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Journal of NeuroEngineering and Rehabilitation

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Open Access 01-12-2017 | Research

Overground vs. treadmill-based robotic gait training to improve seated balance in people with motor-complete spinal cord injury: a case report

Authors: Amanda E. Chisholm, Raed A. Alamro, Alison M. M. Williams, Tania Lam

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2017

Abstract

Background

Robotic overground gait training devices, such as the Ekso, require users to actively participate in triggering steps through weight-shifting movements. It remains unknown how much the trunk muscles are activated during these movements, and if it is possible to transfer training effects to seated balance control. This study was conducted to compare the activity of postural control muscles of the trunk during overground (Ekso) vs. treadmill-based (Lokomat) robotic gait training, and evaluate changes in seated balance control in people with high-thoracic motor-complete spinal cord injury (SCI).

Methods

Three individuals with motor-complete SCI from C7-T4, assumed to have no voluntary motor function below the chest, underwent robotic gait training. The participants were randomly assigned to Ekso-Lokomat-Ekso or Lokomat-Ekso-Lokomat for 10 sessions within each intervention phase for a total of 30 sessions. We evaluated static and dynamic balance control through analysis of center of pressure (COP) movements after each intervention phase. Surface electromyography was used to compare activity of the abdominal and erector spinae muscles during Ekso and Lokomat walking.

Results

We observed improved postural stability after training with Ekso compared to Lokomat during static balance tasks, indicated by reduced COP root mean square distance and ellipse area. In addition, Ekso training increased total distance of COP movements during a dynamic balance task. The trunk muscles showed increased activation during Ekso overground walking compared to Lokomat walking.

Conclusions

Our findings suggest that the Ekso actively recruits trunk muscles through postural control mechanisms, which may lead to improved balance during sitting. Developing effective training strategies to reactivate the trunk muscles is important to facilitate independence during seated balance activity in people with SCI.

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Title: Overground vs. treadmill-based robotic gait training to improve seated balance in people with motor-complete spinal cord injury: a case report
Authors: Amanda E. Chisholm
Raed A. Alamro
Alison M. M. Williams
Tania Lam
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Journal of NeuroEngineering and Rehabilitation / Issue 1/2017
Electronic ISSN: 1743-0003
DOI: https://doi.org/10.1186/s12984-017-0236-z

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Overground vs. treadmill-based robotic gait training to improve seated balance in people with motor-complete spinal cord injury: a case report

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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