Robotic Training and Spinal Cord Plasticity

Brain Res Bull, 2009 · DOI: 10.1016/j.brainresbull.2008.09.018 · Published: January 15, 2009

Assistive Technology Neurology Rehabilitation

Simple Explanation

After a spinal cord injury, the spinal cord can reorganize and use remaining sensory input to control stepping and standing. Motor training, like step or stand training, improves coordination of motor pools, aiding in task-specific learning. Robotic training with an “assist-as-needed” approach allows variability in movement, mimicking normal conditions and improving rehabilitation success after spinal cord injury.

Study Duration

Not specified

Participants

Human and animal studies

Evidence Level

Not specified

Key Findings

1
Motor training can improve the coordination of motor pools within and among limbs after spinal cord injury.
2
Robotic training with an “assist-as-needed” paradigm enhances rehabilitation success by allowing variability in step trajectory.
3
Integrating normal hip and leg motion in robotic devices is critical for effective step training.

Research Summary

The spinal cord has the potential to reorganize after injury and utilize remaining peripheral input to control stepping and standing. Motor training, especially with variability in the task, can improve motor pool coordination within and among limbs. Robotic training using an 'assist-as-needed' approach, integrating normal hip and leg motion, shows promise in enhancing locomotor ability after spinal cord injury.

Practical Implications

Enhanced Rehabilitation Strategies

Robotic devices with 'assist-as-needed' paradigms and integrated hip and leg motion can aid therapists in improving locomotor outcomes for spinal cord injured individuals.

Home-Based Therapy

Properly designed robotic devices can be used safely and readily in the home, increasing practice frequency and motivation through game-like environments.

Personalized Training

Robotic systems can provide immediate visual feedback, quantifying the work performed by the robot versus the subject, motivating individuals and providing quantitative assessment of progress.

Study Limitations

1
The resources, knowledge, and skill required to accomplish adaptive potential after spinal cord injury are not widely available.
2
The potential for 'learned disuse' exists with monotonous repetition of sensorimotor patterns in training.
3
Refining the dose-response curve for the amount and frequency of training versus improvement in stepping is needed.

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