A combined robotic and cognitive training for locomotor rehabilitation: evidences of cerebral functional reorganization in two chronic traumatic brain injured patients

Frontiers in Human Neuroscience, 2011 · DOI: 10.3389/fnhum.2011.00146 · Published: November 23, 2011

Simple Explanation

The study investigates whether combining robotic-assisted movement with cognitive training (motor imagery) can improve walking ability in patients with chronic traumatic brain injury (TBI). It looks at changes in brain activity after this combined training. Two patients with chronic TBI and walking difficulties participated. They received robotic-assisted gait training combined with motor imagery tasks. Brain activity was measured before and after the training using fMRI. The results showed increased brain activity in areas related to movement and improved functional connections within the motor network after the training. The patients also showed improvements in balance and walking ability.

Study Duration

4 weeks

Participants

Two chronic traumatic brain injury patients with major gait impairments

Evidence Level

Case series

Key Findings

1
Greater activation post-training was observed in the sensorimotor and supplementary motor cortices.
2
Enhanced functional connectivity was found within the motor network after the combined robotic and cognitive training.
3
Improvements in balance and, to a lesser extent, in gait outcomes were observed in the patients.

Research Summary

This study investigated the impact of a combined robotic and cognitive gait rehabilitation (RCGR) protocol on cerebral functional reorganization in two chronic traumatic brain injury (TBI) patients with gait impairments. The RCGR protocol involved robotic-assisted walking combined with locomotor imagery tasks, and functional magnetic resonance imaging (fMRI) was used to assess brain activity before and after the intervention. Results indicated increased activation in sensorimotor areas and enhanced functional connectivity within the motor network, along with improvements in balance and gait, suggesting that RCGR may be a useful tool for gait rehabilitation in TBI patients.

Practical Implications

Rehabilitation Strategy

Combining robotic gait training with motor imagery may be a beneficial rehabilitation strategy for individuals with TBI and gait impairments.

Neuroplasticity

The study provides evidence of neuroplasticity in the brain following RCGR, suggesting that the brain can adapt and reorganize after injury.

Balance Improvement

The RCGR protocol appears to have a primary impact on improving balance in TBI patients.

Study Limitations

1
Small sample size (two patients) limits the generalizability of the findings.
2
The study cannot differentiate the effect of the robotic gait and motor imagery components on brain changes.
3
The robotic gait system lacks foot contact and ankle motion, which may limit its effectiveness.

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