Ankle voluntary movement enhancement following robotic-assisted locomotor training in spinal cord injury

Journal of NeuroEngineering and Rehabilitation, 2014 · DOI: 10.1186/1743-0003-11-46 · Published: March 31, 2014

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

This study investigates how robotic-assisted training, using a device called Lokomat, affects ankle movement in people with incomplete spinal cord injury (iSCI). The researchers measured ankle movement and walking ability before and after a month of Lokomat training, comparing the results to a control group. The study found that Lokomat training improved the active range of motion, speed, and smoothness of ankle movements. Participants also showed increased strength in their ankle muscles and improvements in walking speed and mobility. These improvements in ankle movement were related to better walking performance, suggesting that robotic-assisted training can help improve motor skills in people with iSCI. The study highlights the potential benefits of using robotic devices to enhance rehabilitation outcomes.

Study Duration

1 Month

Participants

30 chronic iSCI subjects (15 intervention, 15 control)

Evidence Level

Not specified

Key Findings

1
Lokomat training significantly improved the active range of motion (AROM), maximal velocity peak (VP), and movement smoothness (AROM1stMU) in voluntary ankle dorsiflexion movement.
2
Patients exhibited a significant improvement in the maximal voluntary contraction (MVC) for both ankle dorsi- and plantar-flexor muscles after Lokomat training.
3
The study found a significant enhancement in mobility (TUG) and over-ground gait velocity (10MWT) with Lokomat training, indicating improved functional activity.

Research Summary

This study investigated the effects of a one-month Lokomat training program on ankle voluntary movement in chronic iSCI patients. The results demonstrated improvements in ankle dorsiflexion movement, muscle strength, mobility, and over-ground walking velocity. The study found correlations between kinematic and kinetic variables and clinical measures, suggesting that these parameters can help understand the mechanisms underlying improvements in walking capacity following robotic-assisted locomotor training. The authors suggest that the Lokomat training, even without active ankle control, can improve ankle voluntary movement due to enhanced voluntary activation of dorsiflexor muscles and reduced joint stiffness.

Practical Implications

Rehabilitation Strategy

Robotic-assisted locomotor training can be used as a therapeutic intervention to improve ankle motor control and walking ability in individuals with chronic iSCI.

Personalized Therapy

Recovery patterns vary among patients, highlighting the need for systematic assessment to determine which patients would benefit most from robotic-assisted therapy and to tailor training duration and intensity.

Efficacy Assessment

Kinematic and kinetic parameters of ankle voluntary movement can be used to assess the efficacy of robotic-driven locomotor training in improving walking capacities.

Study Limitations

1
The study focused on a specific ankle movement task in PF and DF, and confirmation during functional tasks like walking is needed.
2
Researchers were not blinded to group allocation.
3
The duration of the training might explain the absence of changes in the 6MWT.

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