Department of Physical Therapy, New York Medical College, New York, NY, USA.
Department of Mechanical Engineering, Columbia University, New York, NY, USA.
Spinal Cord Ser Cases. 2022 Nov 25;8(1):88. doi: 10.1038/s41394-022-00554-2.
Single-subject-research-design.
To improve seated postural control in a participant with spinal cord injury (SCI) with a robotic Trunk-Support-Trainer (TruST).
Laboratory.
TruST delivered "assist-as-needed" forces on the participant's torso during a motor learning-and-control-based intervention (TruST-intervention). TruST-assistive forces were progressed and matched to the participant's postural trunk control gains across six intervention sessions. The T-shirt test was used to capture functional improvements while dressing the upper body. Kinematics were used to compute upper body excursions (cm) and velocity (cm), and sitting workspace area (cm). Functional trunk dynamometry was used to examine muscle force (Kg). Surface electromyography (sEMG) was applied to measure trunk muscle activity. The Borg Rating of Perceived Exertion (RPE) was used to monitor physical exertion during TruST-intervention. A two-standard-deviation bandwidth method was adopted for data interpretation.
After TruST-intervention, the participant halved the time needed to don and doff a T-shirt, increased muscle force of trunk muscles (mean = 3 kg), acquired a steadier postural sitting control without vision (mean excursion baseline: 76.0 ± 2 SD = 5.25 cm and post-intervention: 44.1 cm; and mean velocity baseline: 3.0 ± 2 SD = 0.2 cm/s and post-intervention: 1.8 cm/s), and expanded his sitting workspace area (mean baseline: 36.7 ± 2 SD = 36.6 cm and post-intervention: 419.2 cm). The participant increased his tolerance to counteract greater TruST-force perturbations in lateral and posterior directions. Furthermore, abdominal muscle activity substantially augmented after completion of TruST-intervention across all perturbation directions.
Our data indicate a potential effectiveness of TruST-intervention to promote functional sitting in SCI.
单病例研究设计。
利用机器人躯干支撑训练器（Trunk-Support-Trainer，TruST）提高脊髓损伤（spinal cord injury，SCI）患者的坐姿平衡控制能力。
实验室。
在基于运动学习和控制的干预（TruST 干预）期间，TruST 向参与者的躯干提供“按需辅助”的力。随着参与者的躯干姿势控制能力的提高，TruST 辅助力在六个干预疗程中逐步增加并与参与者的躯干控制增益相匹配。使用 T 恤测试来捕捉穿脱衣服时的功能改善情况。运动学用于计算上身的偏移量（cm）和速度（cm），以及坐姿工作空间面积（cm）。功能性躯干测力用于检查肌肉力量（kg）。表面肌电图（surface electromyography，sEMG）用于测量躯干肌肉活动。采用 Borg 感知用力等级（rating of perceived exertion，RPE）来监测 TruST 干预期间的体力消耗。采用双标准差带宽法进行数据解释。
经过 TruST 干预后，参与者穿脱 T 恤的时间缩短了一半，躯干肌肉力量增加了（平均增加 3kg），在没有视觉的情况下获得了更稳定的坐姿平衡控制（无视觉时基线偏移量：76.0±2SD=5.25cm，干预后：44.1cm；基线速度：3.0±2SD=0.2cm/s，干预后：1.8cm/s），并且扩大了坐姿工作空间面积（基线：36.7±2SD=36.6cm，干预后：419.2cm）。参与者增加了对侧向和后侧更大 TruST 力干扰的耐受能力。此外，在完成 TruST 干预后，所有干扰方向的腹部肌肉活动都显著增加。
我们的数据表明，TruST 干预有可能促进 SCI 患者的功能性坐姿。
