Robot-assisted training with functional electrical stimulation enhances lower extremity function after spinal cord...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Functional electrical stimulation (FES) synchronized with robot-assisted lower extremity training is a key intervention in spinal cord injury (SCI) rehabilitation.
• This approach aims to enhance and promote the recovery of residual motor functions in individuals with SCI.

Purpose of the Study:

• To evaluate the effectiveness of robot-assisted training with FES in improving muscle strength and voluntary muscle function in the lower limbs of SCI patients.
• To determine the correlation between FES-assisted force improvements and voluntary muscle activation.

Main Methods:

• Retrospective analysis of data from 72 SCI inpatients undergoing lower limb mobilization on a stationary robotic system.
• Primary outcome: improvement in muscle strength (flexion and extension) during FES-assisted and voluntary movements.
• Secondary outcome: change in the sum score of voluntary muscle function in the lower limbs.

Main Results:

• Significant increases in FES-assisted and voluntary muscle strength for both extension and flexion were observed (p < 0.001 for extension, p < 0.006 for flexion).
• Strong correlations were found between increased FES-assisted force and improvements in voluntary flexion (r=0.730, p=0.001) and extension (r=0.881, p<0.001).
• The sum score of voluntary muscle function significantly increased from 15 to 24 points.

Conclusions:

• Robot-assisted training integrated with FES demonstrates efficacy in supporting the regeneration of residual functions post-SCI.
• The observed improvements in motor function and lower limb strength indicate the potential of this combined therapeutic approach.