title: Effects of robotic-locomotor training on stretch reflex function and muscular properties in individuals with spinal cord injury.
abstract: OBJECTIVE
  We sought to determine the therapeutic effect of robotic-assisted step training (RAST) on neuromuscular abnormalities associated with spasticity by characterization of their recovery patterns in people with spinal cord injury (SCI).
  
  
  METHODS
  Twenty-three motor-incomplete SCI subjects received one-hour RAST sessions three times per week for 4 weeks, while an SCI control group received no training. Neuromuscular properties were assessed using ankle perturbations prior to and during the training, and a system-identification technique quantified stretch reflex and intrinsic stiffness magnitude and modulation with joint position. Growth-mixture modeling classified subjects based on similar intrinsic and reflex recovery patterns.
  
  
  RESULTS
  All recovery classes in the RAST group presented significant (p<0.05) reductions in intrinsic and reflex stiffness magnitude and modulation with position; the control group presented no changes over time. Subjects with larger baseline abnormalities exhibited larger reductions, and over longer training periods.
  
  
  CONCLUSIONS
  Our findings demonstrate that RAST can effectively reduce neuromuscular abnormalities, with greater improvements for subjects with higher baseline abnormalities.
  
  
  CONCLUSIONS
  Our findings suggest, in addition to its primary goal of improving locomotor patterns, RAST can also reduce neuromuscular abnormalities associated with spasticity. These findings also demonstrate that these techniques can be used to characterize neuromuscular recovery patterns in response to various types of interventions.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Northwestern University, USA; Sensory Motor Performance Program, Rehabilitation Institute of Chicago, USA. Electronic address: Mehdi@northwestern.edu.
authors.forename: Mehdi M
authors.initials: MM
authors.lastname: Mirbagheri
authors.affiliation: Sensory Motor Performance Program, Rehabilitation Institute of Chicago, USA.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Kindig
authors.affiliation: Department of Physical Medicine and Rehabilitation, Northwestern University, USA; Sensory Motor Performance Program, Rehabilitation Institute of Chicago, USA.
authors.forename: Xun
authors.initials: X
authors.lastname: Niu
mesh_terms: D000328:Adult; D000843:Ankle Joint / Q000503:physiopathology; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000503:physiopathology / Q000534:rehabilitation; D018482:Muscle, Skeletal / Q000503:physiopathology*; D012026:Reflex, Stretch; D012371:Robotics; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000534:rehabilitation
keywords: Ankle; Gait rehabilitation; Locomotor training; Reflex; Spasticity; Spinal cord injury