Neuro-Locomotion Projects
Current projects investigating locomotor recovery following neurological injury using body-weight supported treadmill training with manual or robotic assistance.
1) Case series on the use of robotic assistance during treadmill training in the subacute stages following spinal cord injury and stroke.
Currently looking for subjects in the Chicago area who fit the below criteria and can attend training session for maximum of 16 weeks (but possibly less). We are looking for clues on the best ways to use robotic vs. manual assistance with body weight supported treadmill training vs. conventional overground ambulation training (who is appropriate, when to transition them from one stage to another, when to stop). Answers to this question will be provided in the next study as well.
2) Patients with sub-acute spinal cord injury (up to 6 months post-injury) - randomization into control (conventional therapy) group, manual-assisted treadmill training group vs. Lokomat training group (2 grants recently funded, one multi-center trial in works).
Research project starts in January. All patients randomized into the conventional therapy group will be offered Lokomat training following cessation of conventional therapy training.
3) Patients with sub-acute stroke (between 1 and 4 months post-injury) randomized into conventional rehabilitation and Lokomat with biofeedback - funded.
Trial starts when biofeedback apparatus is instrumented onto Lokomat (fall 2003).
4) Patients with sub-acute spinal cord injury (up to one year post-injury) using different pharmacological or physical (afferent) interventions in combination with locomotor training (two grants submitted).
Inclusion criteria for SCI patients are as follows:
- a history of SCI (C1-T11)
- classification on the ASIA Impairment Scale with grades of C or D, indicating motor incomplete SCI
- lower extremity range of motion to maintain the ankle at 900 (neutral) dorsiflexion, knee flexion from 0 to 90 degrees, and hip flexion from 10 degrees extension to 90 flexion
- stand or walk as part of ADLs. (different in subacute vs. chronic studies)
- between the ages of 16-65 yrs (flexible lower limit, will include all who fit in Lokomat)
Inclusion criteria for stroke patients:
- history of recent cerebrovascular accident (within 6 mos) resulting in hemiplegia
- stand or walk as part of ADLs
- lower extremity range of motion as described above
- between ages of 16-65 yrs
Exclusion criteria include:
- presence of concurrent severe medical illness, including unhealed decubiti, existing bladder or other infection, thromboembolic disease, severe contractures, osteoporosis, active heterotropic classification, pneumonia/atelectasis, or metabolic or cardiovascular instability
- inability to tolerate upright position for at least 30 min
- inability to provide informed consent
- history of peripheral nerve injury in either leg
- history of previous, repeated fractures in either lower extremity
- presence of significant secondary neurological disorder (i.e.severe to moderate traumatic brain injury)
- must be able to fit into Lokomat (i.e., size restrictions, both height and girth)
- excessive spasticity may limit ability to ambulate with correct gait pattern (e.g., excessive plantar flexor spasticity limiting heel strike during initial stance)
More information on these and other projects are available. Please contact Jennifer Kahn or Jennifer Moore at 312 238-1398 for more information.