Effects of Robotic Postural Stand Training with Epidural Stimulation on Sitting Postural Control in Individuals with Spinal Cord Injury: A Pilot Study

被引:0
|
作者
Rejc, Enrico [1 ,2 ,3 ]
Zaccaron, Simone [2 ,4 ]
Bowersock, Collin [3 ,5 ]
Pisolkar, Tanvi [3 ]
Ugiliweneza, Beatrice [3 ,6 ]
Forrest, Gail F. [1 ,7 ]
Agrawal, Sunil [8 ,9 ]
Harkema, Susan J. [3 ,6 ]
Angeli, Claudia A. [1 ]
机构
[1] Kessler Fdn, Tim & Caroline Reynolds Ctr Spinal Stimulat, 1199 Pleasant Valley Way, West Orange, NJ 07052 USA
[2] Univ Udine, Dept Med, Ple Kolbe 4, I-33100 Udine, UD, Italy
[3] Univ Louisville, Kentucky Spinal Cord Injury Res Ctr, 220 Abraham Flexner Way, Louisville, KY 40202 USA
[4] Univ Verona, Dept Neurosci Biomed & Movement Sci, Verona, Italy
[5] No Arizona Univ, Dept Mech Engn, Biomechatron Lab, S San Francisco St, Flagstaff, AZ 86011 USA
[6] Univ Louisville, Dept Neurol Surg, Louisville, KY 40202 USA
[7] Rutgers New Jersey Med Sch, Dept Phys Med & Rehabil, Newark, NJ 07103 USA
[8] Columbia Univ, Dept Mech Engn, 220 S W Mudd Bldg,500 West 120th St, New York, NY 10027 USA
[9] Columbia Univ, Dept Rehabil & Regenerat Med, New York, NY 10032 USA
关键词
epidural stimulation; spinal cord injury; postural control; sitting; stand training; NEUROMUSCULAR RECOVERY SCALE; MOTOR FUNCTION; TRUNK CONTROL; REHABILITATION; VARIABILITY; WHEELCHAIR; KINEMATICS; PLASTICITY; STABILITY; PEOPLE;
D O I
10.3390/jcm13154309
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
(1) Background. High-level spinal cord injury (SCI) disrupts trunk control, leading to an impaired performance of upright postural tasks in sitting and standing. We previously showed that a novel robotic postural stand training with spinal cord epidural stimulation targeted at facilitating standing (Stand-scES) largely improved standing trunk control in individuals with high-level motor complete SCI. Here, we aimed at assessing the effects of robotic postural stand training with Stand-scES on sitting postural control in the same population. (2) Methods. Individuals with cervical (n = 5) or high-thoracic (n = 1) motor complete SCI underwent approximately 80 sessions (1 h/day; 5 days/week) of robotic postural stand training with Stand-scES, which was performed with free hands (i.e., without using handlebars) and included periods of standing with steady trunk control, self-initiated trunk and arm movements, and trunk perturbations. Sitting postural control was assessed on a standard therapy mat, with and without scES targeted at facilitating sitting (Sit-scES), before and after robotic postural stand training. Independent sit time and trunk center of mass (CM) displacement were assessed during a 5 min time window to evaluate steady sitting control. Self-initiated antero-posterior and medial-lateral trunk movements were also attempted from a sitting position, with the goal of covering the largest distance in the respective cardinal directions. Finally, the four Neuromuscular Recovery Scale items focused on sitting trunk control (Sit, Sit-up, Trunk extension in sitting, Reverse sit-up) were assessed. (3) Results. In summary, neither statistically significant differences nor large Effect Size were promoted by robotic postural stand training for the sitting outcomes considered for analysis. (4) Conclusions. The findings of the present study, together with previous observations, may suggest that robotic postural stand training with Stand-scES promoted trunk motor learning that was posture- and/or task-specific and, by itself, was not sufficient to significantly impact sitting postural control.
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页数:14
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