Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people
Abstract Background Gait disorders are major symptoms of neurological diseases affecting the quality of life. Interventions that restore walking and allow patients to maintain safe and independent mobility are essential. Robot-assisted gait training (RAGT) proved to be a promising treatment for rest...
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doaj-8037cf26d94b4ae58f2485bbd5c2f3b22020-12-27T12:08:01ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032019-12-0116111310.1186/s12984-019-0636-3Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy peopleAlisa Berger0Fabian Horst1Fabian Steinberg2Fabian Thomas3Claudia Müller-Eising4Wolfgang I. Schöllhorn5Michael Doppelmayr6Department of Sport Psychology, Institute of Sport Science, Johannes Gutenberg-University MainzDepartment of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University MainzDepartment of Sport Psychology, Institute of Sport Science, Johannes Gutenberg-University MainzDepartment of Sport Psychology, Institute of Sport Science, Johannes Gutenberg-University MainzCenter of Neurorehabilitation neuroneumDepartment of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University MainzDepartment of Sport Psychology, Institute of Sport Science, Johannes Gutenberg-University MainzAbstract Background Gait disorders are major symptoms of neurological diseases affecting the quality of life. Interventions that restore walking and allow patients to maintain safe and independent mobility are essential. Robot-assisted gait training (RAGT) proved to be a promising treatment for restoring and improving the ability to walk. Due to heterogenuous study designs and fragmentary knowlegde about the neural correlates associated with RAGT and the relation to motor recovery, guidelines for an individually optimized therapy can hardly be derived. To optimize robotic rehabilitation, it is crucial to understand how robotic assistance affect locomotor control and its underlying brain activity. Thus, this study aimed to investigate the effects of robotic assistance (RA) during treadmill walking (TW) on cortical activity and the relationship between RA-related changes of cortical activity and biomechanical gait characteristics. Methods Twelve healthy, right-handed volunteers (9 females; M = 25 ± 4 years) performed unassisted walking (UAW) and robot-assisted walking (RAW) trials on a treadmill, at 2.8 km/h, in a randomized, within-subject design. Ground reaction forces (GRFs) provided information regarding the individual gait patterns, while brain activity was examined by measuring cerebral hemodynamic changes in brain regions associated with the cortical locomotor network, including the sensorimotor cortex (SMC), premotor cortex (PMC) and supplementary motor area (SMA), using functional near-infrared spectroscopy (fNIRS). Results A statistically significant increase in brain activity was observed in the SMC compared with the PMC and SMA (p < 0.05), and a classical double bump in the vertical GRF was observed during both UAW and RAW throughout the stance phase. However, intraindividual gait variability increased significantly with RA and was correlated with increased brain activity in the SMC (p = 0.05; r = 0.57). Conclusions On the one hand, robotic guidance could generate sensory feedback that promotes active participation, leading to increased gait variability and somatosensory brain activity. On the other hand, changes in brain activity and biomechanical gait characteristics may also be due to the sensory feedback of the robot, which disrupts the cortical network of automated walking in healthy individuals. More comprehensive neurophysiological studies both in laboratory and in clinical settings are necessary to investigate the entire brain network associated with RAW.https://doi.org/10.1186/s12984-019-0636-3WalkingGait variabilityGRFBrain activityNeuroimagingFunctional near-infrared spectroscopy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Alisa Berger Fabian Horst Fabian Steinberg Fabian Thomas Claudia Müller-Eising Wolfgang I. Schöllhorn Michael Doppelmayr |
spellingShingle |
Alisa Berger Fabian Horst Fabian Steinberg Fabian Thomas Claudia Müller-Eising Wolfgang I. Schöllhorn Michael Doppelmayr Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people Journal of NeuroEngineering and Rehabilitation Walking Gait variability GRF Brain activity Neuroimaging Functional near-infrared spectroscopy |
author_facet |
Alisa Berger Fabian Horst Fabian Steinberg Fabian Thomas Claudia Müller-Eising Wolfgang I. Schöllhorn Michael Doppelmayr |
author_sort |
Alisa Berger |
title |
Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people |
title_short |
Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people |
title_full |
Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people |
title_fullStr |
Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people |
title_full_unstemmed |
Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people |
title_sort |
increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people |
publisher |
BMC |
series |
Journal of NeuroEngineering and Rehabilitation |
issn |
1743-0003 |
publishDate |
2019-12-01 |
description |
Abstract Background Gait disorders are major symptoms of neurological diseases affecting the quality of life. Interventions that restore walking and allow patients to maintain safe and independent mobility are essential. Robot-assisted gait training (RAGT) proved to be a promising treatment for restoring and improving the ability to walk. Due to heterogenuous study designs and fragmentary knowlegde about the neural correlates associated with RAGT and the relation to motor recovery, guidelines for an individually optimized therapy can hardly be derived. To optimize robotic rehabilitation, it is crucial to understand how robotic assistance affect locomotor control and its underlying brain activity. Thus, this study aimed to investigate the effects of robotic assistance (RA) during treadmill walking (TW) on cortical activity and the relationship between RA-related changes of cortical activity and biomechanical gait characteristics. Methods Twelve healthy, right-handed volunteers (9 females; M = 25 ± 4 years) performed unassisted walking (UAW) and robot-assisted walking (RAW) trials on a treadmill, at 2.8 km/h, in a randomized, within-subject design. Ground reaction forces (GRFs) provided information regarding the individual gait patterns, while brain activity was examined by measuring cerebral hemodynamic changes in brain regions associated with the cortical locomotor network, including the sensorimotor cortex (SMC), premotor cortex (PMC) and supplementary motor area (SMA), using functional near-infrared spectroscopy (fNIRS). Results A statistically significant increase in brain activity was observed in the SMC compared with the PMC and SMA (p < 0.05), and a classical double bump in the vertical GRF was observed during both UAW and RAW throughout the stance phase. However, intraindividual gait variability increased significantly with RA and was correlated with increased brain activity in the SMC (p = 0.05; r = 0.57). Conclusions On the one hand, robotic guidance could generate sensory feedback that promotes active participation, leading to increased gait variability and somatosensory brain activity. On the other hand, changes in brain activity and biomechanical gait characteristics may also be due to the sensory feedback of the robot, which disrupts the cortical network of automated walking in healthy individuals. More comprehensive neurophysiological studies both in laboratory and in clinical settings are necessary to investigate the entire brain network associated with RAW. |
topic |
Walking Gait variability GRF Brain activity Neuroimaging Functional near-infrared spectroscopy |
url |
https://doi.org/10.1186/s12984-019-0636-3 |
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