O106 / #796 FEASIBILITY OF TRANSCUTANEOUS SPINAL CORD STIMULATION COMBINED WITH ROBOTIC-ASSISTED GAIT TRAINING (LOKOMAT) FOR GAIT REHABILITATION FOLLOWING INCOMPLETE SPINAL CORD INJURY. A CASE SERIES STUDY

Transcutaneous electrical spinal cord stimulation (tSCS) is a non-invasive technique for neuromodulation with therapeutic potential for motor rehabilitation following spinal cord injury (SCI). The aim of the present study was to analyze the feasibility of a program of 20 sessions of 30-Hz tSCS combined with robotic-assisted gait training in incomplete SCI. The results of the present work partially belong to a randomized clinical trial that is in progress

Cinemática del movimiento del miembro superior durante una tarea funcional realizada en entorno virtual y entorno físico real en población sana y con lesión medular cervical

Hay un interés creciente en nuevas terapias por medio de tecnología, como la Realidad Virtual (RV). La RV ofrece un gran potencial para mejorar la función motora de miembro superior (MS) en paciente neurológicos. No obstante, se desconoce acerca de las características de los patrones de movimiento ejecutados en entornos virtuales en contexto rehabilitador. Por ello, este estudio analiza las características cinemáticas de los movimientos de MS durante la ejecución de una tarea funcional, el test clínico Box and Block (BBT), en pacientes con lesión medular (LM) cervical y en población sana en entornos virtuales inmersivos (3D), no inmersivos (2D) y en el entorno físico real. El análisis principal se centra en comparar la cinemática de los pacientes con la de los sujetos sanos para conocer la funcionalidad global del MS durante la ejecución del BBT en los tres entornos de experimentación. Para ello se estudian medidas relativas al desempeño de la tarea y medidas relativas al patrón de movimiento. Finalmente, existen diferencias entre los patrones cinemáticos ejecutados en el BBT de entorno real y los de RV. En ambas poblaciones existen diferencias en los rangos de movimiento (ROM) articular de codo y muñeca. En pacientes con LM, además, varían el ROM de hombro y el desplazamiento de tronco. En ambos grupos, la velocidad y suavidad disminuyen en entornos de RV respecto al entorno físico real. La longitud de trayectoria aumenta en sanos en el entorno de RV 3D, mientras que, en el caso de pacientes con LM, disminuye.Proyecto REHAB-IMMERSIVE PID2020-117361RB-C22 financiado por MCIN/AEI/10.13039/501100011033

Lokomat robotic-assisted versus overground training within 3 to 6 months of incomplete spinal cord lesion: randomized controlled trial

About 75% of persons with ASIA (American Spinal Injury Association) Impairment Scale C and D incomplete spinal cord injury (SCI) achieve walking ability. Our objective was to compare a walking reeducation program using Lokomat with conventional overground4.278 JCR (2012) Q1, 30/191 Clinical neurology, 2/63 RehabilitationUE

A comparison of robotic walking therapy and conventional walking therapy in individuals with upper versus lower motor neuron lesions: A randomized controlled trial

To compare a walking reeducation program with robotic locomotor training plus overground therapy (LKOGT) to conventional overground training (OGT) in individuals with incomplete upper motor neuron (UMN) or lower motor neuron (LMN) injuries having either traumatic or nontraumatic nonprogressive etiology.2.565 JCR (2014) Q1, 7/64 Rehabilitation, 14/81 Sport sciencesUE

Lokomat Robotic-Assisted Versus Overground Training Within 3 to 6 Months of Incomplete Spinal Cord Lesion

About 75% of persons with ASIA (American Spinal Injury Association) Impairment Scale C and D incomplete spinal cord injury (SCI) achieve walking ability. Our objective was to compare a walking reeducation program using Lokomat with conventional overground4.278 JCR (2012) Q1, 30/191 Clinical neurology, 2/63 RehabilitationUE

Transcranial direct current stimulation combined with robotic therapy for upper and lower limb function after stroke: a systematic review and meta-analysis of randomized control trials

Background: Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation method able to modulate neuronal activity after stroke. The aim of this systematic review was to determine if tDCS combined with robotic therapy (RT) improves limb function after stroke when compared to RT alone. Methods: A search for randomized controlled trials (RCTs) published prior to July 15, 2021 was performed. The main outcome was function assessed with the Fugl-Meyer motor assessment for upper extremities (FM/ue) and 10-m walking test (10MWT) for the lower limbs. As secondary outcomes, strength was assessed with the Motricity Index (MI) or Medical Research Council scale (MRC), spasticity with the modified Ashworth scale (MAS), functional independence with the Barthel Index (BI), and kinematic parameters. Results: Ten studies were included for analysis (n = 368 enrolled participants). The results showed a non-significant effect for tDCS combined with RT to improve upper limb function [standardized mean difference (SMD) = − 0.12; 95% confidence interval (CI): − 0.35–0.11)]. However, a positive effect of the combined therapy was observed in the lower limb function (SMD = 0.48; 95% CI: − 0.15–1.12). Significant results favouring tDCS combined with RT were not found in strength (SMD = − 0.15; 95% CI: − 0.4–0.1), spasticity [mean difference (MD) = − 0.15; 95% CI: − 0.8–0.5)], functional independence (MD = 2.5; 95% CI: − 1.9–6.9) or velocity of movement (SMD = 0.06; 95% CI: − 0.3–0.5) with a “moderate” or “low” recommendation level according to the GRADE guidelines. Conclusions: Current findings suggest that tDCS combined with RT does not improve upper limb function, strength, spasticity, functional independence or velocity of movement after stroke. However, tDCS may enhance the effects of RT alone for lower limb function. tDCS parameters and the stage or type of stroke injury could be crucial factors that determine the effectiveness of this therapy.This was supported by the Ministerio de Economía, Industria y Competitividad. RECODE project [Grant number: DPI2017‑91117‑EXP]; and by Junta de Comunidades de Castilla la Mancha and Fondo Europeo de Desarrollo Regional (Fondos FEDER). EXO‑STIM Project [Grant number: SBPLY/19/180501/000316]