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

doi:10.3233/NRE-151291

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 journal › Article › peer-review

45 Scopus citations

Abstract

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 language	English
Pages (from-to)	15-25
Number of pages	11
Journal	NeuroRehabilitation
Volume	38
Issue number	1
DOIs	https://doi.org/10.3233/NRE-151291
State	Published - 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.

Keywords

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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10.3233/NRE-151291

Cite this

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

abstract = "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.",

keywords = "Lower extremity, motor function, neuroplasticity, transcranial direct current stimulation, treadmill training",

author = "Ravi Raithatha and Cheryl Carrico and Powell, {Elizabeth Salmon} and Westgate, {Philip M.} and Chelette, {Kenneth C.} and Kara Lee and Laura Dunsmore and Sara Salles and Lumy Sawaki",

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{\textquoteright}s fourth Spinal Cord Symposium: August 2010; Phoenix, AZ. There are no conflicts of interest related to this research or this manuscript. Publisher Copyright: {\textcopyright} 2016 - IOS Press and the authors. All rights reserved.",

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AU - Westgate, Philip M.

AU - Chelette, Kenneth C.

AU - Lee, Kara

AU - Dunsmore, Laura

AU - Salles, Sara

AU - Sawaki, Lumy

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PY - 2016/2/10

Y1 - 2016/2/10

N2 - 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.

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

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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