title: Non-invasive brain stimulation and robot-assisted gait training after incomplete spinal cord injury: A randomized pilot study.
abstract: BACKGROUND
  Locomotor training with a robot-assisted gait orthosis (LT-RGO) and transcranial direct current stimulation (tDCS) are interventions that can significantly enhance motor performance after spinal cord injury (SCI). No studies have investigated whether combining these interventions enhances lower extremity motor function following SCI.
  
  
  OBJECTIVE
  Determine whether active tDCS paired with LT-RGO improves lower extremity motor function more than a sham condition, in subjects with motor incomplete SCI.
  
  
  METHODS
  Fifteen adults with SCI received 36 sessions of either active (n = 9) or sham (n = 6) tDCS (20 minutes) preceding LT-RGO (1 hour). Outcome measures included manual muscle testing (MMT; primary outcome measure); 6-Minute Walk Test (6MinWT); 10-Meter Walk Test (10MWT); Timed Up and Go Test (TUG); Berg Balance Scale (BBS); and Spinal Cord Independence Measure-III (SCIM-III).
  
  
  RESULTS
  MMT showed significant improvements after active tDCS, with the most pronounced improvement in the right lower extremity. 10MWT, 6MinWT, and BBS showed improvement for both groups. TUG and SCIM-III showed improvement only for the sham tDCS group.
  
  
  CONCLUSIONS
  Pairing tDCS with LT-RGO can improve lower extremity motor function more than LT-RGO alone. Future research with a larger sample size is recommended to determine longer-term effects on motor function and activities of daily living.
authors.affiliation: University of Pikeville Kentucky College of Osteopathic Medicine, Pikeville, KY, USA.
authors.forename: Ravi
authors.initials: R
authors.lastname: Raithatha
authors.affiliation: University of Kentucky, Department of Physical Medicine and Rehabilitation, Lexington, KY, USA.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Carrico
authors.affiliation: University of Kentucky, Department of Physical Medicine and Rehabilitation, Lexington, KY, USA.
authors.forename: Elizabeth Salmon
authors.initials: ES
authors.lastname: Powell
authors.affiliation: University of Kentucky, Department of Biostatistics, College of Public Health, Lexington, KY, USA.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Westgate
authors.affiliation: University of Kentucky, Department of Physical Medicine and Rehabilitation, Lexington, KY, USA.
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Chelette Ii
authors.affiliation: University of Kentucky College of Health Sciences, Lexington, KY, USA.
authors.forename: Kara
authors.initials: K
authors.lastname: Lee
authors.affiliation: HealthSouth Cardinal Hill Rehabilitation Hospital, Lexington, KY, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Dunsmore
authors.affiliation: University of Kentucky, Department of Physical Medicine and Rehabilitation, Lexington, KY, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Salles
authors.affiliation: University of Kentucky, Department of Physical Medicine and Rehabilitation, Lexington, KY, USA.|HealthSouth Cardinal Hill Rehabilitation Hospital, Lexington, KY, USA.
authors.forename: Lumy
authors.initials: L
authors.lastname: Sawaki
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001915:Braces; D001921:Brain / Q000502:physiology; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods; D005260:Female; D005684:Gait / Q000502:physiology; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000295:instrumentation; D010865:Pilot Projects; D012371:Robotics / Q000295:instrumentation / Q000379:methods*; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000628:therapy*; D013238:Stereotaxic Techniques / Q000295:instrumentation; D065908:Transcranial Direct Current Stimulation / Q000295:instrumentation / Q000379:methods*
keywords: Lower extremity; motor function; neuroplasticity; transcranial direct current stimulation; treadmill training