Usefulness of robotic gait training plus neuromodulation in chronic spinal cord injury: a case report

The Journal of Spinal Cord Medicine, 2017 · DOI: 10.1080/10790268.2016.1153275 · Published: January 1, 2017

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

This case report explores how combining robotic gait training with brain stimulation might help people with long-term spinal cord injuries. A 31-year-old man with a spinal cord injury for about 20 months underwent two rehabilitation treatments: robotic gait training alone and robotic gait training combined with rTMS. The study found that the combined treatment led to greater improvements in motor function compared to robotic training alone.

Study Duration

8 weeks for each treatment

Participants

1 man with chronic spinal cord injury

Evidence Level

Case Report

Key Findings

1
The LokomatPro training alone did not significantly improve the clinical, kinetic, and electrophysiological outcomes in our patient.
2
The combination of rTMS with LokomatPro training induced a significant improvement in nearly all clinical scale scores, MEP amplitude, MUNE, and the other kinetic parameters.
3
An improvement of erectile function was also noted only after rTMS application

Research Summary

This case report investigated the effects of robotic gait training (LokomatPro) alone and in combination with repetitive transcranial magnetic stimulation (rTMS) on a patient with chronic spinal cord injury (SCI). The patient underwent two separate intensive rehabilitation treatments, one with LokomatPro alone and another with LokomatPro combined with rTMS. The combined LokomatPro-rTMS rehabilitation approach showed a more significant improvement in motor function, clinical scale scores, MEP amplitude, MUNE, and kinetic parameters compared to LokomatPro alone, suggesting it may be a valuable approach for improving motor function in patients with chronic SCI.

Practical Implications

Combined Therapy Potential

Combining robotic gait training with rTMS may offer a more effective rehabilitation strategy for chronic SCI patients compared to robotic training alone.

Neuroplasticity Enhancement

The study suggests that rTMS could enhance neuroplasticity and improve motor function recovery in chronic SCI patients.

Erectile Function Improvement

The study indicates that rTMS may improve erectile function in patients with SCI.

Study Limitations

1
Single case study limits generalizability.
2
Absence of a sham rTMS session.
3
The number of sessions, training total duration, and conventional physiotherapy combination could be methodological issues.

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