title: Training with robot-applied resistance in people with motor-incomplete spinal cord injury: Pilot study.
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.
  
  
  BACKGROUND
  ClinicalTrials.gov; NCT00610974. "Enhancing Walking in People With Incomplete Spinal Cord Injury: a Pilot Study"; https://clinicaltrials.gov/ct2/show/NCT00610974.
authors.affiliation: School of Kinesiology and.
authors.forename: Tania
authors.initials: T
authors.lastname: Lam
authors.forename: Katherine
authors.initials: K
authors.lastname: Pauhl
authors.forename: Amanda
authors.initials: A
authors.lastname: Ferguson
authors.forename: Raza N
authors.initials: RN
authors.lastname: Malik
authors.forename: Andrei
authors.initials: A
authors.lastname: Krassioukov
authors.forename: Janice J
authors.initials: JJ
authors.lastname: Eng
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae; D004311:Double-Blind Method; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008124:Locomotion; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D005082:Physical Exertion; D010865:Pilot Projects; D055070:Resistance Training / Q000295:instrumentation / Q000379:methods*; D012371:Robotics; D013119:Spinal Cord Injuries / Q000145:classification / Q000534:rehabilitation*; D013904:Thoracic Vertebrae; D016138:Walking / Q000502:physiology*
keywords: Lokomat; body weight support; functional ambulation; gait training; motor learning; motor-incomplete SCI; resistance; robotics; skilled walking; spinal cord injury