Physiological Responses of Individuals With Spinal Cord Injury During Robotic-Assisted Treadmill Walking.

Israel, Jeffrey F; Hornby, T. George

doi:10.1097/01.npt.0000282389.25807.ae

Cited by 1 publication

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“…One explanation may lie in the extent of aerobic stimulus elicited during therapist-and robotic-assisted LT. Previous data in subjects with incomplete SCI revealed greater metabolic costs during therapist-versus robotic-assisted stepping, particularly when subjects were asked to simply "walk with the robot," 23,38 which was associated with different hip flexor electromyographic activity associated with swing initiation. When subjects were asked to exert maximal effort during robotic-assisted walking and were provided biofeedback, consistent with robotic-assisted LT provided in this study, differences in metabolic costs between stepping conditions were reduced, although other abnormal muscle activity patterns were observed.…”

Section: Discussionmentioning

confidence: 99%

“…23 Whether subjects maintained maximal effort during robotic-assisted stepping throughout the study is uncertain, although preliminary data indicate that metabolic activity during robotic-assisted stepping decreases over prolonged durations. 38,39 Reduced metabolic activity during robotic-assisted LT may limit adaptations which occur during treadmill exercise in individuals poststroke, which are thought to be a primary factor contributing to improved ambulation. 24 The extent of guidance provided during robotic-assisted LT may be an additional factor that contributed to observed differences between treatment groups.…”

Section: Discussionmentioning

confidence: 99%

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Enhanced Gait-Related Improvements After Therapist- Versus Robotic-Assisted Locomotor Training in Subjects With Chronic Stroke

Hornby

Campbell

Kahn

et al. 2008

Stroke

479

403

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Background and Purpose-Locomotor training (LT) using a treadmill can improve walking ability over conventional rehabilitation in individuals with hemiparesis, although the personnel requirements often necessary to provide LT may limit its application. Robotic devices that provide consistent symmetrical assistance have been developed to facilitate LT, although their effectiveness in improving locomotor ability has not been well established. Methods-Forty-eight ambulatory chronic stroke survivors stratified by severity of locomotor deficits completed a randomized controlled study on the effects of robotic-versus therapist-assisted LT. Both groups received 12 LT sessions for 30 minutes at similar speeds, with guided symmetrical locomotor assistance using a robotic orthosis versus manual facilitation from a single therapist using an assist-as-needed paradigm. Outcome measures included gait speed and symmetry, and clinical measures of activity and participation. Results-Greater improvements in speed and single limb stance time on the impaired leg were observed in subjects who received therapist-assisted LT, with larger speed improvements in those with less severe gait deficits. Perceived rating of the effects of physical limitations on quality of life improved only in subjects with severe gait deficits who received therapist-assisted LT. Conclusions-Therapist-assisted LT facilitates greater improvements in walking ability in ambulatory stroke survivors as compared to a similar dosage of robotic-assisted LT.

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Section: Discussionmentioning

confidence: 99%