HAL® exoskeleton training improves walking parameters and normalizes cortical excitability in primary somatosensory cortex in spinal cord injury patients

Spinal cord injury (SCI) can lead to changes in the brain's sensorimotor cortex, causing increased excitability and larger body representations. This study explores whether robotic-assisted treadmill training using a HAL® exoskeleton can help the brain reorganize and improve walking ability in SCI patients. The researchers measured cortical excitability in the primary somatosensory cortex (S1) using paired-pulse somatosensory evoked potentials (ppSEP) before and after a 3-month training period with the HAL® exoskeleton. Walking function was assessed using tests like the 10-m walk test and the 6-min walk test. The study found that HAL®-assisted treadmill training can help the brain adapt after spinal cord injury. Although there was no direct link found between brain excitability and improved walking, the study highlights the potential of robotic-assisted training for SCI rehabilitation.

• 1
  SCI patients had significantly increased ppSEPs compared to healthy controls at the start of the study, indicating higher cortical excitability.
• 2
  Following the 3-month HAL® training, ppSEPs in SCI patients increased from baseline and were no longer significantly different from those of the control group, suggesting a normalization of cortical excitability.
• 3
  Walking parameters, including speed in the 10-m walk test and distance in the 6-min walk test, showed significant improvements after the training period.