Azizi Sh, Birgani P M, Marzbani H, Nourian R, Kohanpour M, Mirbagheri M M
Annu Int Conf IEEE Eng Med Biol Soc. 2018 Jul;2018:2495-2498. doi: 10.1109/EMBC.2018.8512730.
The aim of this study was to assess neuroplasticity that occurred in the corticospinal tract (CST) following antigravity treadmill (AlterG) training. AlterG can facilitate walking by having up to an 80% reduction of weight-bearing in patients. Systematic and intensive gait training for sufficient periods of time may lead to neuroplasticity and walking capacity improvement. AlterG gait training was done for eight weeks, 3 sessions per week, and 45 minutes each session. Three cerebral palsy (CP) children participated in this study. The function and structure of CST on the brain's more affected side were evaluated using Transcranial Magnetic Stimulation (TMS) and Diffusion Tensor Imaging (DTI). Also, some common clinical tests were performed to evaluate walking capacity and endurance. DTI features such as fractional anisotropy (FA) and mean diffusivity (MD) as well as some TMS features were extracted to estimate structural changes of the CST. The evaluations were performed before and after 8week AlterG training. The results showed an improvement in the DTI metrics of the CST following AlterG training. Also, TMS parameters were improved and these changes in CST function and structure were concurrent with changes in walking capacity. These results suggest that AlterG training can be used as a therapeutic tool to provide an effective and persistent gait improvement in CP children.
本研究的目的是评估在抗重力跑步机（AlterG）训练后皮质脊髓束（CST）中发生的神经可塑性。AlterG可以通过使患者的负重减轻多达80%来促进步行。进行系统且强化的步态训练足够长的时间可能会导致神经可塑性和步行能力的提高。AlterG步态训练为期八周，每周3次，每次45分钟。三名脑瘫（CP）儿童参与了本研究。使用经颅磁刺激（TMS）和扩散张量成像（DTI）评估大脑受影响更严重一侧的CST的功能和结构。此外，还进行了一些常见的临床测试来评估步行能力和耐力。提取了诸如分数各向异性（FA）和平均扩散率（MD）等DTI特征以及一些TMS特征，以估计CST的结构变化。在为期8周的AlterG训练前后进行评估。结果显示，AlterG训练后CST的DTI指标有所改善。此外，TMS参数也得到了改善，并且CST功能和结构的这些变化与步行能力的变化同时出现。这些结果表明，AlterG训练可以用作一种治疗工具，为CP儿童提供有效且持久的步态改善。
