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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Main Authors: Raed A. Alamro, Amanda E. Chisholm, Alison M. M. Williams, Mark G. Carpenter, Tania Lam
Format: Article
Language:English
Published: BMC 2018-11-01
Series:Journal of NeuroEngineering and Rehabilitation
Subjects:
EMG
Online Access:http://link.springer.com/article/10.1186/s12984-018-0453-0
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spelling doaj-4216e804c0774fc5be754c7f3c0fba2e2020-11-25T02:12:18ZengBMCJournal 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
collection DOAJ
language English
format Article
sources DOAJ
author Raed A. Alamro
Amanda E. Chisholm
Alison M. M. Williams
Mark G. Carpenter
Tania Lam
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
author_facet Raed A. Alamro
Amanda E. Chisholm
Alison M. M. Williams
Mark G. Carpenter
Tania Lam
author_sort Raed A. Alamro
title 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_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_sort overground walking with a robotic exoskeleton elicits trunk muscle activity in people with high-thoracic motor-complete spinal cord injury
publisher BMC
series Journal of NeuroEngineering and Rehabilitation
issn 1743-0003
publishDate 2018-11-01
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.
topic Exoskeletons
Spinal cord injury
Trunk muscles
EMG
url http://link.springer.com/article/10.1186/s12984-018-0453-0
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