Usefulness of robotic gait training plus neuromodulation in chronic spinal cord injury: a case report

Context: Spinal cord injury (SCI) affects more than 2.5 million people worldwide, often leading to severe disability. Thus, a proper management of individuals with SCI is required either in the acute or in the post-acute rehabilitative phase. Findings: A 31-year-old man, affected by chronic SCI, underwent two different intensive rehabilitation treatments, including either LokomatPro or a paired LokomatPro-rTMS training. We evaluated the clinical, kinetic, and electrophysiological parameters before and after each training session. In particular, the intensive robotic training was articulated in a total of 40 one-hour training sessions (i.e. 5 times a week for 8 weeks), whereas the rTMS sessions were delivered 3 days per week for 3 consecutive weeks, just before the LokomatPro session. Only at the end of the experimental treatment, we observed an important improvement in nearly all parameters we investigated. Clinical relevance: The combined LokomatPro-rTMS rehabilitation may be a valuable approach in improving the motor function in patients affected by SCI, even in the chronic phase.