Overground walking with a robotic exoskeleton elicits trunk muscle activity in people with high-thoracic motor-complete spinal cord injury
Abstract Background The trunk muscles are critical for postural control. Recent neurophysiological studies have revealed sparing of trunk muscle function in individuals with spinal cord injury (SCI) classified with thoracic or cervical motor-complete injuries. These findings raise the possibility fo...
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| Format: | Article |
| Language: | English |
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BMC
2018-11-01
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| Series: | Journal of NeuroEngineering and Rehabilitation |
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| Online Access: | http://link.springer.com/article/10.1186/s12984-018-0453-0 |
| _version_ | 1818912912332292096 |
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| author | Raed A. Alamro Amanda E. Chisholm Alison M. M. Williams Mark G. Carpenter Tania Lam |
| author_facet | Raed A. Alamro Amanda E. Chisholm Alison M. M. Williams Mark G. Carpenter Tania Lam |
| author_sort | Raed A. Alamro |
| collection | DOAJ |
| description | Abstract Background The trunk muscles are critical for postural control. Recent neurophysiological studies have revealed sparing of trunk muscle function in individuals with spinal cord injury (SCI) classified with thoracic or cervical motor-complete injuries. These findings raise the possibility for recruiting and retraining this spared trunk function through rehabilitation. Robotic gait training devices may provide a means to promote trunk muscle activation. Thus, the objective of this study was to characterize and compare the activation of the trunk muscles during walking with two robotic gait training devices (Ekso and Lokomat) in people with high thoracic motor-complete SCI. Methods Participants with chronic motor-complete paraplegia performed 3 speed-matched walking conditions: Lokomat-assisted walking, Ekso-assisted walking overground, and Ekso-assisted walking on a treadmill. Surface electromyography (EMG) signals were recorded bilaterally from the rectus abdominis (RA), external oblique (EO), and erector spinae (ES) muscles. Results Greater recruitment of trunk muscle EMG was elicited with Ekso-assisted walking compared to the Lokomat. Similar levels of trunk EMG activation were observed between Ekso overground and Ekso on the treadmill, indicating that differences between Ekso and Lokomat could not be attributed to the use of a hand-held gait aid. The level of trunk EMG activation during Lokomat walking was not different than that recorded during quiescent supine lying. Conclusions Ekso-assisted walking elicits greater activation of trunk muscles compared to Lokomat-assisted walking, even after controlling for the use of hand-held assistive devices. The requirement of the Ekso for lateral weight-shifting in order to activate each step could lead to better postural muscle activation. |
| first_indexed | 2024-12-19T23:22:08Z |
| format | Article |
| id | doaj.art-4216e804c0774fc5be754c7f3c0fba2e |
| institution | Directory Open Access Journal |
| issn | 1743-0003 |
| language | English |
| last_indexed | 2024-12-19T23:22:08Z |
| publishDate | 2018-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of NeuroEngineering and Rehabilitation |
| spelling | doaj.art-4216e804c0774fc5be754c7f3c0fba2e2022-12-21T20:01:56ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032018-11-0115111110.1186/s12984-018-0453-0Overground walking with a robotic exoskeleton elicits trunk muscle activity in people with high-thoracic motor-complete spinal cord injuryRaed A. Alamro0Amanda E. Chisholm1Alison M. M. Williams2Mark G. Carpenter3Tania Lam4School of Kinesiology, University of British ColumbiaSchool of Kinesiology, University of British ColumbiaSchool of Kinesiology, University of British ColumbiaInternational Collaboration on Repair Discoveries (ICORD)School of Kinesiology, University of British ColumbiaAbstract Background The trunk muscles are critical for postural control. Recent neurophysiological studies have revealed sparing of trunk muscle function in individuals with spinal cord injury (SCI) classified with thoracic or cervical motor-complete injuries. These findings raise the possibility for recruiting and retraining this spared trunk function through rehabilitation. Robotic gait training devices may provide a means to promote trunk muscle activation. Thus, the objective of this study was to characterize and compare the activation of the trunk muscles during walking with two robotic gait training devices (Ekso and Lokomat) in people with high thoracic motor-complete SCI. Methods Participants with chronic motor-complete paraplegia performed 3 speed-matched walking conditions: Lokomat-assisted walking, Ekso-assisted walking overground, and Ekso-assisted walking on a treadmill. Surface electromyography (EMG) signals were recorded bilaterally from the rectus abdominis (RA), external oblique (EO), and erector spinae (ES) muscles. Results Greater recruitment of trunk muscle EMG was elicited with Ekso-assisted walking compared to the Lokomat. Similar levels of trunk EMG activation were observed between Ekso overground and Ekso on the treadmill, indicating that differences between Ekso and Lokomat could not be attributed to the use of a hand-held gait aid. The level of trunk EMG activation during Lokomat walking was not different than that recorded during quiescent supine lying. Conclusions Ekso-assisted walking elicits greater activation of trunk muscles compared to Lokomat-assisted walking, even after controlling for the use of hand-held assistive devices. The requirement of the Ekso for lateral weight-shifting in order to activate each step could lead to better postural muscle activation.http://link.springer.com/article/10.1186/s12984-018-0453-0ExoskeletonsSpinal cord injuryTrunk musclesEMG |
| spellingShingle | Raed A. Alamro Amanda E. Chisholm Alison M. M. Williams Mark G. Carpenter Tania Lam Overground walking with a robotic exoskeleton elicits trunk muscle activity in people with high-thoracic motor-complete spinal cord injury Journal of NeuroEngineering and Rehabilitation Exoskeletons Spinal cord injury Trunk muscles EMG |
| title | Overground walking with a robotic exoskeleton elicits trunk muscle activity in people with high-thoracic motor-complete spinal cord injury |
| title_full | Overground walking with a robotic exoskeleton elicits trunk muscle activity in people with high-thoracic motor-complete spinal cord injury |
| title_fullStr | Overground walking with a robotic exoskeleton elicits trunk muscle activity in people with high-thoracic motor-complete spinal cord injury |
| title_full_unstemmed | Overground walking with a robotic exoskeleton elicits trunk muscle activity in people with high-thoracic motor-complete spinal cord injury |
| title_short | Overground walking with a robotic exoskeleton elicits trunk muscle activity in people with high-thoracic motor-complete spinal cord injury |
| title_sort | overground walking with a robotic exoskeleton elicits trunk muscle activity in people with high thoracic motor complete spinal cord injury |
| topic | Exoskeletons Spinal cord injury Trunk muscles EMG |
| url | http://link.springer.com/article/10.1186/s12984-018-0453-0 |
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