Cable-driven robotic resistance training may be used as an adjunct to body-weight-supported treadmill training (BWSTT) for improving overground walking function in patients with incomplete spinal cord injury (SCI), particularly those with relatively high function, say authors of an article published in Archives of Physical Medicine and Rehabilitation.
This study took place in research units of rehabilitation hospitals in Chicago. Researchers randomly assigned patients with chronic incomplete SCI (N=10) to 1 of 2 groups. One group participated in 4 weeks of assistance training followed by 4 weeks of resistance training. The other group participated in 4 weeks of resistance training followed by 4 weeks of assistance training. Locomotor training was provided by using a cable-driven robotic locomotor training system, which is highly backdrivable and compliant, allowing patients the freedom to voluntarily move their legs in a natural gait pattern during BWSTT, while providing controlled assistance/resistance forces to the leg during the swing phase of gait.
Primary outcome measures were evaluated for each participant before training and 4 and 8 weeks after training. Primary measures were self-selected and fast overground walking velocity and 6-minute walking distance. Secondary measures included clinical assessments of balance, muscle tone, and strength.
A significant improvement in walking speed and balance in participants was observed after robotic treadmill training using the cable-driven robotic locomotor trainer. There was no significant difference in walking functional gains after resistance versus assistance training, although resistance training was more effective for higher functioning patients.
APTA member T. George Hornby, PT, PhD, is coauthor of the study.
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