Robotic Rehabilitation in Spinal Cord Injury: A Pilot Study on End-Effectors and Neurophysiological Outcomes

Rocco Salvatore Calabrò, Serena Filoni, Luana Billeri, Tina Balletta, Antonino Cannavò, Angela Militi, Demetrio Milardi, Loris Pignolo, Antonino Naro

Research output: Contribution to journalArticlepeer-review

Abstract

Robot-aided gait training (RAGT) has been implemented to provide patients with spinal cord injury (SCI) with a physiological limb activation during gait, cognitive engagement, and an appropriate stimulation of peripheral receptors, which are essential to entrain neuroplasticity mechanisms supporting functional recovery. We aimed at assessing whether RAGT by means of an end-effector device equipped with body weight support could improve functional ambulation in patients with subacute, motor incomplete SCI. In this pilot study, 15 patients were provided with six RAGT sessions per week for eight consecutive weeks. The outcome measures were muscle strength, ambulation, going upstairs, and disease burden. Furthermore, we estimated the activation patterns of lower limb muscles during RAGT by means of surface electromyography and the resting state networks’ functional connectivity (RSN-FC) before and after RAGT. Patients achieved a clinically significant improvement in the clinical outcome measures substantially up to six months post-treatment. These data were paralleled by an improvement in the stair-climbing cycle and a potentiating of frequency-specific and area-specific RSN-FC patterns. Therefore, RAGT, by means of an end-effector device equipped with body weight support, is promising in improving gait in patients with subacute, motor incomplete SCI, and it could produce additive benefit for the neuromuscular reeducation to gait in SCI when combined with conventional physiotherapy.

Original languageEnglish
Pages (from-to)732-745
Number of pages14
JournalAnnals of Biomedical Engineering
Volume49
Issue number2
DOIs
Publication statusPublished - Feb 2021

Keywords

  • End-effector devices
  • Functional connectivity (FC)
  • Resting state networks (RSN)
  • Robot-aided gait training (RAGT)
  • Spinal cord injury (SCI)

ASJC Scopus subject areas

  • Biomedical Engineering

Fingerprint Dive into the research topics of 'Robotic Rehabilitation in Spinal Cord Injury: A Pilot Study on End-Effectors and Neurophysiological Outcomes'. Together they form a unique fingerprint.

Cite this