Comparison of lower extremity motor score parameters for patients with motor incomplete spinal cord injury using gait parameters

BACKGROUND: Robotic exoskeleton (RE) enables individuals with lower extremity weakness or paralysis to stand and walk in a stereotypical pattern. OBJECTIVE: Examine whether people with chronic incomplete spinal cord injury (SCI) demonstrate a more typical gait pattern when walking overground in a RE than when walking without. METHODS: Motion analysis system synchronized with a surface electromyographic (EMG) was used to obtain temporospatial gait parameters, lower extremity kinematics, and muscle activity in ambulatory individuals with SCI and healthy adults. RESULTS: Temporospatial parameters and kinematics for participants with SCI (n = 12; age 41.4±12.5 years) with and without RE were significantly different than a typical gait (healthy adults: n = 15; age 26.2±8.3 years). EMG amplitudes during the stance phase of a typical gait were similar to those with SCI with and without RE, except the right rectus femoris (p = 0.005) and left gluteus medius (p = 0.014) when participants with SCI walked with RE. EMG amplitudes of participants with SCI during the swing phase were significantly greater compared to those of a typical gait, except for left medial hamstring with (p = 0.025) and without (p = 0.196) RE. CONCLUSIONS: First-time walking in a RE does not appear to produce a typical gait pattern in people with incomplete SCI.

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Non-invasive assessment of lower extremity muscle composition after incomplete spinal cord injury

Spinal Cord ◽

10.1038/sc.2008.10 ◽

2008 ◽

Vol 46 (8) ◽

pp. 565-570 ◽

Cited By ~ 13

Author(s):

P K Shah ◽

C M Gregory ◽

J E Stevens ◽

N C Pathare ◽

A Jayaraman ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Lower Extremity ◽

Incomplete Spinal Cord Injury ◽

Muscle Composition ◽

Non Invasive ◽

Lower Extremity Muscle ◽

Cord Injury

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A study to evaluate the effects of upper limb support during treadmill training with partial body weight support on postural reactions and gait parameters in incomplete spinal cord injury (pilot study)

http://isrctn.org/> ◽

10.1186/isrctn44928338 ◽

2012 ◽

Author(s):

Amanda Austin

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Body Weight ◽

Body Weight Support ◽

Incomplete Spinal Cord Injury ◽

Postural Reactions ◽

Weight Support ◽

Gait Parameters ◽

Cord Injury ◽

Partial Body

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The Effectiveness and Safety of Exoskeletons as Assistive and Rehabilitation Devices in the Treatment of Neurologic Gait Disorders in Patients with Spinal Cord Injury: A Systematic Review

Global Spine Journal ◽

10.1055/s-0036-1593805 ◽

2016 ◽

Vol 6 (8) ◽

pp. 822-841 ◽

Cited By ~ 35

Author(s):

Christian Fisahn ◽

Mirko Aach ◽

Oliver Jansen ◽

Marc Moisi ◽

Angeli Mayadev ◽

...

Keyword(s):

Systematic Review ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Lower Extremity ◽

Assistive Device ◽

Walk Test ◽

Incomplete Spinal Cord Injury ◽

Lower Extremity Function ◽

Extremity Function ◽

Cord Injury

Study Design Systematic review. Clinical Questions (1) When used as an assistive device, do wearable exoskeletons improve lower extremity function or gait compared with knee-ankle-foot orthoses (KAFOs) in patients with complete or incomplete spinal cord injury? (2) When used as a rehabilitation device, do wearable exoskeletons improve lower extremity function or gait compared with other rehabilitation strategies in patients with complete or incomplete spinal cord injury? (3) When used as an assistive or rehabilitation device, are wearable exoskeletons safe compared with KAFO for assistance or other rehabilitation strategies for rehabilitation in patients with complete or incomplete spinal cord injury? Methods PubMed, Cochrane, and Embase databases and reference lists of key articles were searched from database inception to May 2, 2016, to identify studies evaluating the effectiveness of wearable exoskeletons used as assistive or rehabilitative devices in patients with incomplete or complete spinal cord injury. Results No comparison studies were found evaluating exoskeletons as an assistive device. Nine comparison studies (11 publications) evaluated the use of exoskeletons as a rehabilitative device. The 10-meter walk test velocity and Spinal Cord Independence Measure scores showed no difference in change from baseline among patients undergoing exoskeleton training compared with various comparator therapies. The remaining primary outcome measures of 6-minute walk test distance and Walking Index for Spinal Cord Injury I and II and Functional Independence Measure–Locomotor scores showed mixed results, with some studies indicating no difference in change from baseline between exoskeleton training and comparator therapies, some indicating benefit of exoskeleton over comparator therapies, and some indicating benefit of comparator therapies over exoskeleton. Conclusion There is no data to compare locomotion assistance with exoskeleton versus conventional KAFOs. There is no consistent benefit from rehabilitation using an exoskeleton versus a variety of conventional methods in patients with chronic spinal cord injury. Trials comparing later-generation exoskeletons are needed.

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Lower-Extremity Muscle Cross-Sectional Area After Incomplete Spinal Cord Injury

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2006.02.028 ◽

2006 ◽

Vol 87 (6) ◽

pp. 772-778 ◽

Cited By ~ 37

Author(s):

Prithvi K. Shah ◽

Jennifer E. Stevens ◽

Chris M. Gregory ◽

Neeti C. Pathare ◽

Arun Jayaraman ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Lower Extremity ◽

Cross Sectional Area ◽

Sectional Area ◽

Incomplete Spinal Cord Injury ◽

Cross Sectional ◽

Lower Extremity Muscle ◽

Cord Injury ◽

Muscle Cross Sectional Area

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Erratum: Validation of the instrumented evaluation of spatio-temporal gait parameters in patients with motor incomplete spinal cord injury

Spinal Cord ◽

10.1038/sc.2017.51 ◽

2017 ◽

Vol 55 (7) ◽

pp. 712-712 ◽

Cited By ~ 2

Author(s):

A I Pérez-Sanpablo ◽

J Quinzaños-Fresnedo ◽

R Loera-Cruz ◽

I Quiñones-Uriostegui ◽

G Rodriguez-Reyes ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Incomplete Spinal Cord Injury ◽

Gait Parameters ◽

Cord Injury ◽

Spatio Temporal

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Comparison of the effects of solid versus hinged ankle foot orthoses on select temporal gait parameters in patients with incomplete spinal cord injury during treadmill walking

Prosthetics and Orthotics International ◽

10.1177/0309364612448511 ◽

2012 ◽

Vol 37 (1) ◽

pp. 70-75 ◽

Cited By ~ 4

Author(s):

Mokhtar Arazpour ◽

Hamid Reza Tajik ◽

Gholamreza Aminian ◽

Monireh Ahmadi Bani ◽

Farhad Tabatabai Ghomshe ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Step Length ◽

Foot Orthoses ◽

Incomplete Spinal Cord Injury ◽

Gait Parameters ◽

Significant Difference ◽

Cord Injury ◽

Ankle Foot Orthoses ◽

The Mean

Background:Ankle foot orthoses (AFOs) are usually used for patients with incomplete spinal cord injury (ISCI) to provide support in walking.Objectives:The aim of this study was to compare the effect of AFOs, with and without ankle hinges, on specific gait parameters during treadmill training by subjects with ISCI.Study Design:Quasi-experimental.Methods:Five patients with ISCI at the thoracic level participated in this study. Gait evaluation was performed when walking 1) barefoot 2) wearing a solid AFO and 3) wearing a hinged AFO.Results:The mean step length when walking barefoot was 26.3 ± 16.37cm compared to 31.3 ± 17.27 cm with a solid AFO and 28.5 ± 15.86 cm with a hinged AFO. The mean cadence for walking barefoot was 61.59 ± 25.65 steps/min. compared to 50.94 ± 22.36 steps/min. with a solid AFO and 56.25 ± 24.44 steps/min with a hinged AFO. Significant differences in cadence and step length during walking were only demonstrated between the barefoot condition and when wearing a solid AFO. Significant difference was not observed between conditions in mean of ankle range of motion.Conclusion:The solid AFO was the only condition which improved cadence and step length in patients during ISCI gait training.Clinical relevanceA solid AFO could be used permanently to compensate for impaired ankle function or it could be used while retraining stepping.

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