiology and 2International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada; 3NeuroMotion Physical Therapy, Vancouver, British Columbia, Canada; 4Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada; 5GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada 6Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada

Abstract — 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

Key words: body weight support, functional ambulation, gait training, Lokomat resistance, motor-incomplete SCI, motor learning, robotics, skilled walking, spinal cord injury.


View HTML ?? View PDF ?? Contents Vol. 52, No. 1
This article and any supplementary material should be cited as follows:
Lam T, Pauhl K, Ferguson A, Malik RN, Krassioukov A, Eng JJ. Training with robot-applied resistance in people with motor-incomplete spinal cord injury: Pilot study. J Rehabil Res Dev. 2015;52(1):113–30.
http://dx.doi.org/10.1682/JRRD.2014.03.0090

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