To compare a walking reeducation program with robotic locomotor training plus overground therapy (LKOGT) to conventional overground training (OGT) in individuals with incomplete upper motor neuron (UMN) or lower motor neuron (LMN) injuries having either traumatic or nontraumatic nonprogressive etiology.
Randomized open controlled trial with blind evaluation by an independent observer.
An inpatient spinal cord injury rehabilitation center.
A total of 88 adults within 6 months of spinal cord injury onset (group A, 44 with UMN injury, and group B, 44 with LMN injury) were graded on the American Spinal Injury Association Impairment Scale as C or D. Each of these groups was then randomly allocated to conditions 1 or 2.
Condition 1: Subgroups A1 and B1 were treated with LKOGT for 60 minutes. Condition 2: Subgroups A2 and B2 received 60 minutes of conventional OGT 5 days per week for 8 weeks. Subjects with UMN and LMN were randomized into 2 training groups.
Main Outcome Measures
Ten-meter walk test and 6-minute walk test (6MWT). Walking Index for Spinal Cord Injury II, lower extremity motor score (LEMS), and the FIM-Locomotor were secondary outcome measures.
By using the LKOGT program compared with OGT, we found significant differences in the 6MWT for groups A1 and B1. LKOGT also provided higher scores than did OGT in secondary outcomes such as the LEMS and the FIM-Locomotor.
Robotic-assisted step training yielded better results in the 6MWT and the LEMS in patients with UMN and LMN.
List of abbreviations:BWSTT (body weight–supported treadmill training), CPG (central pattern generator), LEMS (lower extremity motor score), LKOGT (robotic locomotor training plus overground therapy), LMN (lower motor neuron), OGT (overground therapy), SCI (spinal cord injury), 6MWT (6-minute walk test), 10MWT (10-meter walk test), UMN (upper motor neuron)
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Published online: January 06, 2014
Supported by the Founding for Research of Castilla La Mancha (grant no. PI 2006-45).
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.