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Journal of NeuroEngineering and Rehabilitation

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Open Access 01-12-2010 | Research

Patient-cooperative control increases active participation of individuals with SCI during robot-aided gait training

Authors: Alexander Duschau-Wicke, Andrea Caprez, Robert Riener

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2010

Abstract

Background

Manual body weight supported treadmill training and robot-aided treadmill training are frequently used techniques for the gait rehabilitation of individuals after stroke and spinal cord injury. Current evidence suggests that robot-aided gait training may be improved by making robotic behavior more patient-cooperative. In this study, we have investigated the immediate effects of patient-cooperative versus non-cooperative robot-aided gait training on individuals with incomplete spinal cord injury (iSCI).

Methods

Eleven patients with iSCI participated in a single training session with the gait rehabilitation robot Lokomat. The patients were exposed to four different training modes in random order: During both non-cooperative position control and compliant impedance control, fixed timing of movements was provided. During two variants of the patient-cooperative path control approach, free timing of movements was enabled and the robot provided only spatial guidance. The two variants of the path control approach differed in the amount of additional support, which was either individually adjusted or exaggerated. Joint angles and torques of the robot as well as muscle activity and heart rate of the patients were recorded. Kinematic variability, interaction torques, heart rate and muscle activity were compared between the different conditions.

Results

Patients showed more spatial and temporal kinematic variability, reduced interaction torques, a higher increase of heart rate and more muscle activity in the patient-cooperative path control mode with individually adjusted support than in the non-cooperative position control mode. In the compliant impedance control mode, spatial kinematic variability was increased and interaction torques were reduced, but temporal kinematic variability, heart rate and muscle activity were not significantly higher than in the position control mode.

Conclusions

Patient-cooperative robot-aided gait training with free timing of movements made individuals with iSCI participate more actively and with larger kinematic variability than non-cooperative, position-controlled robot-aided gait training.

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Title: Patient-cooperative control increases active participation of individuals with SCI during robot-aided gait training
Authors: Alexander Duschau-Wicke
Andrea Caprez
Robert Riener
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: Journal of NeuroEngineering and Rehabilitation / Issue 1/2010
Electronic ISSN: 1743-0003
DOI: https://doi.org/10.1186/1743-0003-7-43

At a glance: The STEP trials

Springer Medicine

Patient-cooperative control increases active participation of individuals with SCI during robot-aided gait training

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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