The effect of impedance-controlled robotic gait training on walking ability and quality in individuals with chronic incomplete spinal cord injury: An explorative study

The effect of impedance-controlled robotic gait training on walking ability and quality in individuals with chronic incomplete spinal cord injury: An explorative study

Fleerkotte, B.M.
Koopman, B.
Buurke, J.H.
Van Asseldonk, E.H.F.
Van der Kooij, H.
Rietman, J.S.

Mechanical, Maritime and Materials Engineering

Biomechanical Engineering

2014-04-04

Background There is increasing interest in the use of robotic gait-training devices in walking rehabilitation of incomplete spinal cord injured (iSCI) individuals. These devices provide promising opportunities to increase the intensity of training and reduce physical demands on therapists. Despite these potential benefits, robotic gait-training devices have not yet demonstrated clear advantages over conventional gait-training approaches, in terms of functional outcomes. This might be due to the reduced active participation and step-to-step variability in most robotic gait-training strategies, when compared to manually assisted therapy. Impedance-controlled devices can increase active participation and step-to-step variability. The aim of this study was to assess the effect of impedance-controlled robotic gait training on walking ability and quality in chronic iSCI individuals. Methods A group of 10 individuals with chronic iSCI participated in an explorative clinical trial. Participants trained three times a week for eight weeks using an impedance-controlled robotic gait trainer (LOPES: LOwer extremity Powered ExoSkeleton). Primary outcomes were the 10-meter walking test (10MWT), the Walking Index for Spinal Cord Injury (WISCI II), the six-meter walking test (6MWT), the Timed Up and Go test (TUG) and the Lower Extremity Motor Scores (LEMS). Secondary outcomes were spatiotemporal and kinematics measures. All participants were tested before, during, and after training and at 8 weeks follow-up. Results Participants experienced significant improvements in walking speed (0.06 m/s, p?=?0.008), distance (29 m, p?=?0.005), TUG (3.4 s, p?=?0.012), LEMS (3.4, p?=?0.017) and WISCI after eight weeks of training with LOPES. At the eight-week follow-up, participants retained the improvements measured at the end of the training period. Significant improvements were also found in spatiotemporal measures and hip range of motion. Conclusion Robotic gait training using an impedance-controlled robot is feasible in gait rehabilitation of chronic iSCI individuals. It leads to improvements in walking ability, muscle strength, and quality of walking. Improvements observed at the end of the training period persisted at the eight-week follow-up. Slower walkers benefit the most from the training protocol and achieve the greatest relative improvement in speed and walking distance.

spinal cord injury
robotic gait rehabilitation
locomotor training
impedance control
OA-Fund TU Delft

http://resolver.tudelft.nl/uuid:952735c4-bfc0-4828-b217-b9ecb252f7f7

https://doi.org/10.1186/1743-0003-11-26

BioMed Central

1743-0003

http://www.jneuroengrehab.com/content/11/1/26

Journal of NeuroEngineering and Rehabilitation, 11, 2014

Institutional Repository

journal article

© 2014 The Author(s); licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.