Facilitating weight shifting during treadmill training improves walking function in humans with SCI: a randomized controlled pilot study

Objective To determine whether the integration of dynamic weight shifting into treadmill training would improve the efficacy of treadmill training in humans with spinal cord injury (SCI). Design Sixteen humans with SCI were randomly assigned to receive robotic or treadmill only training, and underwent 6 weeks of training. A force was applied to the pelvis for facilitating weight shifting and to the legs for assisting with leg swing for participants in the robotic group. No assistance force was applied for participants in the treadmill only group. Outcome measures consisted of overground walking speed, 6-minute walking distance, and other clinical measures, and were assessed pre, post 6 weeks of training, and 8 weeks after the end of training. Results A greater improvement in 6-minute walking distance was observed after robotic training than that after treadmill only training (p = 0.03), but there was not a significant difference between the two groups in improvements in walking speed. However, a greater improvement was observed for the participants who underwent robotic training than those who underwent treadmill only training (i.e., 15% vs. 2%). Conclusion Applying a pelvis assistance force for facilitating weight shifting during treadmill training may improve locomotor function in humans with SCI. Correspondence to: Ming Wu Ph.D., Legs and walking lab, Shirley Ryan Abilitylab, 355 East Erie Street, 23 floor, Chicago, IL, USA, 60611, E_mail: w-ming@Northwestern.edu Acknowledgement: This work is supported by the Davee Foundation, in partial by NIH (NIH/NICHD R01HD082216). We thank Dr. Sheng-Che Yen, Mrs. Jillian MacDonald, and Ms. Pooja Arora for their assistance during data collection. We thank Ms. Jill Landry for her suggestions and comments. Suppliers: GaitRite, CIR Systems Inc. 12 Cork Hill Road, Bldg #2, Franklin, NJ, 07416 Woodway, WOODWAY USA, Inc. W229 N591 Foster Ct., Waukesha, WI, 53186 Highlights: Humans with SCI underwent 6 weeks (3/week) of robotic or treadmill only training. Pelvis assistance was applied for facilitating weight shifting for robotic group. A greater improvement in endurance was obtained through robotic training. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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