Robotics for Gait Training After Spinal Cord Injury

Locomotor training can help people with spinal cord injury to regain some mobility. However, the amount of hands-on therapy that patients can receive is limited, as economic pressures are inherent in the health care system. Therefore, worldwide efforts are being made to automate locomotor training. Automation has the potential to make therapy more affordable and thus more available for more patients and for more time. This article reviews efforts to automate locomotor training. We suggest that developing robotic devices that assist only as needed during step training is an important direction for future research.

[1]  K. Pearson,et al.  Inhibition of flexor burst generation by loading ankle extensor muscles in walking cats , 1980, Brain Research.

[2]  T W Meade,et al.  Remedial therapy after stroke: a randomised controlled trial. , 1981, British medical journal.

[3]  R. J. Gregor,et al.  Effects of training on the recovery of full-weight-bearing stepping in the adult spinal cat , 1986, Experimental Neurology.

[4]  S. Rossignol,et al.  Recovery of locomotion after chronic spinalization in the adult cat , 1987, Brain Research.

[5]  H Barbeau,et al.  The Effects of Body Weight Support on the Locomotor Pattern of Spastic Paretic Patients , 1989, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[6]  K J Klose,et al.  Rehabilitation therapy for patients with long-term spinal cord injuries. , 1990, Archives of physical medicine and rehabilitation.

[7]  V. Dietz,et al.  Locomotor activity in spinal man , 1994, The Lancet.

[8]  A. Wernig,et al.  Laufband Therapy Based on‘Rules of Spinal Locomotion’is Effective in Spinal Cord Injured Persons , 1995, The European journal of neuroscience.

[9]  L. Lippman,et al.  Consequences of error production in a perceptual-motor task. , 1997, The Journal of general psychology.

[10]  B. Dobkin,et al.  Human lumbosacral spinal cord interprets loading during stepping. , 1997, Journal of neurophysiology.

[11]  A. Wernig,et al.  Maintenance of locomotor abilities following Laufband (treadmill) therapy in para- and tetraplegic persons: follow-up studies , 1998, Spinal Cord.

[12]  V R Edgerton,et al.  Retention of hindlimb stepping ability in adult spinal cats after the cessation of step training. , 1999, Journal of neurophysiology.

[13]  G. Kwakkel,et al.  Intensity of leg and arm training after primary middle-cerebral-artery stroke: a randomised trial , 1999, The Lancet.

[14]  V. Dietz,et al.  Treadmill training of paraplegic patients using a robotic orthosis. , 2000, Journal of rehabilitation research and development.

[15]  N. Hogan,et al.  Increasing productivity and quality of care: robot-aided neuro-rehabilitation. , 2000, Journal of rehabilitation research and development.

[16]  S. Harkema,et al.  Locomotor training after human spinal cord injury: a series of case studies. , 2000, Physical therapy.

[17]  S. Hesse,et al.  A mechanized gait trainer for restoration of gait. , 2000, Journal of rehabilitation research and development.

[18]  H. F. Machiel van der Loos,et al.  Development of robots for rehabilitation therapy: the Palo Alto VA/Stanford experience. , 2000, Journal of rehabilitation research and development.

[19]  W. Rymer,et al.  Understanding and treating arm movement impairment after chronic brain injury: progress with the ARM guide. , 2014, Journal of rehabilitation research and development.

[20]  V. Dietz,et al.  Long term effects of locomotor training in spinal humans , 2001, Journal of neurology, neurosurgery, and psychiatry.

[21]  V. Dietz,et al.  Driven gait orthosis for improvement of locomotor training in paraplegic patients , 2001, Spinal Cord.

[22]  V. Dietz.  Proprioception and locomotor disorders , 2002, Nature Reviews Neuroscience.

[23]  V R Edgerton,et al.  The rat lumbosacral spinal cord adapts to robotic loading applied during stance. , 2002, Journal of neurophysiology.

[24]  David J. Reinkensmeyer,et al.  A robotic tool for studying locomotor adaptation and rehabilitation , 2002, Proceedings of the Second Joint 24th Annual Conference and the Annual Fall Meeting of the Biomedical Engineering Society] [Engineering in Medicine and Biology.

[25]  S. Hesse,et al.  Treadmill Training With Partial Body Weight Support and an Electromechanical Gait Trainer for Restoration of Gait in Subacute Stroke Patients: A Randomized Crossover Study , 2002, Stroke.

[26]  Gary Dudley,et al.  Methods for a Randomized Trial of Weight-Supported Treadmill Training Versus Conventional Training for Walking During Inpatient Rehabilitation after Incomplete Traumatic Spinal Cord Injury , 2003, Neurorehabilitation and neural repair.

[27]  David J. Reinkensmeyer,et al.  How to retrain movement after neurologic injury: a computational rationale for incorporating robot (or therapist) assistance , 2003, Proceedings of the 25th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (IEEE Cat. No.03CH37439).

[28]  H. Barbeau.  Locomotor Training in Neurorehabilitation: Emerging Rehabilitation Concepts , 2003, Neurorehabilitation and neural repair.

[29]  M. Morari,et al.  Adaptive robotic rehabilitation of locomotion: a clinical study in spinally injured individuals , 2003, Spinal Cord.

[30]  Michael Hillman,et al.  Rehabilitation robotics from past to present - a historical perspective , 2003 .

[31]  B. Dobkin.  The Clinical Science of Neurologic Rehabilitation , 2003 .

[32]  M. Barnes.  The clinical science of neurologic rehabilitation. 2nd edition , 2003 .

[33]  C. Braun,et al.  Motor learning elicited by voluntary drive. , 2003, Brain : a journal of neurology.

[34]  Dragoljub Surdilovic,et al.  STRING-MAN: a new wire robot for gait rehabilitation , 2004, IEEE International Conference on Robotics and Automation, 2004. Proceedings. ICRA '04. 2004.

[35]  B. Dobkin,et al.  Basic advances and new avenues in therapy of spinal cord injury. , 2004, Annual review of medicine.

[36]  Manfred Morari,et al.  Automatic gait-pattern adaptation algorithms for rehabilitation with a 4-DOF robotic orthosis , 2004, IEEE Transactions on Robotics and Automation.

[37]  Noriyuki Tejima,et al.  A safety strategy for rehabilitation robots , 2004 .

[38]  R. Bernhardt,et al.  Safety concept for robotic gait trainers , 2004, The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[39]  J. Burdick,et al.  Effects of consistency vs. variability in robotically controlled training of stepping in adult spinal mice , 2005, 9th International Conference on Rehabilitation Robotics, 2005. ICORR 2005..

[40]  V. Dietz,et al.  Effectiveness of automated locomotor training in patients with chronic incomplete spinal cord injury: a multicenter trial. , 2005, Archives of physical medicine and rehabilitation.

[41]  J. Hidler,et al.  Alterations in muscle activation patterns during robotic-assisted walking. , 2005, Clinical biomechanics.

[42]  L. Cohen,et al.  Role of voluntary drive in encoding an elementary motor memory. , 2005, Journal of neurophysiology.

[43]  D.J. Reinkensmeyer,et al.  Robot-enhanced motor learning: accelerating internal model formation during locomotion by transient dynamic amplification , 2005, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[44]  J.A. Galvez,et al.  Measuring human trainers' skill for the design of better robot control algorithms for gait training after spinal cord injury , 2005, 9th International Conference on Rehabilitation Robotics, 2005. ICORR 2005..

[45]  T. Hornby,et al.  Robotic-assisted, body-weight-supported treadmill training in individuals following motor incomplete spinal cord injury. , 2005, Physical therapy.

[46]  Roger Weber,et al.  Tools for understanding and optimizing robotic gait training. , 2006, Journal of rehabilitation research and development.