Improved motor performance in chronic spinal cord injury following upper-limb robotic training.
Publication/Presentation Date
1-1-2013
Abstract
BACKGROUND: Recovering upper-limb motor function has important implications for improving independence of patients with tetraplegia after traumatic spinal cord injury (SCI).
OBJECTIVE: To evaluate the feasibility, safety and effectiveness of robotic-assisted training of upper limb in a chronic SCI population.
METHODS: A total of 10 chronic tetraplegic SCI patients (C4 to C6 level of injury, American Spinal Injury Association Impairment Scale, A to D) participated in a 6-week wrist-robot training protocol (1 hour/day 3 times/week). The following outcome measures were recorded at baseline and after the robotic training: a) motor performance, assessed by robot-measured kinematics, b) corticospinal excitability measured by transcranial magnetic stimulation (TMS), and c) changes in clinical scales: motor strength (Upper extremity motor score), pain level (Visual Analog Scale) and spasticity (Modified Ashworth scale).
RESULTS: No adverse effects were observed during or after the robotic training. Statistically significant improvements were found in motor performance kinematics: aim (pre 1.17 ± 0.11 raduans, post 1.03 ± 0.08 raduans, p = 0.03) and smoothness of movement (pre 0.26 ± 0.03, post 0.31 ± 0.02, p = 0.03). These changes were not accompanied by changes in upper-extremity muscle strength or corticospinal excitability. No changes in pain or spasticity were found.
CONCLUSIONS: Robotic-assisted training of the upper limb over six weeks is a feasible and safe intervention that can enhance movement kinematics without negatively affecting pain or spasticity in chronic SCI. In addition, robot-assisted devices are an excellent tool to quantify motor performance (kinematics) and can be used to sensitively measure changes after a given rehabilitative intervention.
Volume
33
Issue
1
First Page
57
Last Page
65
ISSN
1878-6448
Published In/Presented At
Cortes, M., Elder, J., Rykman, A., Murray, L., Avedissian, M., Stampas, A., Thickbroom, G. W., Pascual-Leone, A., Krebs, H. I., Valls-Sole, J., & Edwards, D. J. (2013). Improved motor performance in chronic spinal cord injury following upper-limb robotic training. NeuroRehabilitation, 33(1), 57–65. https://doi.org/10.3233/NRE-130928
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
23949034
Department(s)
Administration and Leadership
Document Type
Article