Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Journal of NeuroEngineering and Rehabilitation
Published in: Journal of NeuroEngineering and Rehabilitation 1/2012

Open Access 01-12-2012 | Research

Feasibility and effects of patient-cooperative robot-aided gait training applied in a 4-week pilot trial

Authors: Alex Schück, Rob Labruyère, Heike Vallery, Robert Riener, Alexander Duschau-Wicke

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2012

Login to get access

Abstract

Background

Functional training is becoming the state-of-the-art therapy approach for rehabilitation of individuals after stroke and spinal cord injury. Robot-aided treadmill training reduces personnel effort, especially when treating severely affected patients. Improving rehabilitation robots towards more patient-cooperative behavior may further increase the effects of robot-aided training. This pilot study aims at investigating the feasibility of applying patient-cooperative robot-aided gait rehabilitation to stroke and incomplete spinal cord injury during a therapy period of four weeks. Short-term effects within one training session as well as the effects of the training on walking function are evaluated.

Methods

Two individuals with chronic incomplete spinal cord injury and two with chronic stroke trained with the Lokomat gait rehabilitation robot which was operated in a new, patient-cooperative mode for a period of four weeks with four training sessions of 45 min per week. At baseline, after two and after four weeks, walking function was assessed with the ten meter walking test. Additionally, muscle activity of the major leg muscles, heart rate and the Borg scale were measured under different walking conditions including a non-cooperative position control mode to investigate the short-term effects of patient-cooperative versus non-cooperative robot-aided gait training.

Results

Patient-cooperative robot-aided gait training was tolerated well by all subjects and performed without difficulties. The subjects trained more actively and with more physiological muscle activity than in a non-cooperative position-control mode. One subject showed a significant and relevant increase of gait speed after the therapy, the three remaining subjects did not show significant changes.

Conclusions

Patient-cooperative robot-aided gait training is feasible in clinical practice and overcomes the main points of criticism against robot-aided gait training: It enables patients to train in an active, variable and more natural way. The limited number of subjects in this pilot trial does not permit valid conclusions on the effect of patient-cooperative robot-aided gait training on walking function. A large, possibly multi-center randomized controlled clinical trial is required to shed more light on this question.
Appendix
Available only for authorised users
Literature
1.
Lennon S: The Bobath concept: a critical review of the theoretical assumptions that guide physiotherapy practice in stroke rehabilitation. Phys Therapy Rev. 1996, 35-45.
2.
Seligman MEP: Helplessness: On Depression, Development, and Death. 1975, San Francisco: WH Freeman
3.
Taub E, Miller NE, Novack TA, Cook EW, Fleming WC, Nepomuceno CS, Connell JS, Crago JE: Technique to improve chronic motor deficit after stroke. Arch Phys Med Rehabilitation. 1993, 74 (4): 347-354.
4.
Wolf SL, Winstein CJ, Miller JP, Taub E, Uswatte G, Morris D, Giuliani C, Light KE, Nichols-Larsen D, for the EXCITE Investigators: Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial. JAMA. 2006, 296 (17): 2095-2104. 10.1001/jama.296.17.2095.CrossRefPubMed
5.
Wolf SL, Winstein CJ, Miller JP, Thompson PA, Taub E, Uswatte G, Morris D, Blanton S, Nichols-Larsen D, Clark PC: Retention of upper limb function in stroke survivors who have received constraint-induced movement therapy: the EXCITE randomised trial. Lancet Neurol. 2008, 7 (1): 33-40. 10.1016/S1474-4422(07)70294-6.PubMedCentralCrossRefPubMed
6.
Lin K-C, Wu C-Y, Liu J-S, Chen Y-T, Hsu C-J: Constraint-induced therapy versus dose-matched control intervention to improve motor ability, basic/extended daily functions, and quality of life in stroke. Neurorehabil Neural Repair. 2009, 23 (2): 160-165.CrossRefPubMed
7.
Maier IC, Baumann K, Thallmair M, Weinmann O, Scholl J, Schwab ME: Constraint-induced movement therapy in the adult rat after unilateral corticospinal tract injury. J Neurosci. 2008, 28 (38): 9386-9403. 10.1523/JNEUROSCI.1697-08.2008.CrossRefPubMed
8.
Barbeau H, Wainberg M, Finch L: Description and application of a system for locomotor rehabilitation. Med Biol Eng Comput. 1987, 25 (3): 341-344. 10.1007/BF02447435.CrossRefPubMed
9.
Barbeau H, Visintin M: Optimal outcomes obtained with body-Weight support combined with treadmill training in stroke subjects. Arch Phys Med Rehabilitation. 2003, 84 (10): 1458-1465. 10.1016/S0003-9993(03)00361-7.CrossRef
10.
Barbeau H, Nadeau S, Garneau C: Physical determinants, emerging concepts, and training approaches in gait of individuals with spinal cord injury. J Neurotrauma. 2006, 23 (3-4): 571-585. 10.1089/neu.2006.23.571.CrossRefPubMed
11.
Cai LL, Fong AJ, Otoshi CK, Liang Y, Burdick JW, Roy RR, Edgerton VR: Implications of assist-as-needed robotic step training after a complete spinal cord injury on intrinsic strategies of motor learning. J Neurosci. 2006, 26 (41): 10564-10568. 10.1523/JNEUROSCI.2266-06.2006.CrossRefPubMed
12.
13.
Norman K, Pepin A, Ladouceur M, Barbeau H: A treadmill apparatus and harness support for evaluation and rehabilitation of gait. Arch Phys Med Rehabilitation. 1995, 76 (8): 772-778. 10.1016/S0003-9993(95)80533-8.CrossRef
14.
Visintin M, Barbeau H, Korner-Bitensky N, Mayo NE: A new approach to retrain gait in stroke patients through body weight support and treadmill stimulation. Stroke; J Cerebral Circulation. 1998, 29 (6): 1122-1128. 10.1161/01.STR.29.6.1122.CrossRef
15.
Dobkin B, Apple D, Barbeau H, Basso M, Behrman A, Deforge D, Ditunno J, Dudley G, Elashoff R, Fugate L, Harkema S, Saulino M, Scott M: Weight-supported treadmill vs over-ground training for walking after acute incomplete SCI. Neurology. 2006, 66 (4): 484-493. 10.1212/01.wnl.0000202600.72018.39.PubMedCentralCrossRefPubMed
16.
van Hedel Hubertus JA: Weight-supported treadmill versus over-ground training after spinal cord injury: from a physical therapist’s point of view. PHYS THER. 2006, 86 (10): 1444-1447. 10.2522/ptj.2006.86.10.1444.CrossRefPubMed
17.
Sullivan KJ, Brown DA, Klassen T, Mulroy S, Ge T, Azen SP, Winstein CJ: Effects of task-specific locomotor and strength training in adults who were ambulatory after stroke: results of the STEPS randomized clinical trial. Phys Therapy. 2007, 87 (12): 1580-1602. 10.2522/ptj.20060310.CrossRef
18.
Colombo G, Joerg M, Schreier R, Dietz V: Treadmill training of paraplegic patients using a robotic orthosis. J Rehabil Res Dev. 2000, 37 (6): 693-700.PubMed
19.
Riener R, Lünenburger L, Maier I, Colombo G, Dietz V: Locomotor training in subjects with sensori-motor deficits: an overview of the robotic gait orthosis Lokomat. J Healthcare Eng. 2010, 1 (2): l216-CrossRef
20.
Hesse S, Uhlenbrock D: A mechanized gait trainer for restoration of gait. J Rehabilitation Res Dev. 2000, 37 (6): 701-708.
21.
Sayers SP, Krug J: Robotic gait-assisted therapy in patients with neurological injury. Missouri Med. 2008, 105 (2): 153-158.PubMed
22.
Schmidt H, Werner C, Bernhardt R, Hesse S, Krüger Jörg: Gait rehabilitation machines based on programmable footplates. J Neuroengineering Rehabilitation. 2007, 4: 2+-10.1186/1743-0003-4-2.CrossRef
23.
Veneman JF, Kruidhof R, Hekman EEG, Ekkelenkamp R, Van Asseldonk EHF, van der Kooij H: Design and evaluation of the LOPES exoskeleton robot for interactive gait rehabilitation. IEEE Trans Neural Syst Rehabil Eng. 2007, 15 (3): 379-386.CrossRefPubMed
24.
Banala SK, Agrawal SK, Scholz JP: Active Leg Exoskeleton (ALEX) for gait rehabilitation of motor-impaired patients. Proc IEEE 10th Int Conf Rehabil Robot. 2007, Noordwijk, 401-407.
25.
Aoyagi D, Ichinose WE, Harkema SJ, Reinkensmeyer DJ, Bobrow JE: A robot and control algorithm that can synchronously assist in naturalistic motion during body-weight-supported gait training following neurologic injury. IEEE Trans Neural Syst Rehabil Eng. 2007, 15 (3): 387-400.CrossRefPubMed
26.
Dollar AM, Herr H: Lower extremity exoskeletons and active orthoses: challenges and state-of-the-art. Robotics IEEE Trans on. 2008, 24 (1): 144-158.CrossRef
27.
Mehrholz J, Werner C, Kugler J, Pohl M: Electromechanical-assisted training for walking after stroke. Cochrane Database of Systematic Rev (Online). 2007, 4
28.
Mehrholz J, Kugler J, Pohl M: Locomotor training for walking after spinal cord injury. Cochrane Database of Systematic Rev (Online). 2008, 2
29.
Husemann B, Müller F, Krewer C, Heller S, Koenig E: Effects of locomotion training with assistance of a robot-driven gait orthosis in hemiparetic patients after stroke: a randomized controlled pilot study. Stroke; J Cerebral Circulation. 2007, 38 (2): 349-354. 10.1161/01.STR.0000254607.48765.cb.CrossRef
30.
Mayr A, Kofler M, Quirbach E, Matzak H, Frohlich K, Saltuari L: Prospective, blinded, randomized crossover study of gait rehabilitation in stroke patients using the lokomat gait orthosis. Neurorehabil Neural Repair. 2007, 21 (4): 307-314. 10.1177/1545968307300697.CrossRefPubMed
31.
Schwartz I, Sajin A, Fisher I, Neeb M, Shochina M, Katz-Leurer M, Meiner Z: The effectiveness of locomotor therapy using robotic-assisted gait training in subacute stroke patients: a randomized controlled trial. PM R : J Injury, Funct, Rehabilitation. 2009, 1 (6): 516-523. 10.1016/j.pmrj.2009.03.009.CrossRef
32.
Westlake Kelly, Patten C: Pilot study of Lokomat versus manual-assisted treadmill training for locomotor recovery post-stroke. J NeuroEngineering Rehabilitation. 2009, 6 (1): 18+-10.1186/1743-0003-6-18.CrossRef
33.
Hidler J, Nichols D, Pelliccio M, Brady K, Campbell DD, Kahn JH, Hornby GT: Multicenter randomized clinical trial evaluating the effectiveness of the Lokomat in subacute stroke. Neurorehabil Neural Repair. 2009, 23 (1): 5-13.CrossRefPubMed
34.
Hornby GT, Campbell DD, Kahn JH, Demott T, Moore JL, Roth HR: Enhanced gait-related improvements after therapist- versus robotic-assisted locomotor training in subjects with chronic stroke: a randomized controlled study. Stroke. 2008, 39 (6): 1786-1792. 10.1161/STROKEAHA.107.504779.CrossRefPubMed
35.
Murray AF, Edwards PJ: Synaptic weight noise during MLP learning enhances fault-tolerance, generalisation and learning trajectory. IEEE Trans on Neural Networks. 1993, 5 (5): 792-802.CrossRef
36.
Bernstein NA: The Co-ordination and regulation of movements. 1967, First English edition. Pergamon Press Ltd.
37.
Hogan N: Impedance control - an approach to manipulation. I - Theory. II - Implementation. III - Applications. ASME Trans J Dynamic Syst Meas Control B. 1985, 107: 1-24. 10.1115/1.3140702.CrossRef
38.
Riener R, Lünenburger L, Jezernik S, Anderschitz M, Colombo G, Dietz V: Patient-cooperative strategies for robot-aided treadmill training: first experimental results. IEEE Trans Neural Syst Rehabil Eng. 2005, 13 (3): 380-394. 10.1109/TNSRE.2005.848628.CrossRefPubMed
39.
Emken JL, Bobrow JE, Reinkensmeyer DJ: Robotic movement training as an optimization problem: designing a controller that assists only as needed. IEEE Int. Conf. on Rehabilitation Robotics (ICORR). 2005, Chicago, 307-312.
40.
Reinkensmeyer DJ, Emken JL, Cramer SC: Robotics, motor learning, and neurologic recovery. Ann Rev Biomed Eng. 2004, 6: 497-525. 10.1146/annurev.bioeng.6.040803.140223.CrossRef
41.
Riener R, Fuhr T: Patient-driven control of FES-supported standing up: a simulation study. Rehabilitation Eng, IEEE Trans on. 1998, 6 (2): 113-124. 10.1109/86.681177.CrossRef
42.
Jezernik S, Colombo G, Morari M: Automatic gait-pattern adaptation algorithms for rehabilitation with a 4-DOF robotic orthosis. IEEE Trans Robot Autom. 2004, 20 (3): 574-582. 10.1109/TRA.2004.825515.CrossRef
43.
Riener R, Frey M, Bernhardt M, Nef T, Colombo G: Human-centered rehabilitation robotics. Rehabilitation Robotics, 2005. ICORR 2005. 9th International Conference on. 2005, 319-322.CrossRef
44.
Reinkensmeyer DJ, Aoyagi D, Emken JL, Galvez JA, Ichinose W, Kerdanyan G, Maneekobkunwong S, Minakata K, Nessler JA, Weber R, Roy RR, de Leon R, Bobrow JE, Harkema SJ, Edgerton VR: Tools for understanding and optimizing robotic gait training. J Rehabil Res Dev. 2006, 43 (5): 657-670. 10.1682/JRRD.2005.04.0073.CrossRefPubMed
45.
van Asseldonk EHF, Veneman JF, Ekkelenkamp R, Buurke JH, van der Helm FCT, van der Kooij H: The effects on kinematics and muscle activity of walking in a robotic gait trainer during zero-force control. IEEE Trans Neural Syst Rehabil Eng. 2008, 16 (4): 360-370.CrossRefPubMed
46.
Vallery H, Guidali M, Duschau-Wicke A, Riener R: Patient-cooperative control: providing safe support without restricting movement. World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany. Edited by: Dössel Olaf, Schlegel WolfgangC. 2009, Berlin, Heidelberg: Springer Berlin Heidelberg, 166-169.CrossRef
47.
Emken JL, Harkema SJ, Beres-Jones JA, Ferreira CK, Reinkensmeyer DJ: Feasibility of manual teach-and-replay and continuous impedance shaping for robotic locomotor training following spinal cord injury. IEEE Trans Biomed Eng. 2008, 55 (1): 322-334.CrossRefPubMed
48.
Marchal Crespo L, Reinkensmeyer D: Review of control strategies for robotic movement training after neurologic injury. J Neuroengineering rehabilitation. 2009, 6 (1): 20+-10.1186/1743-0003-6-20.CrossRef
49.
Cai LL, Fong AJ, Otoshi CK, Liang YQ, Cham JG, Zhong H, Roy RR, Edgerton VR, Burdick JW: Effects of consistency vs. variability in robotically controlled training of stepping in adult spinal mice. 2005, ChicagoCrossRef
50.
Duschau-Wicke A, von Zitzewitz J, Caprez A, Lünenburger L, Riener R: Path control: a method for patient-cooperative robot-aided gait rehabilitation. IEEE Trans Neural Syst Rehabilitation Eng. 2010, 18 (1): 38-48.CrossRef
51.
Duschau-Wicke A, Caprez A, Riener R: Patient-cooperative control increases active participation of individuals with SCI during robot-aided gait training. J NeuroEngineering Rehabilitation. 2010, 7 (1): 43+-10.1186/1743-0003-7-43.CrossRef
52.
Frey M, Colombo G, Vaglio M, Bucher R, Jörg M, Riener R: A novel mechatronic body weight support system. IEEE Trans Neural Syst Rehabil Eng. 2006, 14 (3): 311-321. 10.1109/TNSRE.2006.881556.CrossRefPubMed
53.
Vallery H, Duschau-Wicke A, Riener R: Generalized elasticities improve patient-cooperative control of rehabilitation robots. IEEE Int Conf on Rehabilitation Robotics (ICORR). 2009, 535-541.
54.
Vallery H, Duschau-Wicke A, Riener R: Optimized passive dynamics improve transparency of haptic devices. IEEE Int Conf Robot Aut (ICRA). 2009, 301-306.
55.
von Zitzewitz J, Bernhardt M, Riener R: A Novel method for automatic treadmill speed adaptation. IEEE Trans Neural Syst Rehabil Eng. 2007, 15 (3): 401-409.CrossRefPubMed
56.
Maynard FM, Bracken MB, Creasey G, Ditunno JF, Donovan WH, Ducker TB, Garber SL, Marino RJ, Stover SL, Tator CH, Others: International standards for neurological and functional classification of spinal cord injury. Spinal Cord. 1997, 35: 266-274. 10.1038/sj.sc.3100432.CrossRefPubMed
57.
Itzkovich M, Gelernter I, Biering-Sorensen F, Weeks C, Laramee MT, Craven BC, Tonack M, Hitzig SL, Glaser E, Zeilig G, Aito S, Scivoletto G, Mecci M, Chadwick RJ, Masry WS, Osman A, Glass CA, Silva P, Soni BM, Gardner BP, Savic G, Bergström EM, Bluvshtein V, Ronen J, Catz A: The Spinal Cord Independence Measure (SCIM) version III: reliability and validity in a multi-center international study. Disabil Rehabil. 2007, 29 (24): 1926-1933. 10.1080/09638280601046302.CrossRefPubMed
58.
Cuthbert SC, Goodheart GJ: On the reliability and validity of manual muscle testing: a literature review. Chiropractic Osteopathy. 2007, 15: 4+-10.1186/1746-1340-15-4.PubMedCentralCrossRefPubMed
59.
Schmitt WH, Cuthbert SC: Common errors and clinical guidelines for manual muscle testing: "the arm test" and other inaccurate procedures. Chiropractic Osteopathy. 2008, 16: 16+-10.1186/1746-1340-16-16.PubMedCentralCrossRefPubMed
60.
Cockrell JR, Folstein MF: Mini-mental state examination. Principles Pract Geriatric Psychiatry. 1988, 140-141.
61.
Dittuno PL, Dittuno JF: Walking index for spinal cord injury (WISCI II): scale revision. Spinal Cord. 2001, 39: 654-656. 10.1038/sj.sc.3101223.CrossRefPubMed
62.
van Hedel HJ, Dietz V, European multicenter study on human spinal cord injury EM-SCI study group: Walking during daily life can be validly and responsively assessed in subjects with a spinal cord injury. Neurorehabilitation Neural Repair. 2009, 23 (2): 117-124.CrossRefPubMed
63.
Zimmerli L, Duschau-Wicke A, Mayr A, Riener R, Lünenburger L: Virtual reality and gait rehabilitation Augmented feedback for the Lokomat. Virtual Rehabilitation International Conference. 2009, 150-153.CrossRef
64.
Borg G: Perceived exertion as an indicator of somatic stress. Scand J Rehabilitation Med. 1970, 2 (2): 92-98.
65.
Lewis JE, Nash MS, Hamm LF, Martins SC, Groah SL: The relationship between perceived exertion and physiologic indicators of stress during graded arm exercise in persons with spinal cord injuries. Arch Phys Med Rehabilitation. 2007, 88 (9): 1205-1211. 10.1016/j.apmr.2007.05.016.CrossRef
66.
Hermens HJ, Freriks B, Merletti R, Stegeman D, Blok J, Rau G, Disselhorst-Klug C, Haegg G: European Recommendations for Surface Electromyography. 1999
67.
Marino RJ, Barros T, Biering-Sorensen F, Burns SP, Donovan WH, Graves DE, Haak M, Hudson LM, Priebe MM, ASIA Neurological Standards Committee 2002: International standards for neurological classification of spinal cord injury. J Spinal Cord Med. 2003, 26 (Suppl 1):
68.
Alexander MS, Anderson KD, Biering-Sorensen F, Blight AR, Brannon R, Bryce TN, Creasey G, Catz A, Curt A, Donovan W, Ditunno J, Ellaway P, Finnerup NB, Graves DE, Haynes BA, Heinemann AW, Jackson AB, Johnston MV, Kalpakjian CZ, Kleitman N, Krassioukov A, Krogh K, Lammertse D, Magasi S, Mulcahey MJ, Schurch B, Sherwood A, Steeves JD, Stiens S, Tulsky DS, van Hedel HJA, Whiteneck G: Outcome measures in spinal cord injury: recent assessments and recommendations for future directions. Spinal Cord. 2009, 47 (8): 582-591. 10.1038/sc.2009.18.PubMedCentralCrossRefPubMed
69.
Ricamato AL, Hidler JM: Quantification of the dynamic properties of EMG patterns during gait. J Electromyography Kinesiology. 2005, 15 (4): 384-392. 10.1016/j.jelekin.2004.10.003.CrossRef
70.
Gibbons JD: Nonparametric Statistical Inference. 1985, Marcel Dekker Ltd
71.
Hochberg Yosef, Tamhane AjitC: Multiple Comparison Procedures (Wiley Series in Probability and Statistics). 1987, WileyCrossRef
72.
Goosey-Tolfrey V, Lenton J, Goddard J, Oldfield V, Tolfrey K, Eston R: Regulating intensity using perceived exertion in spinal cord-injured participants. Med Sci Sports Exercise. 2010, 42 (3): 608-613. 10.1249/MSS.0b013e3181b72cbc.CrossRef
73.
Hidler JM, Wall AE: Alterations in muscle activation patterns during robotic-assisted walking. Clin Biomech. 2005, 20 (2): 184-193. 10.1016/j.clinbiomech.2004.09.016.CrossRef
74.
Israel JF, Campbell DD, Kahn JH, Hornby GT: Metabolic costs and muscle activity patterns during robotic- and therapist-assisted treadmill walking in individuals with incomplete spinal cord injury. Phys Therapy. 2006, 86 (11): 1466-1478. 10.2522/ptj.20050266.CrossRef
75.
Reinkensmeyer DJ, Maier MA, Guigon E, Chan V, Akoner O, Wolbrecht ET, Cramer SC, Bobrow JE: Do robotic and non-robotic arm movement training drive motor recovery after stroke by a common neural mechanism? Experimental evidence and a computational model. Conf. IEEE Engineering in Medicine and Biology Society (EMBS). 2009, 2439-2441.
76.
Wirz M, Zemon DH, Rupp R, Scheel A, Colombo G, Dietz V, Hornby TG: Effectiveness of automated locomotor training in patients with chronic incomplete spinal cord injury: a multicenter trial. Arch Phys Med Rehabil. 2005, 86 (4): 672-680. 10.1016/j.apmr.2004.08.004.CrossRefPubMed
77.
Schweighofer N, Han CE, Wolf SL, Arbib MA, Winstein CJ: A functional threshold for long-term use of hand and arm function can be determined: predictions from a computational model and supporting data from the Extremity Constraint-Induced Therapy Evaluation (EXCITE) Trial. Phys therapy. 2009, 89 (12): 1327-1336. 10.2522/ptj.20080402.CrossRef
78.
Han CE, Arbib MA, Schweighofer N: Stroke rehabilitation reaches a threshold. PLoS Computat Biol. 2008, 4 (8):
Metadata
Title
Feasibility and effects of patient-cooperative robot-aided gait training applied in a 4-week pilot trial
Authors
Alex Schück
Rob Labruyère
Heike Vallery
Robert Riener
Alexander Duschau-Wicke
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Journal of NeuroEngineering and Rehabilitation / Issue 1/2012
Electronic ISSN: 1743-0003
DOI
https://doi.org/10.1186/1743-0003-9-31

Other articles of this Issue 1/2012

Journal of NeuroEngineering and Rehabilitation 1/2012 Go to the issue

Research

Sensory nerve action potentials and sensory perception in women with arthritis of the hand

Research

Self-reported gait unsteadiness in mildly impaired neurological patients: an objective assessment through statistical gait analysis

Research

Comparison of walking overground and in a Computer Assisted Rehabilitation Environment (CAREN) in individuals with and without transtibial amputation

Research

Forelimb EMG-based trigger to control an electronic spinal bridge to enable hindlimb stepping after a complete spinal cord lesion in rats

Commentary

Why do we need improved mobility technology?

Research

Healthy younger and older adults control foot placement to avoid small obstacles during gait primarily by modulating step width