Spinal plasticity in robot-mediated therapy for the lower limbs

Robot-mediated therapy can help improve walking ability in patients following injuries to the central nervous system, such as spinal cord injury (SCI) or stroke. This review discusses the evidence for spinal plasticity in humans following robotic training, particularly in the lower limbs, and suggests ways to measure this plasticity using robotic devices. The review emphasizes the potential of integrating stretch reflex elicitation into robotic devices to routinely test spinal circuitry as part of training and evaluation protocols.

• 1
  BWS robotic-assisted step training can lead to changes in spinal reflex pathways in patients with SCI or stroke, including re-emergence of physiological phase modulation.
• 2
  Stretch reflexes elicited by joint rotations are a tool of interest because they can be integrated into robotic devices to probe spinal circuitry.
• 3
  Spinal reflex conditioning, particularly operant conditioning, can alter the size of spinal reflexes and lead to functionally beneficial changes during dynamic activities.