Abstract
Objective
To explore responses to overground bionic ambulation (OBA) training from an interdisciplinary
perspective including key components of neuromuscular activation, exercise conditioning,
mobility capacity, and neuropathic pain.
Design
Case series.
Setting
Academic research center.
Participants
Persons (N=3; 2 men, 1 woman) aged 26 to 38 years with complete spinal cord injury
(SCI) (American Spinal Injury Association Impairment Scale grade A) between the levels
of T1 and T10 for ≥1 year.
Intervention
OBA 3d/wk for 6 weeks.
Main Outcome Measures
To obtain a comprehensive understanding of responses to OBA, an array of measures
were obtained while walking in the device, including walking speeds and distances,
energy expenditure, exercise conditioning effects, and neuromuscular and cortical
activity patterns. Changes in spasticity and pain severity related to OBA use were
also assessed.
Results
With training, participants were able to achieve walking speeds and distances in the
OBA device similar to those observed in persons with motor-incomplete SCI (10-m walk
speed, .11–.33m/s; 2-min walk distance, 11–33m). The energy expenditure required for
OBA was similar to walking in persons without disability (ie, 25%–41% of peak oxygen
consumption). Subjects with lower soleus reflex excitability walked longer during
training, but there was no change in the level or amount of muscle activity with training.
There was no change in cortical activity patterns. Exercise conditioning effects were
small or nonexistent. However, all participants reported an average reduction in pain
severity over the study period ranging between −1.3 and 1.7 on a 0-to-6 numeric rating
scale.
Conclusions
OBA training improved mobility in the OBA device without significant changes in exercise
conditioning or in neuromuscular or cortical activity. However, pain severity was
reduced and no severe adverse events were encountered during training. OBA therefore
opens the possibility to reduce the common consequences of chronic, complete SCI such
as reduced functional mobility and neuropathic pain.
Keywords
List of abbreviations:
EEG (electroencephalography), MG (medial gastrocnemius), MVC (maximal voluntary contraction), NRS (numeric rating scale), OBA (overground bionic ambulation), SCI (spinal cord injury), TEE (total energy expenditure), Vo2peak (peak oxygen consumption)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 17, 2014
Footnotes
Disclosures: none.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
