Dosing of Overground Robotic Gait Training with Functional Outcomes and Neuroplasticity After Spinal Cord Injury
Baylor Research Institute
Summary
The DOOR SCI project examines dosing effects of robotic gait training (RGT) and transcranial magnetic stimulation (TMS) initiated during inpatient rehabilitation and continued through early outpatient rehabilitation
Description
Emerging evidence indicates that robotic exoskeleton use results in positive outcomes for those with chronic SCI, yet limited evidence exists for the acute setting. The potential benefit of RGT initiated during inpatient rehabilitation when recovery is greatest is unknown yet appears promising due to established principles of neuroplasticity and the fact that RGT incorporates the critical components of gait training. As a result of the lack of evidence, no clinical practice guidelines exist that delineate which gait retraining approach or dose during early phases of recovery results in the bes…
Eligibility
- Age range
- 16–85 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * All types of motor incomplete SCI (traumatic and non-traumatic) * Acute/Subacute phase of recovery * Medically stable as deemed by physician * Undergoing medical care and rehabilitation at Baylor Scott \& White Institute for Rehabilitation * Both genders and all races and ethnicities * Meet the Ekso robotic exoskeleton frame limitations * Continence of or a program for bladder and bowel management Exclusion Criteria: * Concurrent moderate to severe traumatic brain injury (TBI) * Degenerative diagnoses * Pre-morbid developmental disability, significant psychological…
Interventions
- DeviceRobotic Gait Training
Subjects will be randomized to one of 4 gait training group. The duration of treatment will span across their inpatient rehabilitation length of stay after providing informed consent to their 9 months post-SCI visit in the outpatient rehabilitation setting. Subjects will wear an exoskeleton device and receive robotic gait training (RGT) with a physical therapist during a 45-minutes inpatient rehabilitation session. Subjects will complete 24 robotic gait training sessions over different durations during outpatient rehabilitation. Subjects will also complete a transcranial magnetic stimulation (TMS) assessment and questionnaires about walking and function. Subjects will be asked to wear an activity monitor to measure their activity.
- OtherUsual Care (UC) Gait Training
Subjects will be randomized to one of 4 gait training group. The duration of treatment will span across their inpatient rehabilitation length of stay after providing informed consent to their 9 months post-SCI visit in the outpatient rehabilitation setting. Subjects will complete gait training with a physical therapist during a 45-minutes inpatient rehabilitation session. Subjects will also complete a transcranial magnetic stimulation (TMS) assessment and questionnaires about walking and function. Subjects will be asked to wear an activity monitor to measure their activity.
Location
- Baylor Scott & White Institute for RehabilitationDallas, Texas