Spinal Cord Injuries Clinical Trial
Official title:
Differential Effects of Robotic vs. Manually-Assisted Locomotor Training
The purpose of this study is to collect data comparing two means of providing locomotor training: manual and robotic and the possible differential effects it may have on walking ability for persons with spinal cord injury (SCI).
Spinal cord injury (SCI) is one of the most disabling health problems facing adults today,
with one of the consequences often being inability to walk or difficulty walking. Recent
studies suggest that intensive step training on a treadmill using body-weight support (BWS)
and manual assistance that provides repetitive task-specific sensory cues to the neural axis
can improve the recovery of walking for persons with incomplete SCI. More recently, robotics
have been developed as an alternative to manually-assisted training. Robotic-assisted
training may allow for increased intensity of training, improve the reproducibility and
consistency of training, and reduce the personnel needed to implement the training. However,
the effects of robotic-assisted training compared to manually-assisted training are not
known. An improved understanding of these differential effects and the mechanisms of
improvement in walking can facilitate continued advances in evidenced-based practice of
neuro-rehabilitation, therefore improving the treatment of persons with SCI.
The primary objective of this project is to assess and compare the effects of
robotic-assisted versus manually-assisted locomotor training (LT) using the body-weight
support (BWS) on sub-tasks of walking. Specifically, we believe that at least four sub-tasks
of walking are differentially affected by the robotic-assisted training when compared to
manually-assisted training (propulsion, transition from stance to step, stepping, and
equilibrium). The investigators hypothesize that robotic-assisted training will have a
greater effect on improving propulsion, transition and equilibrium. The effect of these two
modalities on adaptability, a fifth sub-task of walking, is unclear; therefore, a development
component of the pilot project will involve establishing a quantitative measure of
adaptability and assessing differential effects of training. Participants will be randomized
to one of two training groups: robotic-assisted or manually-assisted, and evaluated for
performance on sub-tasks of walking.
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