title: Acute effects of locomotor training on neuromuscular and metabolic profile after incomplete spinal cord injury.
abstract: OBJECTIVE
  Locomotor training (LT) enhances walking in individuals with spinal cord injuries (SCIs). We tested the acute effects of 4 days of LT using BWSTT combined with Robotic Locomotor therapy compared to BWSTT twice weekly.
  
  
  METHODS
  Two non-ambulatory participants with an American Spinal Injury Association Impairment Scale (AIS) D. Both received LT for 2 weeks as a portion of their clinical inpatient rehabilitation program and both used wheelchairs as their primary method of mobility. Over a 2 week period, one participant received a total of 8 visits consisting of manual BWSTT (twice weekly) combined with Robotic locomotor therapy (twice weekly). The other participant preformed manual BWSTT (twice weekly) for a total of 4 visits. Resting energy expenditure, body composition, muscle strength, submaximal oxygen consumption (VO2) and blood lactate during LT were measured pre and post-training.
  
  
  RESULTS
  The average maximum voluntary contraction of both knee extensor muscle groups increased by 28-34% with associated reduction in spasticity to the BWSTT participant. Two week interventions resulted in a downward shift of the lactate concentrations for both participants, increase in resting energy expenditure and shift in substrate utilization.
  
  
  CONCLUSIONS
  A clinical paradigm of incorporating BWSTT with robotic locomotor therapy for 4 days/ week did not provide additional physiological benefits to skeletal muscle strength, spasticity or metabolic profile compared to twice weekly of LT using BWSTT.
authors.affiliation: Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, Richmond, VA 23249, USA. ashraf.gorgey@va.gov
authors.forename: Ashraf S
authors.initials: AS
authors.lastname: Gorgey
authors.forename: Hunter
authors.initials: H
authors.lastname: Poarch
authors.forename: Christopher
authors.initials: C
authors.lastname: Harnish
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Miller
authors.forename: David
authors.initials: D
authors.lastname: Dolbow
authors.forename: David R
authors.initials: DR
authors.lastname: Gater
mesh_terms: D001835:Body Weight; D005080:Exercise Test / Q000379:methods*; D006801:Humans; D008297:Male; D055442:Metabolome / Q000502:physiology*; D008875:Middle Aged; D015915:Motion Therapy, Continuous Passive / Q000379:methods*; D009119:Muscle Contraction / Q000502:physiology; D053581:Muscle Strength Dynamometer; D010101:Oxygen Consumption; D020127:Recovery of Function / Q000502:physiology; D012371:Robotics; D013119:Spinal Cord Injuries / Q000378:metabolism* / Q000534:rehabilitation*; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*