title: Investigation of robotic-assisted tilt-table therapy for early-stage spinal cord injury rehabilitation.
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.
authors.affiliation: Centre for Rehabilitation Engineering, School of Engineering, James Watt (South) Building, University of Glasgow, Glasgow G12 8QQ, UK. c.craven.1@research.gla.ac.uk
authors.forename: Colm T D
authors.initials: CT
authors.lastname: Craven
authors.forename: Henrik
authors.initials: H
authors.lastname: Gollee
authors.forename: Sylvie
authors.initials: S
authors.lastname: Coupaud
authors.forename: Mariel A
authors.initials: MA
authors.lastname: Purcell
authors.forename: David B
authors.initials: DB
authors.lastname: Allan
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D004599:Electric Stimulation Therapy; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods*; D006339:Heart Rate; D006801:Humans; D035002:Lower Extremity; D008875:Middle Aged; D010101:Oxygen Consumption; D010809:Physical Fitness / Q000502:physiology*; D010865:Pilot Projects; D011659:Pulmonary Gas Exchange; D012123:Pulmonary Ventilation; D012371:Robotics; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000534:rehabilitation*; D015599:Trauma Severity Indices; D055815:Young Adult