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Journal of NeuroEngineering and Rehabilitation

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Open Access 01-12-2019 | Neurorehabilitation | Research

Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people

Authors: Alisa Berger, Fabian Horst, Fabian Steinberg, Fabian Thomas, Claudia Müller-Eising, Wolfgang I. Schöllhorn, Michael Doppelmayr

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2019

Abstract

Background

Gait disorders are major symptoms of neurological diseases affecting the quality of life. Interventions that restore walking and allow patients to maintain safe and independent mobility are essential. Robot-assisted gait training (RAGT) proved to be a promising treatment for restoring and improving the ability to walk. Due to heterogenuous study designs and fragmentary knowlegde about the neural correlates associated with RAGT and the relation to motor recovery, guidelines for an individually optimized therapy can hardly be derived. To optimize robotic rehabilitation, it is crucial to understand how robotic assistance affect locomotor control and its underlying brain activity. Thus, this study aimed to investigate the effects of robotic assistance (RA) during treadmill walking (TW) on cortical activity and the relationship between RA-related changes of cortical activity and biomechanical gait characteristics.

Methods

Twelve healthy, right-handed volunteers (9 females; M = 25 ± 4 years) performed unassisted walking (UAW) and robot-assisted walking (RAW) trials on a treadmill, at 2.8 km/h, in a randomized, within-subject design. Ground reaction forces (GRFs) provided information regarding the individual gait patterns, while brain activity was examined by measuring cerebral hemodynamic changes in brain regions associated with the cortical locomotor network, including the sensorimotor cortex (SMC), premotor cortex (PMC) and supplementary motor area (SMA), using functional near-infrared spectroscopy (fNIRS).

Results

A statistically significant increase in brain activity was observed in the SMC compared with the PMC and SMA (p < 0.05), and a classical double bump in the vertical GRF was observed during both UAW and RAW throughout the stance phase. However, intraindividual gait variability increased significantly with RA and was correlated with increased brain activity in the SMC (p = 0.05; r = 0.57).

Conclusions

On the one hand, robotic guidance could generate sensory feedback that promotes active participation, leading to increased gait variability and somatosensory brain activity. On the other hand, changes in brain activity and biomechanical gait characteristics may also be due to the sensory feedback of the robot, which disrupts the cortical network of automated walking in healthy individuals. More comprehensive neurophysiological studies both in laboratory and in clinical settings are necessary to investigate the entire brain network associated with RAW.

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Title: Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people
Authors: Alisa Berger
Fabian Horst
Fabian Steinberg
Fabian Thomas
Claudia Müller-Eising
Wolfgang I. Schöllhorn
Michael Doppelmayr
Publication date: 01-12-2019
Publisher: BioMed Central
Keyword: Neurorehabilitation
Published in: Journal of NeuroEngineering and Rehabilitation / Issue 1/2019
Electronic ISSN: 1743-0003
DOI: https://doi.org/10.1186/s12984-019-0636-3

At a glance: The STEP trials

Springer Medicine

Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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