A Combined Robotic and Cognitive Training for Locomotor Rehabilitation: Evidences of Cerebral Functional Reorganization in Two Chronic Traumatic Brain Injured PatientsBy Sacco, Katiuscia; Cauda, Franco; D'Agata, Federico; Duca, Sergio; Zettin, Marina; Virgilio, Roberta; Nascimbeni, Alberto; Belforte, Guido; Eula, Gabriella; Gastaldi, Laura; Appendino, Silvia; Geminiani, Giuliano; Frontiers in Human Neuroscience, Volume 5, Number 146
Publication Date: November 2011
Study assessed the changes in brain activations after a combined sensorimotor and cognitive training for gait rehabilitation in two patients with chronic traumatic brain injury (TBI). The two participants were a 24-year-old woman and a 28-year-old man, both with impaired gait resulting from chronic TBI. The training protocol consisted of the integrated use of a robotic gait orthosis prototype with locomotor imagery tasks. Training comprised three 20-minute sessions per week over a 4 week period. In the first 10 minutes of each session, participants were supported by means of a body weight support system, while the robotic orthosis moved their legs, reproducing rhythmical walking patterns. During robotic gait, a therapist asked the patients to mentally perform cognitive tasks aimed at focusing their attention on their steps, feeling proprioceptive and kinesthetic inputs, and thinking of the mental actions needed for the mental reproduction of a movement. Patient assessment was conducted using functional magnetic resonance imaging. Physiatric functional scales were used to assess clinical outcomes. Results showed greater activation post training in the sensorimotor and supplementary motor cortices as well as enhanced functional connectivity within the motor network. Improvements in balance and, to a lesser extent, in gait outcomes were also found. Study limitations and directions for future research, including the design of a new gait orthosis prototype, are discussed.
Published by: Frontiers Research Foundation (Website:http://www.frontiersin.org)
Link to text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3254199/?tool=pmcentrez