Efectos a corto plazo del entrenamiento de la marcha en una órtesis robótica (Lokomat®) con retroalimentación auditiva en pacientes con lesión medular incompleta crónica

Abstract

IntroductionGait training on a robotic orthosis has shown good results in patients with chronic incomplete spinal cord injury (SCI). Auditory feedback in these patients can replace the information normally given by the sensory pathways. ObjectiveTo evaluate the effects of gait training on a robotic orthosis with auditory feedback in patients with chronic SCI. Material and methodsWe studied 31 patients with chronic incomplete SCI, who were randomized to 2 groups. Control group was trained on a robotic orthosis and experimental group received auditory feedback added to robotic orthosis training. Auditory feedback consisted on a metronome whose frequency was equal to gait cadence. The variables measured were spatiotemporal gait (by an instrumented mat), torque, spasticity, and range of motion in the hips and knees (by a robotic orthosis) before and after the assigned treatment. Calculation of variance, covariance and bivariate correlation were conducted for the analysis of results. ResultsWe found a statistically significant improvement in gait speed and cadence, range of motion, torque and spasticity in the experimental group and a positive and significant change in the use of assistive devices for walking. ConclusionsThe proposed program improved gait pattern in patients with chronic SCI. Further studies are needed to assess the persistence of these changes in the long-term, as well as the use of auditory feedback in other disorders.