Kinematic, Muscular, and Metabolic Responses During Exoskeletal-, Elliptical-, or Therapist-Assisted Stepping in People With Incomplete Spinal Cord Injury
Identifieur interne : 001690 ( Pmc/Checkpoint ); précédent : 001689; suivant : 001691Kinematic, Muscular, and Metabolic Responses During Exoskeletal-, Elliptical-, or Therapist-Assisted Stepping in People With Incomplete Spinal Cord Injury
Auteurs : T. George Hornby [États-Unis] ; Catherine R. Kinnaird ; Carey L. Holleran ; Miriam R. Rafferty ; Kelly S. Rodriguez ; Julie B. CainSource :
- Physical Therapy [ 0031-9023 ] ; 2012.
Abstract
Robotic-assisted locomotor training has demonstrated some efficacy in individuals with neurological injury and is slowly gaining clinical acceptance. Both exoskeletal devices, which control individual joint movements, and elliptical devices, which control endpoint trajectories, have been utilized with specific patient populations and are available commercially. No studies have directly compared training efficacy or patient performance during stepping between devices.
The purpose of this study was to evaluate kinematic, electromyographic (EMG), and metabolic responses during elliptical- and exoskeletal-assisted stepping in individuals with incomplete spinal cord injury (SCI) compared with therapist-assisted stepping.
A prospective, cross-sectional, repeated-measures design was used.
Participants with incomplete SCI (n=11) performed 3 separate bouts of exoskeletal-, elliptical-, or therapist-assisted stepping. Unilateral hip and knee sagittal-plane kinematics, lower-limb EMG recordings, and oxygen consumption were compared across stepping conditions and with control participants (n=10) during treadmill stepping.
Exoskeletal stepping kinematics closely approximated normal gait patterns, whereas significantly greater hip and knee flexion postures were observed during elliptical-assisted stepping. Measures of kinematic variability indicated consistent patterns in control participants and during exoskeletal-assisted stepping, whereas therapist- and elliptical-assisted stepping kinematics were more variable. Despite specific differences, EMG patterns generally were similar across stepping conditions in the participants with SCI. In contrast, oxygen consumption was consistently greater during therapist-assisted stepping.
Limitations included a small sample size, lack of ability to evaluate kinetics during stepping, unilateral EMG recordings, and sagittal-plane kinematics.
Despite specific differences in kinematics and EMG activity, metabolic activity was similar during stepping in each robotic device. Understanding potential differences and similarities in stepping performance with robotic assistance may be important in delivery of repeated locomotor training using robotic or therapist assistance and for consumers of robotic devices.
Url:
DOI: 10.2522/ptj.20110310
PubMed: 22700537
PubMed Central: 3925942
Affiliations:
Links toward previous steps (curation, corpus...)
Links to Exploration step
PMC:3925942Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Kinematic, Muscular, and Metabolic Responses During Exoskeletal-, Elliptical-, or Therapist-Assisted Stepping in People With Incomplete Spinal Cord Injury</title><author><name sortKey="Hornby, T George" sort="Hornby, T George" uniqKey="Hornby T" first="T. George" last="Hornby">T. George Hornby</name><affiliation wicri:level="2"><nlm:aff id="aff1">T.G. Hornby, PT, PhD, Department of Physical Therapy and Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois; Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, Illinois; and Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Mailing address: Department of Physical Therapy and Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W Taylor St, 4th Floor, M/C 898, Chicago, IL 60612 (USA).</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>T.G. Hornby, PT, PhD, Department of Physical Therapy and Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois; Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, Illinois; and Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Mailing address: Department of Physical Therapy and Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W Taylor St, 4th Floor, M/C 898, Chicago</wicri:cityArea></affiliation></author><author><name sortKey="Kinnaird, Catherine R" sort="Kinnaird, Catherine R" uniqKey="Kinnaird C" first="Catherine R." last="Kinnaird">Catherine R. Kinnaird</name><affiliation><nlm:aff id="aff2">C.R. Kinnaird, MS, Sensory Motor Performance Program, Rehabilitation Institute of Chicago.</nlm:aff><wicri:noCountry code="subfield">Rehabilitation Institute of Chicago.</wicri:noCountry></affiliation></author><author><name sortKey="Holleran, Carey L" sort="Holleran, Carey L" uniqKey="Holleran C" first="Carey L." last="Holleran">Carey L. Holleran</name><affiliation><nlm:aff id="aff3">C.L. Holleran, PT, NCS, Sensory Motor Performance Program, Rehabilitation Institute of Chicago.</nlm:aff><wicri:noCountry code="subfield">Rehabilitation Institute of Chicago.</wicri:noCountry></affiliation></author><author><name sortKey="Rafferty, Miriam R" sort="Rafferty, Miriam R" uniqKey="Rafferty M" first="Miriam R." last="Rafferty">Miriam R. Rafferty</name><affiliation><nlm:aff id="aff4">M.R. Rafferty, PT, NCS, Sensory Motor Performance Program, Rehabilitation Institute of Chicago.</nlm:aff><wicri:noCountry code="subfield">Rehabilitation Institute of Chicago.</wicri:noCountry></affiliation></author><author><name sortKey="Rodriguez, Kelly S" sort="Rodriguez, Kelly S" uniqKey="Rodriguez K" first="Kelly S." last="Rodriguez">Kelly S. Rodriguez</name><affiliation><nlm:aff id="aff5">K.S. Rodriguez, PT, NCS, Sensory Motor Performance Program, Rehabilitation Institute of Chicago.</nlm:aff><wicri:noCountry code="subfield">Rehabilitation Institute of Chicago.</wicri:noCountry></affiliation></author><author><name sortKey="Cain, Julie B" sort="Cain, Julie B" uniqKey="Cain J" first="Julie B." last="Cain">Julie B. Cain</name><affiliation><nlm:aff id="aff6">J.B. Cain, MS, Department of Physical Therapy and Department of Kinesiology and Nutrition, University of Illinois at Chicago, and Sensory Motor Performance Program, Rehabilitation Institute of Chicago.</nlm:aff><wicri:noCountry code="subfield">Rehabilitation Institute of Chicago.</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">22700537</idno><idno type="pmc">3925942</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3925942</idno><idno type="RBID">PMC:3925942</idno><idno type="doi">10.2522/ptj.20110310</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">001519</idno><idno type="wicri:Area/Pmc/Curation">001519</idno><idno type="wicri:Area/Pmc/Checkpoint">001690</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Kinematic, Muscular, and Metabolic Responses During Exoskeletal-, Elliptical-, or Therapist-Assisted Stepping in People With Incomplete Spinal Cord Injury</title><author><name sortKey="Hornby, T George" sort="Hornby, T George" uniqKey="Hornby T" first="T. George" last="Hornby">T. George Hornby</name><affiliation wicri:level="2"><nlm:aff id="aff1">T.G. Hornby, PT, PhD, Department of Physical Therapy and Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois; Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, Illinois; and Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Mailing address: Department of Physical Therapy and Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W Taylor St, 4th Floor, M/C 898, Chicago, IL 60612 (USA).</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Illinois</region></placeName><wicri:cityArea>T.G. Hornby, PT, PhD, Department of Physical Therapy and Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois; Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, Illinois; and Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Mailing address: Department of Physical Therapy and Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W Taylor St, 4th Floor, M/C 898, Chicago</wicri:cityArea></affiliation></author><author><name sortKey="Kinnaird, Catherine R" sort="Kinnaird, Catherine R" uniqKey="Kinnaird C" first="Catherine R." last="Kinnaird">Catherine R. Kinnaird</name><affiliation><nlm:aff id="aff2">C.R. Kinnaird, MS, Sensory Motor Performance Program, Rehabilitation Institute of Chicago.</nlm:aff><wicri:noCountry code="subfield">Rehabilitation Institute of Chicago.</wicri:noCountry></affiliation></author><author><name sortKey="Holleran, Carey L" sort="Holleran, Carey L" uniqKey="Holleran C" first="Carey L." last="Holleran">Carey L. Holleran</name><affiliation><nlm:aff id="aff3">C.L. Holleran, PT, NCS, Sensory Motor Performance Program, Rehabilitation Institute of Chicago.</nlm:aff><wicri:noCountry code="subfield">Rehabilitation Institute of Chicago.</wicri:noCountry></affiliation></author><author><name sortKey="Rafferty, Miriam R" sort="Rafferty, Miriam R" uniqKey="Rafferty M" first="Miriam R." last="Rafferty">Miriam R. Rafferty</name><affiliation><nlm:aff id="aff4">M.R. Rafferty, PT, NCS, Sensory Motor Performance Program, Rehabilitation Institute of Chicago.</nlm:aff><wicri:noCountry code="subfield">Rehabilitation Institute of Chicago.</wicri:noCountry></affiliation></author><author><name sortKey="Rodriguez, Kelly S" sort="Rodriguez, Kelly S" uniqKey="Rodriguez K" first="Kelly S." last="Rodriguez">Kelly S. Rodriguez</name><affiliation><nlm:aff id="aff5">K.S. Rodriguez, PT, NCS, Sensory Motor Performance Program, Rehabilitation Institute of Chicago.</nlm:aff><wicri:noCountry code="subfield">Rehabilitation Institute of Chicago.</wicri:noCountry></affiliation></author><author><name sortKey="Cain, Julie B" sort="Cain, Julie B" uniqKey="Cain J" first="Julie B." last="Cain">Julie B. Cain</name><affiliation><nlm:aff id="aff6">J.B. Cain, MS, Department of Physical Therapy and Department of Kinesiology and Nutrition, University of Illinois at Chicago, and Sensory Motor Performance Program, Rehabilitation Institute of Chicago.</nlm:aff><wicri:noCountry code="subfield">Rehabilitation Institute of Chicago.</wicri:noCountry></affiliation></author></analytic><series><title level="j">Physical Therapy</title><idno type="ISSN">0031-9023</idno><idno type="eISSN">1538-6724</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Robotic-assisted locomotor training has demonstrated some efficacy in individuals with neurological injury and is slowly gaining clinical acceptance. Both exoskeletal devices, which control individual joint movements, and elliptical devices, which control endpoint trajectories, have been utilized with specific patient populations and are available commercially. No studies have directly compared training efficacy or patient performance during stepping between devices.</p></sec><sec><title>Objective</title><p>The purpose of this study was to evaluate kinematic, electromyographic (EMG), and metabolic responses during elliptical- and exoskeletal-assisted stepping in individuals with incomplete spinal cord injury (SCI) compared with therapist-assisted stepping.</p></sec><sec><title>Design</title><p>A prospective, cross-sectional, repeated-measures design was used.</p></sec><sec><title>Methods</title><p>Participants with incomplete SCI (n=11) performed 3 separate bouts of exoskeletal-, elliptical-, or therapist-assisted stepping. Unilateral hip and knee sagittal-plane kinematics, lower-limb EMG recordings, and oxygen consumption were compared across stepping conditions and with control participants (n=10) during treadmill stepping.</p></sec><sec><title>Results</title><p>Exoskeletal stepping kinematics closely approximated normal gait patterns, whereas significantly greater hip and knee flexion postures were observed during elliptical-assisted stepping. Measures of kinematic variability indicated consistent patterns in control participants and during exoskeletal-assisted stepping, whereas therapist- and elliptical-assisted stepping kinematics were more variable. Despite specific differences, EMG patterns generally were similar across stepping conditions in the participants with SCI. In contrast, oxygen consumption was consistently greater during therapist-assisted stepping.</p></sec><sec><title>Limitations</title><p>Limitations included a small sample size, lack of ability to evaluate kinetics during stepping, unilateral EMG recordings, and sagittal-plane kinematics.</p></sec><sec><title>Conclusions</title><p>Despite specific differences in kinematics and EMG activity, metabolic activity was similar during stepping in each robotic device. Understanding potential differences and similarities in stepping performance with robotic assistance may be important in delivery of repeated locomotor training using robotic or therapist assistance and for consumers of robotic devices.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Phys Ther</journal-id><journal-id journal-id-type="iso-abbrev">Phys Ther</journal-id><journal-id journal-id-type="hwp">ptjournal</journal-id><journal-id journal-id-type="pmc">ptjournal</journal-id><journal-id journal-id-type="publisher-id">PTJOURNAL</journal-id><journal-title-group><journal-title>Physical Therapy</journal-title></journal-title-group><issn pub-type="ppub">0031-9023</issn><issn pub-type="epub">1538-6724</issn><publisher><publisher-name>American Physical Therapy Association</publisher-name><publisher-loc>Alexandria, VA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22700537</article-id><article-id pub-id-type="pmc">3925942</article-id><article-id pub-id-type="publisher-id">2011-0310</article-id><article-id pub-id-type="doi">10.2522/ptj.20110310</article-id><article-categories><subj-group subj-group-type="hwp-journal-coll"><subject>1301</subject><subject>1306</subject><subject>1312</subject><subject>1403</subject><subject>1404</subject><subject>1512</subject></subj-group><subj-group subj-group-type="heading"><subject>Research Reports</subject></subj-group></article-categories><title-group><article-title>Kinematic, Muscular, and Metabolic Responses During Exoskeletal-, Elliptical-, or Therapist-Assisted Stepping in People With Incomplete Spinal Cord Injury</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Hornby</surname><given-names>T. George</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Kinnaird</surname><given-names>Catherine R.</given-names></name><xref ref-type="aff" rid="aff2"></xref></contrib><contrib contrib-type="author"><name><surname>Holleran</surname><given-names>Carey L.</given-names></name><xref ref-type="aff" rid="aff3"></xref></contrib><contrib contrib-type="author"><name><surname>Rafferty</surname><given-names>Miriam R.</given-names></name><xref ref-type="aff" rid="aff4"></xref></contrib><contrib contrib-type="author"><name><surname>Rodriguez</surname><given-names>Kelly S.</given-names></name><xref ref-type="aff" rid="aff5"></xref></contrib><contrib contrib-type="author"><name><surname>Cain</surname><given-names>Julie B.</given-names></name><xref ref-type="aff" rid="aff6"></xref></contrib><aff id="aff1">T.G. Hornby, PT, PhD, Department of Physical Therapy and Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois; Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, Illinois; and Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Mailing address: Department of Physical Therapy and Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W Taylor St, 4th Floor, M/C 898, Chicago, IL 60612 (USA).</aff><aff id="aff2">C.R. Kinnaird, MS, Sensory Motor Performance Program, Rehabilitation Institute of Chicago.</aff><aff id="aff3">C.L. Holleran, PT, NCS, Sensory Motor Performance Program, Rehabilitation Institute of Chicago.</aff><aff id="aff4">M.R. Rafferty, PT, NCS, Sensory Motor Performance Program, Rehabilitation Institute of Chicago.</aff><aff id="aff5">K.S. Rodriguez, PT, NCS, Sensory Motor Performance Program, Rehabilitation Institute of Chicago.</aff><aff id="aff6">J.B. Cain, MS, Department of Physical Therapy and Department of Kinesiology and Nutrition, University of Illinois at Chicago, and Sensory Motor Performance Program, Rehabilitation Institute of Chicago.</aff></contrib-group><author-notes><corresp>Address all correspondence to Dr Hornby at: <email>tgh@uic.edu</email>.</corresp></author-notes><pub-date pub-type="ppub"><month>10</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>14</day><month>6</month><year>2012</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>4</month><year>2013</year></pub-date><pmc-comment> PMC Release delay is 6 months and
0 days and was based on the
<volume>92</volume><issue>10</issue><fpage>1278</fpage><lpage>1291</lpage><history><date date-type="received"><day>18</day><month>9</month><year>2011</year></date><date date-type="accepted"><day>5</day><month>6</month><year>2012</year></date></history><permissions><copyright-statement>© 2012 American Physical Therapy Association</copyright-statement><copyright-year>2012</copyright-year></permissions><self-uri xlink:title="pdf" xlink:type="simple" xlink:href="zad01012001278.pdf"></self-uri><abstract><sec><title>Background</title><p>Robotic-assisted locomotor training has demonstrated some efficacy in individuals with neurological injury and is slowly gaining clinical acceptance. Both exoskeletal devices, which control individual joint movements, and elliptical devices, which control endpoint trajectories, have been utilized with specific patient populations and are available commercially. No studies have directly compared training efficacy or patient performance during stepping between devices.</p></sec><sec><title>Objective</title><p>The purpose of this study was to evaluate kinematic, electromyographic (EMG), and metabolic responses during elliptical- and exoskeletal-assisted stepping in individuals with incomplete spinal cord injury (SCI) compared with therapist-assisted stepping.</p></sec><sec><title>Design</title><p>A prospective, cross-sectional, repeated-measures design was used.</p></sec><sec><title>Methods</title><p>Participants with incomplete SCI (n=11) performed 3 separate bouts of exoskeletal-, elliptical-, or therapist-assisted stepping. Unilateral hip and knee sagittal-plane kinematics, lower-limb EMG recordings, and oxygen consumption were compared across stepping conditions and with control participants (n=10) during treadmill stepping.</p></sec><sec><title>Results</title><p>Exoskeletal stepping kinematics closely approximated normal gait patterns, whereas significantly greater hip and knee flexion postures were observed during elliptical-assisted stepping. Measures of kinematic variability indicated consistent patterns in control participants and during exoskeletal-assisted stepping, whereas therapist- and elliptical-assisted stepping kinematics were more variable. Despite specific differences, EMG patterns generally were similar across stepping conditions in the participants with SCI. In contrast, oxygen consumption was consistently greater during therapist-assisted stepping.</p></sec><sec><title>Limitations</title><p>Limitations included a small sample size, lack of ability to evaluate kinetics during stepping, unilateral EMG recordings, and sagittal-plane kinematics.</p></sec><sec><title>Conclusions</title><p>Despite specific differences in kinematics and EMG activity, metabolic activity was similar during stepping in each robotic device. Understanding potential differences and similarities in stepping performance with robotic assistance may be important in delivery of repeated locomotor training using robotic or therapist assistance and for consumers of robotic devices.</p></sec></abstract></article-meta></front></pmc><affiliations><list><country><li>États-Unis</li></country><region><li>Illinois</li></region></list><tree><noCountry><name sortKey="Cain, Julie B" sort="Cain, Julie B" uniqKey="Cain J" first="Julie B." last="Cain">Julie B. Cain</name><name sortKey="Holleran, Carey L" sort="Holleran, Carey L" uniqKey="Holleran C" first="Carey L." last="Holleran">Carey L. Holleran</name><name sortKey="Kinnaird, Catherine R" sort="Kinnaird, Catherine R" uniqKey="Kinnaird C" first="Catherine R." last="Kinnaird">Catherine R. Kinnaird</name><name sortKey="Rafferty, Miriam R" sort="Rafferty, Miriam R" uniqKey="Rafferty M" first="Miriam R." last="Rafferty">Miriam R. Rafferty</name><name sortKey="Rodriguez, Kelly S" sort="Rodriguez, Kelly S" uniqKey="Rodriguez K" first="Kelly S." last="Rodriguez">Kelly S. Rodriguez</name></noCountry><country name="États-Unis"><region name="Illinois"><name sortKey="Hornby, T George" sort="Hornby, T George" uniqKey="Hornby T" first="T. George" last="Hornby">T. George Hornby</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Ticri/CIDE/explor/HapticV1/Data/Pmc/Checkpoint
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001690 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Checkpoint/biblio.hfd -nk 001690 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Ticri/CIDE
|area= HapticV1
|flux= Pmc
|étape= Checkpoint
|type= RBID
|clé= PMC:3925942
|texte= Kinematic, Muscular, and Metabolic Responses During Exoskeletal-, Elliptical-, or Therapist-Assisted Stepping in People With Incomplete Spinal Cord Injury
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Checkpoint/RBID.i -Sk "pubmed:22700537" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Checkpoint/biblio.hfd \
| NlmPubMed2Wicri -a HapticV1
| This area was generated with Dilib version V0.6.23. |  |