Article

OBJECTIVE: To explore responses to overground bionic ambulation (OBA) training
from an interdisciplinary perspective including key components of neuromuscular
activation, exercise conditioning, mobility capacity, and neuropathic pain.
DESIGN: Case series. SETTING: Academic research center. PARTICIPANTS: Persons
(N=3; 2 men, 1 woman) aged 26 to 38 years with complete spinal cord injury (SCI)
(American Spinal Injury Association Impairment Scale grade A) between the levels
of T1 and T10 for >/=1 year. INTERVENTION: OBA 3d/wk for 6 weeks. MAIN OUTCOME
MEASURES: To obtain a comprehensive understanding of responses to OBA, an array
of measures were obtained while walking in the device, including walking speeds
and distances, energy expenditure, exercise conditioning effects, and
neuromuscular and cortical activity patterns. Changes in spasticity and pain
severity related to OBA use were also assessed. RESULTS: With training,
participants were able to achieve walking speeds and distances in the OBA device
similar to those observed in persons with motor-incomplete SCI (10-m walk speed,
.11-.33m/s; 2-min walk distance, 11-33m). The energy expenditure required for OBA
was similar to walking in persons without disability (ie, 25%-41% of peak oxygen
consumption). Subjects with lower soleus reflex excitability walked longer during
training, but there was no change in the level or amount of muscle activity with
training. There was no change in cortical activity patterns. Exercise
conditioning effects were small or nonexistent. However, all participants
reported an average reduction in pain severity over the study period ranging
between -1.3 and 1.7 on a 0-to-6 numeric rating scale. CONCLUSIONS: OBA training
improved mobility in the OBA device without significant changes in exercise
conditioning or in neuromuscular or cortical activity. However, pain severity was
reduced and no severe adverse events were encountered during training. OBA
therefore opens the possibility to reduce the common consequences of chronic,
complete SCI such as reduced functional mobility and neuropathic pain.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS