Effects of Robotic Postural Stand Training with Epidural Stimulation on Sitting Postural Control in Individuals with Spinal Cord Injury: A Pilot Study

J. Clin. Med., 2024 · DOI: 10.3390/jcm13154309 · Published: July 24, 2024

Spinal Cord Injury Assistive Technology Neurology Rehabilitation

Simple Explanation

This study investigates whether robotic postural stand training with epidural stimulation, which improved trunk control in standing, can also improve trunk control while sitting in individuals with spinal cord injury. The study involved six participants with cervical or high-thoracic spinal cord injuries who underwent approximately 80 sessions of robotic postural stand training with epidural stimulation. Sitting postural control was assessed before and after the training, with and without epidural stimulation targeted at facilitating sitting, to evaluate steady sitting control and self-initiated trunk movements.

Study Duration

Approximately 5.2 ± 1.1 months

Participants

6 individuals with cervical or high-thoracic motor complete SCI

Evidence Level

Pilot Study

Key Findings

1
Robotic postural stand training with epidural stimulation did not promote statistically significant changes in sitting trunk control outcomes.
2
A non-significant trend of improved sitting postural control was observed for self-initiated antero-posterior trunk displacement without spinal cord stimulation.
3
Trunk displacement during stable sitting with epidural stimulation tended to be impaired after training.

Research Summary

The study assessed the effects of robotic postural stand training with epidural stimulation (Stand-scES) on sitting postural control in individuals with high-level motor complete spinal cord injury (SCI). Six participants underwent approximately 80 sessions of robotic postural stand training with Stand-scES, and their sitting postural control was evaluated before and after the training. The results indicated that the robotic postural stand training, which improved trunk control in standing, did not lead to significant improvements in sitting postural control.

Practical Implications

Task-Specific Training

Training should be task-specific to promote functional recovery and neuroplasticity.

Posture Specificity

Posture specificity plays a significant role in determining activity-based training-induced neural plasticity and motor recovery.

Combined Training

Concurrent practice of robotic postural training in both standing and sitting may positively affect trunk control.

Study Limitations

1
Limited sample size with heterogeneous characteristics.
2
Missing data due to COVID-19 pandemic.
3
Pelvic tilt was characterized by visual inspection rather than quantified by kinematics.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury