Effect of two different programs of robotic assisted gait training in individuals with chronic motor incomplete spinal cord injury

Abstract

Gait training is one of the main objectives in rehabilitation of motor incomplete spinal cord injury (SCI). There are different modalities of locomotion training, being the robotic orthosis among them, and offering until now, positive outcomes. However there is still a lack of evidence of the optimal training characteristics. To determine the effect of two different training programs with robotic gait orthosis for patients with chronic motor incomplete SCI. Study design: randomized, blinded to the observer, clinical trial. Patients from the National Institute of Rehabilitation (INR) with motor incomplete SCI, with at least 6 months of evolution and who were able to walk, were eligible. Patients were randomly assigned to either one of the two different training groups: 30 minutes or 60 minutes training group. Both groups received a training period of six weeks, five days a week. Assessments of gait pattern analysis with the GaitRite instrument, functional assessment with Spinal Cord Independence measure (SCIM), walking index for spinal cord injury (WISCI) and quality of life with life satisfaction questionnaire (Lisat-9); repeating such evaluations in a 6 and 12 months follow-up. In total, 12 participants were studied. After 30 training sessions with the robotic orthosis, both groups had significant improvements in gait as well as in SCIM, LISAT-9 and WISCI. No significant differences between groups were found. Robotic orthosis gait training has a positive effect improving gait pattern in incomplete SCI. Until now, there are no significant differences between a 30 minutes and a 60 minutes-training program.