Acute effects of locomotor training on neuromuscular and metabolic profile after incomplete spinal cord injury.

OBJECTIVES

Locomotor training (LT) enhances walking in individuals with spinal cord injuries (SCIs). We tested the acute effects of 4 days of LT using BWSTT combined with Robotic Locomotor therapy compared to BWSTT twice weekly.

DESIGN

Two non-ambulatory participants with an American Spinal Injury Association Impairment Scale (AIS) D. Both received LT for 2 weeks as a portion of their clinical inpatient rehabilitation program and both used wheelchairs as their primary method of mobility. Over a 2 week period, one participant received a total of 8 visits consisting of manual BWSTT (twice weekly) combined with Robotic locomotor therapy (twice weekly). The other participant preformed manual BWSTT (twice weekly) for a total of 4 visits. Resting energy expenditure, body composition, muscle strength, submaximal oxygen consumption (VO2) and blood lactate during LT were measured pre and post-training.

RESULTS

The average maximum voluntary contraction of both knee extensor muscle groups increased by 28-34% with associated reduction in spasticity to the BWSTT participant. Two week interventions resulted in a downward shift of the lactate concentrations for both participants, increase in resting energy expenditure and shift in substrate utilization.

DISCUSSION AND CONCLUSION

A clinical paradigm of incorporating BWSTT with robotic locomotor therapy for 4 days/ week did not provide additional physiological benefits to skeletal muscle strength, spasticity or metabolic profile compared to twice weekly of LT using BWSTT.