Improved motor performance in chronic spinal cord injury following upper-limb robotic training

Cortes, Mar; Elder, Jessica; Rykman, Avrielle; Murray, Lynda M.; Avedissian, Manuel; Stampas, Argyrios; Thickbroom, Gary; Pascual‐Leone, Álvaro; Krebs, Hermano Igo; Valls‐Solé, Josep; Edwards, Dylan

doi:10.3233/nre-130928

Cited by 40 publications

(59 citation statements)

References 22 publications

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“…This resulted in exclusion of 230 articles after reading the title and/or abstract. Among the 76 remaining full-text articles, 66 papers were rejected for the following reasons: MI studies with no tetraplegic participants (Boschker et al, 2000 ; Pfurtscheller et al, 2003b ; Wilson, 2003 ; Erfani and Erfanian, 2004 ; Erfanian and Erfani, 2004 ; Grush, 2004 ; Grosjean et al, 2007 ; Szpunar et al, 2007 ; Miller et al, 2010 ; Müller-Putz et al, 2010 ; Olsson and Nyberg, 2010 ; Schill et al, 2011 ; Viswanathan et al, 2012 ; Papageorgiou et al, 2013 ; Smits-Engelsman and Wilson, 2013 ; Kondo et al, 2014 ; Grosprêtre et al, 2015 ; Malik et al, 2015 ); Studies including tetraplegic participants with no MI intervention (Saxena et al, 1995 ; de Castro and Cliquet, 2000a , b ; Laffont et al, 2000 , 2007 , 2009 ; Memberg and Crago, 2000 ; Thorsen et al, 2001 , 2014 ; Hoffmann et al, 2002 ; Nunome et al, 2002 ; Taylor et al, 2002 ; Remy-Neris et al, 2003 ; Shimada et al, 2003 ; Cornwall and Hausman, 2004 ; Pfurtscheller et al, 2005 ; Anderson et al, 2008 ; Robinson et al, 2010 ; de los Reyes-Guzmán et al, 2010 ; Martin et al, 2012 ; Siedziewski et al, 2012 ; Coignard et al, 2013 ; Collinger et al, 2013a , b ; Cortes et al, 2013 ; Mateo et al, 2013 , 2015a ; Wodlinger et al, 2015 ); MI of lower limb movements only (Pfurtscheller et al, 2008 ; Flanagin et al, ...…”

Section: Resultsmentioning

confidence: 99%

Motor imagery reinforces brain compensation of reach-to-grasp movement after cervical spinal cord injury

Mateo

Rienzo

Bergeron

et al. 2015

Front. Behav. Neurosci.

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Individuals with cervical spinal cord injury (SCI) that causes tetraplegia are challenged with dramatic sensorimotor deficits. However, certain rehabilitation techniques may significantly enhance their autonomy by restoring reach-to-grasp movements. Among others, evidence of motor imagery (MI) benefits for neurological rehabilitation of upper limb movements is growing. This literature review addresses MI effectiveness during reach-to-grasp rehabilitation after tetraplegia. Among articles from MEDLINE published between 1966 and 2015, we selected ten studies including 34 participants with C4 to C7 tetraplegia and 22 healthy controls published during the last 15 years. We found that MI of possible non-paralyzed movements improved reach-to-grasp performance by: (i) increasing both tenodesis grasp capabilities and muscle strength; (ii) decreasing movement time (MT), and trajectory variability; and (iii) reducing the abnormally increased brain activity. MI can also strengthen motor commands by potentiating recruitment and synchronization of motoneurons, which leads to improved recovery. These improvements reflect brain adaptations induced by MI. Furthermore, MI can be used to control brain-computer interfaces (BCI) that successfully restore grasp capabilities. These results highlight the growing interest for MI and its potential to recover functional grasping in individuals with tetraplegia, and motivate the need for further studies to substantiate it.

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Section: Resultsmentioning

confidence: 99%

Motor imagery reinforces brain compensation of reach-to-grasp movement after cervical spinal cord injury

Mateo

Rienzo

Bergeron

et al. 2015

Front. Behav. Neurosci.

View full text Add to dashboard Cite

show abstract

“…This device has a visual feedback component where interactive games can be used to increase the quality of therapy sessions as well as keep the user engaged, according to the manufacturer. Research using this device for SCI neurorehabilitation is limited; however, 1 study by Cortes et al [11] (n = 10; > 1 year; AIS A to D) demonstrated that after a 6-week (1 h/day, 3 times/week) training regimen, significant improvements in both aim and smoothness of movement were found. There were, however, no significant changes in upper-extremity strength, pain, or spasticity.…”

Section: Upper Extremity Roboticsmentioning

confidence: 99%

Robotic Rehabilitation and Spinal Cord Injury: a Narrative Review

et al. 2018

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Mobility after spinal cord injury (SCI) is among the top goals of recovery and improvement in quality of life. Those with tetraplegia rank hand function as the most important area of recovery in their lives, and those with paraplegia, walking. Without hand function, emphasis in rehabilitation is placed on accessing one's environment through technology. However, there is still much reliance on caretakers for many activities of daily living. For those with paraplegia, if incomplete, orthoses exist to augment walking function, but they require a significant amount of baseline strength and significant energy expenditure to use. Options for those with motor complete paraplegia have traditionally been limited to the wheelchair. While wheelchairs provide a modified level of independence, wheelchair users continue to face difficulties in access and mobility. In the past decade, research in SCI rehabilitation has expanded to include external motorized or robotic devices that initiate or augment movement. These robotic devices are used with 2 goals: to enhance recovery through repetitive, functional movement and increased neural plasticity and to act as a mobility aid beyond orthoses and wheelchairs. In addition, lower extremity exoskeletons have been shown to provide benefits to the secondary medical conditions after SCI such as pain, spasticity, decreased bone density, and neurogenic bowel. In this review, we discuss advances in robot-guided rehabilitation after SCI for the upper and lower extremities, as well as potential adjuncts to robotics.

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“…The purpose of our study was to compare sensory function as revealed by the ISNCSCI and EPT exams in a group of participants with chronic (≥1 year) incomplete cervical SCI. Studies have reported that individuals with chronic cervical incomplete SCI have the ability to improve upper-limb sensorimotor function 14 . We expected that, after chronic incomplete cervical SCI, the EPT would be more sensitive in detecting spared sensory function at or below the sensory level determined by the ISNCSCI exam.…”

Section: Introductionmentioning

confidence: 99%

Discrepancies between clinical assessments of sensory function and electrical perceptual thresholds after incomplete chronic cervical spinal cord injury

et al. 2015

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Study Design Prospective experimental. Objectives To compare sensory function as revealed by light touch and pin prick tests of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) and the electrical perceptual threshold (EPT) exams in individuals with chronic incomplete cervical spinal cord injury (SCI). Setting Pittsburgh, United States. Methods EPT was tested using cutaneous electrical stimulation (0.5 ms pulse width, 3 Hz) in 32 healthy controls and in 17 participants with SCI over key points on dermatomes C2 to T4 on each side of the body. Light touch and pin prick ISNCSCI scores were tested at the same key dermatomes in SCI participants. Results In controls, EPT values were higher in older males (1.26±0.2 mA, mean±s.d.) compared with younger males (1.0±0.2 mA) and older females (0.9±0.2 mA), regardless of the dermatome and side tested. Fifteen out of seventeen SCI participants showed that the level of sensory impairment detected by the EPT was below the level detected by the ISNCSCI (mean=4.5±2.4, range 1–9). The frequency distribution of EPTs was similar to older male controls in dermatomes above but not below the ISNCSCI sensory level. The difference between EPT and ISNCSCI sensory level was negatively correlated with the time post injury. Conclusions The results show that, in the chronic stage of cervical SCI, the EPT reveals spared sensory function at lower (~5) spinal segments than the ISNCSCI sensory exam. It is hence found that the EPT is a sensitive tool to assess recovery of sensory function after chronic SCI.

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Improved motor performance in chronic spinal cord injury following upper-limb robotic training

Cited by 40 publications

References 22 publications

Motor imagery reinforces brain compensation of reach-to-grasp movement after cervical spinal cord injury

Motor imagery reinforces brain compensation of reach-to-grasp movement after cervical spinal cord injury

Robotic Rehabilitation and Spinal Cord Injury: a Narrative Review

Discrepancies between clinical assessments of sensory function and electrical perceptual thresholds after incomplete chronic cervical spinal cord injury

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