Non-invasive brain stimulation and robot-assisted gait training after incomplete spinal cord injury: A randomized pilot study

Ravi Raithatha, Cheryl Carrico, Elizabeth Salmon Powell, Philip M. Westgate, Kenneth C. Chelette, Kara Lee, Laura Dunsmore, Sara Salles, Lumy Sawaki

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


BACKGROUND: Locomotor training with a robot-assisted gait orthosis (LT-RGO) and transcranial direct current stimulation (tDCS) are interventions that can significantly enhance motor performance after spinal cord injury (SCI). No studies have investigated whether combining these interventions enhances lower extremity motor function following SCI. OBJECTIVE: Determine whether active tDCS paired with LT-RGO improves lower extremity motor function more than a sham condition, in subjects with motor incomplete SCI. METHODS: Fifteen adults with SCI received 36 sessions of either active (n=9) or sham (n=6) tDCS (20 minutes) preceding LT-RGO (1 hour). Outcome measures included manual muscle testing (MMT; primary outcome measure); 6-Minute Walk Test (6MinWT); 10-Meter Walk Test (10MWT); Timed Up and Go Test (TUG); Berg Balance Scale (BBS); and Spinal Cord Independence Measure-III (SCIM-III). RESULTS: MMT showed significant improvements after active tDCS, with the most pronounced improvement in the right lower extremity. 10MWT, 6MinWT, and BBS showed improvement for both groups. TUG and SCIM-III showed improvement only for the sham tDCS group. CONCLUSION: Pairing tDCS with LT-RGO can improve lower extremity motor function more than LT-RGO alone. Future research with a larger sample size is recommended to determine longer-term effects on motor function and activities of daily living.

Original languageEnglish
Pages (from-to)15-25
Number of pages11
Issue number1
StatePublished - Feb 10 2016

Bibliographical note

Funding Information:
Sincere appreciation is extended to the study participants as well as to Lisa Bailey for assistance with this study. This study was funded by Christopher and Dana Reeve Foundation (SAC1-1001-2) and the Cardinal Hill Stroke and Spinal Cord Endowment (1215375670). There are no financial benefits to the authors. Partial results of this study were first presented in poster form at Reeve Foundation’s fourth Spinal Cord Symposium: August 2010; Phoenix, AZ. There are no conflicts of interest related to this research or this manuscript.

Publisher Copyright:
© 2016 - IOS Press and the authors. All rights reserved.


  • Lower extremity
  • motor function
  • neuroplasticity
  • transcranial direct current stimulation
  • treadmill training

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology


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