A Comparison of Robotic Walking Therapy and Conventional Walking Therapy in Individuals With Upper Versus Lower Motor Neuron Lesions: A Randomized Controlled Trial

• Published in: Archives of physical medicine and rehabilitation Vol. 95; no. 6; pp. 1023 - 1031
• Main Authors: Esclarín-Ruz, Ana, Alcobendas-Maestro, Monica, Casado-Lopez, Rosa, Perez-Mateos, Guillermo, Florido-Sanchez, Miguel Angel, Gonzalez-Valdizan, Esteban, Martin, Jose Luis R.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2014
• Subjects: Adult; Analysis of Variance; Clinical trial; Exercise Therapy - methods; Female; Follow-Up Studies; Gait Disorders, Neurologic - diagnosis; Gait Disorders, Neurologic - rehabilitation; Humans; Injury Severity Score; Locomotor; Lower Extremity - physiopathology; Male; Middle Aged; Motor Neuron Disease - diagnosis; Motor Neuron Disease - rehabilitation; Muscle Strength - physiology; Paraplegia - rehabilitation; Physical Medicine and Rehabilitation; Quadriplegia - rehabilitation; Rehabilitation; Rehabilitation Centers; Robotics - methods; Single-Blind Method; Spinal cord injuries; Spinal Cord Injuries - diagnosis; Spinal Cord Injuries - rehabilitation; Time Factors; Treatment Outcome; Upper Extremity - physiopathology; Walking; 10MWT; LMN; 6MWT; LKOGT; BWSTT; UMN; SCI; Clinical trial; Spinal cord injuries; Rehabilitation; CPG; Locomotor; LEMS; OGT; spinal cord injury; lower motor neuron; central pattern generator; 10-meter walk test; overground therapy; body weight–supported treadmill training; 6-minute walk test; upper motor neuron; lower extremity motor score; robotic locomotor training plus overground therapy
• ISSN: 0003-9993; 1532-821X; 1532-821X
• DOI: 10.1016/j.apmr.2013.12.017

To compare a walking reeducation program with robotic locomotor training plus overground therapy (LKOGT) to conventional overground training (OGT) in individuals with incomplete upper motor neuron (UMN) or lower motor neuron (LMN) injuries having either traumatic or nontraumatic nonprogressive etiology. Randomized open controlled trial with blind evaluation by an independent observer. An inpatient spinal cord injury rehabilitation center. A total of 88 adults within 6 months of spinal cord injury onset (group A, 44 with UMN injury, and group B, 44 with LMN injury) were graded on the American Spinal Injury Association Impairment Scale as C or D. Each of these groups was then randomly allocated to conditions 1 or 2. Condition 1: Subgroups A1 and B1 were treated with LKOGT for 60 minutes. Condition 2: Subgroups A2 and B2 received 60 minutes of conventional OGT 5 days per week for 8 weeks. Subjects with UMN and LMN were randomized into 2 training groups. Ten-meter walk test and 6-minute walk test (6MWT). Walking Index for Spinal Cord Injury II, lower extremity motor score (LEMS), and the FIM-Locomotor were secondary outcome measures. By using the LKOGT program compared with OGT, we found significant differences in the 6MWT for groups A1 and B1. LKOGT also provided higher scores than did OGT in secondary outcomes such as the LEMS and the FIM-Locomotor. Robotic-assisted step training yielded better results in the 6MWT and the LEMS in patients with UMN and LMN.